New York
Provider Communications

September 2019 Empire Provider News

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Title Category

Access requirements for Behavioral Healthcare services

Behavioral Health

Changes to PA requirements

Medicare

Claim editing update for Excludes1 notes

Reimbursement Policies

Clinical Criteria and Prior Authorization updates for specialty pharmacy are available

Pharmacy

Clinical Criteria updates

Medicaid

Clinical Criteria updates for specialty pharmacy are available

Pharmacy

Coding Updates

Medical Policy & Clinical Guidelines

Coming soon: electronic attachments

Medicaid

Coming soon: electronic attachments

Medicare

Customizations to the 23rd edition of the MCG Care Guidelines

Medicare

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

Administrative

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

Administrative

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

Medicaid

Evaluation and management services - over-coded services

Medicaid

Keep up with Medicare news

Medicare

MCG Care Guidelines update and customizations

Medicaid

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

Medical Policy & Clinical Guidelines

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

Reimbursement Policies

New Reimbursement Policy - Maternity Services and Multiple Delivery - Professional

Reimbursement Policies

PCP after-hours access requirements

Administrative

Pharmacy benefit manager change to IngenioRx

Medicare

Policy updates

Medical Policy & Clinical Guidelines

Prior authorization changes

Medicaid

Provider satisfaction survey

Medicaid

Provider Transparency Update

Administrative

Reminder about lab services for Suffolk County members

Administrative

Reminder: Changes to timely filing requirements for Medicare Advantage

Administrative
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