New York
Provider Communications

September 2019 Empire Provider News

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Title Category

Reminder: Changes to timely filing requirements for Medicare Advantage

Administrative

PCP after-hours access requirements

Administrative

Empire launches Sydney on September 1; New app offers better digital health care support to members

Administrative

Reminder about lab services for Suffolk County members

Administrative

Empire CRA Reporting Update: Risk Adjustment Data Validation (RADV) Audit happening now

Administrative

Provider Transparency Update

Administrative

Access requirements for Behavioral Healthcare services

Behavioral Health

Coming soon: electronic attachments

Medicaid

Prior authorization changes

Medicaid

Evaluation and management services - over-coded services

Medicaid

Clinical Criteria updates

Medicaid

MCG Care Guidelines update and customizations

Medicaid

Ensuring quality of care when prescribing antipsychotic medications to children and adolescents

Medicaid

Provider satisfaction survey

Medicaid

Policy updates

Medical Policy & Clinical Guidelines

Coding Updates

Medical Policy & Clinical Guidelines

New Clinical Guideline: Pneumatic Compression Devices, effective December 1, 2019

Medical Policy & Clinical Guidelines

Coming soon: electronic attachments

Medicare

Changes to PA requirements

Medicare

Pharmacy benefit manager change to IngenioRx

Medicare

Customizations to the 23rd edition of the MCG Care Guidelines

Medicare

Keep up with Medicare news

Medicare

Clinical Criteria and Prior Authorization updates for specialty pharmacy are available

Pharmacy

Clinical Criteria updates for specialty pharmacy are available

Pharmacy

New Reimbursement Policy - Maternity Services and Multiple Delivery - Professional

Reimbursement Policies

New Reimbursement Policy - Intensity Modulated Radiation Therapy Planning and Delivery - Professional

Reimbursement Policies

Claim editing update for Excludes1 notes

Reimbursement Policies
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