New York
Provider Communications

Articles Recent

Title Publication Category Date

Update to Claim Payment Dispute process

Material Adverse Change (MAC)
April 2023 Provider News - New York Administrative Mar 31, 2023

Medical Oncology Program ProviderPortal case entry enhancements

April 2023 Provider News - New York Administrative Mar 31, 2023

Expansion of Carelon Medical Benefits Management, Inc. cardiology, genetic testing, and radiology programs effective August 1, 2023

Material Adverse Change (MAC)
April 2023 Provider News - New York Administrative Mar 31, 2023

Update use of modifier 25 for billing for visits that include preventive and problem-oriented evaluation and management services

April 2023 Provider News - New York Administrative Mar 31, 2023

Helping to reduce delays when submitting attachments

April 2023 Provider News - New York Administrative Mar 31, 2023

CAA: Maintain your online provider directory information

April 2023 Provider News - New York Administrative Mar 31, 2023

Genetic testing CPT code list update for Carelon Medical Benefits Management (formerly AIM Specialty Health)*

Material Adverse Change (MAC)
April 2023 Provider News - New York Administrative Mar 31, 2023

Statin Therapy Exclusions for Patients With Cardiovascular Disease/Diabetes HEDIS measures

April 2023 Provider News - New York Administrative Mar 31, 2023

Submitting prior authorizations is getting easier

April 2023 Provider News - New York Digital Tools Mar 31, 2023

Survey for all skilled nursing facilities

April 2023 Provider News - New York Digital Tools Mar 31, 2023

Notification Regarding Reimbursement Changes to COVID-19 Vaccine Administration

Material Adverse Change (MAC)
April 2023 Provider News - New York Reimbursement Policies Mar 31, 2023

Reimbursement policy update: Documentation and Reporting Guidelines for Evaluation and Management Services - Professional

April 2023 Provider News - New York Reimbursement Policies Mar 31, 2023

Bundled Services and Supplies - Professional

Material Adverse Change (MAC)
April 2023 Provider News - New York Reimbursement Policies Mar 31, 2023

Let’s Vaccinate

April 2023 Provider News - New York Products & Programs Mar 31, 2023

Pharmacy information available on our provider website

April 2023 Provider News - New York Pharmacy Mar 31, 2023

Provider Pathways - Doing business with Empire BlueCross BlueShield HealthPlus (Empire) eLearning is here!

April 2023 Provider News - New York Medicaid Mar 31, 2023

Correct coding for hospital outpatient clinic visits for Medicaid

April 2023 Provider News - New York Medicaid Mar 31, 2023

Ready, set, renew!

April 2023 Provider News - New York Medicaid Mar 31, 2023

Keep up with Medicaid news - April 2023

View these Medicaid articles:
April 2023 Provider News - New York Medicaid Mar 31, 2023

Authorizations for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) services for consumers with individual, group retiree solutions (GRS), and dual-eligible plans from Medicare Advantage

April 2023 Provider News - New York Medicare Mar 31, 2023

E-visits

April 2023 Provider News - New York Medicare Mar 31, 2023

IBEW Local 25, New York moves to the Retiree Solutions Medicare Advantage Plan from Empire BlueCross BlueShield

April 2023 Provider News - New York Medicare Mar 31, 2023

Keep up with Medicare news - April 2023

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April 2023 Provider News - New York Medicare Mar 31, 2023

HEDIS 2023 Federal Employee Program medical record request requirements

April 2023 Provider News - New York Federal Employee Plan (FEP) Mar 31, 2023

FEP Quality Reimbursement Program update

April 2023 Provider News - New York Federal Employee Plan (FEP) Mar 31, 2023

Federal Employee Program change for medical dental reimbursement

Material Adverse Change (MAC)
FEP medical dental change Federal Employee Plan (FEP) Mar 9, 2023

Time to prepare for HEDIS medical record review

March 2023 Empire Provider News Administrative Mar 1, 2023

March is National Colorectal Cancer Awareness Month

March 2023 Empire Provider News Administrative Mar 1, 2023

Carelon Medical Benefits Management (formerly AIM Specialty Health) Radiology Clinical Appropriateness Guidelines CPT code list update

Material Adverse Change (MAC)
March 2023 Empire Provider News Administrative Mar 1, 2023

Notice of assignment of your Empire Provider Agreement to Carelon (formerly Beacon)

March 2023 Empire Provider News Administrative Mar 1, 2023

Advancing Mental Health Equity for Youth & Young Adults

March 2023 Empire Provider News Administrative Mar 1, 2023

Controlling High Blood Pressure and Submitting Compliant Readings

March 2023 Empire Provider News Administrative Mar 1, 2023

Consumer payment option, Pay Doctor Bill, to terminate effective March 31, 2023

March 2023 Empire Provider News Products & Programs Mar 1, 2023

Policy Update: Modifiers 25 and 57 (Policy G-06003, effective 04/01/2023)

