New York
Provider Communications

October 2021 Newsletter

Download as PDF

Title Category

Are you talking to ALL of your patients about breast cancer screenings?

Administrative

Clarification: Empire’s enhanced claim edits for outpatient facility claims

Administrative

Clinical appeals

Administrative

Clinical Criteria updates for specialty pharmacy

Material adverse change (MAC) notification
Pharmacy

Designated specialty pharmacy network updates effective January 1, 2022

Material adverse change (MAC) notification

Pharmacy

Diabetes testing and screening HEDIS measures

Medicaid

Familiarize yourself with Empire’s Simplified Networks

Administrative

FAQ: Update to AIM phone number

Medicaid

Federal Price Transparency and Consolidated Appropriations Act phase in new mandates beginning January 1, 2022

Administrative

Get your payments faster when you sign up for electronic funds transfer

Medicaid

Get your payments faster when you sign up for electronic funds transfer

Medicare

Good news! Non-payment remittance advice enhancements coming soon

Digital Tools

HEDIS® medical record submission made easier with our Remote EMR Access Service

Medicare

Information about 2021 Special Needs Plans

Medicare

Keep up with Medicaid news - October 2021

View these Medicaid articles:
  • 2021 affirmative statement concerning utilization management decisions
  • May 2021 Medical Policies and Utilization Management Guidelines update
Medicaid

Keep up with Medicare news - October 2021

View these Medicare articles:
  • 2021 affirmative statement concerning utilization management decisions
  • May 2021 Medical Policies and Utilization Management Guidelines update
Medicare

Looking to earn continuing medical education credits? Register for these on-demand webinars

Administrative

Medical policy and clinical guideline updates

Material adverse change (MAC) notification

Medical Policy & Clinical Guidelines

Meet Dr. Carolyn Langer, Empire’s new Chief Medical Officer

Administrative

New Medical Step Therapy Requirements

Medicare

New Reimbursement Policy: Sexually Transmitted Infections Testing (Professional)

Medicaid

New Reimbursement Policy: Sexually Transmitted Infections Testing (Professional)

Medicare

Pharmacy information available on empireblue.com

Pharmacy

Prior authorization updates for specialty pharmacy IV

Medicaid

Prior authorization updates for specialty pharmacy V

Medicaid

Procedure searches in Find Care

Digital Tools

Provider claim payment disputes for Empire’s Commercial lines of business

Digital Tools

REMINDER: EnrollSafe, the new electronic funds transfer enrollment portal for Empire providers – replacing CAQH Enrollhub effective November 1, 2021

Digital Tools

Specialty pharmacy updates - October 2021

Material adverse change (MAC) notification
Pharmacy

Webinars for City of New York retirees transitioning to new Medicare Advantage plan

Medicare

Your recommendation is key to encouraging cancer screenings for your female patients

Administrative
Page 1 of 1