Material Adverse Change (MAC)
March 2023 Empire Provider News Medicaid Mar 1, 2023

Reimbursement policy update: Modifiers 25 and 57 - Professional

March 2023 Empire Provider News Reimbursement Policies Mar 1, 2023

Specialty pharmacy updates for March 2023

Material adverse change (MAC)
March 2023 Empire Provider News Pharmacy Mar 1, 2023

Clinical Criteria updates for specialty pharmacy

Material adverse change (MAC)
March 2023 Empire Provider News Pharmacy Mar 1, 2023

Pharmacy information available on our provider website

March 2023 Empire Provider News Pharmacy Mar 1, 2023

Keep up with Medicaid news - March 2023

View these Medicaid articles:
March 2023 Empire Provider News Medicaid Mar 1, 2023

Informational Update: Modifier Usage (Policy G-06006)

March 2023 Empire Provider News Medicare Mar 1, 2023

Shared savings and transition care management after inpatient discharges

March 2023 Empire Provider News Medicare Mar 1, 2023

Controlling High Blood Pressure and Submitting Compliant Readings

March 2023 Empire Provider News Medicare Mar 1, 2023

Keep up with Medicare news - March 2023

View these Medicare articles:
March 2023 Empire Provider News Medicare Mar 1, 2023

Group number change for Screen Actors Guild-American Federation of Television and Radio Artists Health Plan

March 2023 Empire Provider News Administrative Feb 23, 2023

Notice of assignment of your Empire Provider Agreement to Beacon

Beacon Assignment Administrative Feb 13, 2023

AIM Specialty Health will transition to Carelon Medical Benefits Management Inc.

February 2023 Newsletter Administrative Feb 1, 2023

New policy for clinical data sharing and ADT notifications

Material Adverse Change (MAC)
February 2023 Newsletter Administrative Feb 1, 2023

Controlling High Blood Pressure and Submitting Compliant Readings

February 2023 Newsletter Administrative Feb 1, 2023

Have you reviewed your online provider directory information lately?

February 2023 Newsletter Administrative Feb 1, 2023

Participating provider contractual obligations: Advanced patient notice policy for non-participating provider referrals

February 2023 Newsletter Administrative Feb 1, 2023

Helping to reduce delays when submitting attachments: Make sure your correspondence includes one of these elements

February 2023 Newsletter Digital Tools Feb 1, 2023

Enhancing Provider News website and email communications

February 2023 Newsletter Digital Tools Feb 1, 2023

Medical Policy and Clinical Guideline updates

Material Adverse Change (MAC)
February 2023 Newsletter Medical Policy & Clinical Guidelines Feb 1, 2023

Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List

February 2023 Newsletter Medical Policy & Clinical Guidelines Feb 1, 2023

Clinical Criteria updates for specialty pharmacy

Material Adverse Change (MAC)
February 2023 Newsletter Pharmacy Feb 1, 2023

Specialty pharmacy updates - February 2023

Material Adverse Change (MAC)
February 2023 Newsletter Pharmacy Feb 1, 2023

Keep up with Medicaid news - February 2023

View these Medicaid articles:
February 2023 Newsletter Medicaid Feb 1, 2023

Mutual of America New York moves to the Empire BlueCross BlueShield retiree solutions Medicare Advantage plan

February 2023 Newsletter Medicare Feb 1, 2023

City of Manchester Offers Medicare Advantage Option

February 2023 Newsletter Medicare Feb 1, 2023

Keep up with Medicare news - February 2023

View these Medicare articles:
February 2023 Newsletter Medicare Feb 1, 2023

Important reminder: New ID cards for many of our Empire BlueCross BlueShield members

New ID cards for Empire BlueCross BlueShield members Administrative Jan 19, 2023

Empire BlueCross BlueShield local precertification change in New York

Material Adverse Change (MAC)
January 2023 Newsletter Administrative Dec 30, 2022

Professional system updates for 2023

January 2023 Newsletter Administrative Dec 30, 2022

Engagement with your patient counts

January 2023 Newsletter Administrative Dec 30, 2022

Childhood Immunization Status and Lead Screening in Children for HEDIS

January 2023 Newsletter Administrative Dec 30, 2022

Outpatient system updates for 2023

January 2023 Newsletter Administrative Dec 30, 2022

Remittance advice message enhancements: Providing clear descriptions and actionable next steps

January 2023 Newsletter Administrative Dec 30, 2022

Empire BlueCross BlueShield local precertification change in New York

Material Adverse Change (MAC)
January 2023 Newsletter Administrative Dec 30, 2022

Outpatient facility revenue code billing requirements

January 2023 Newsletter Administrative Dec 30, 2022

Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List

January 2023 Newsletter Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Musculoskeletal - Interventional Pain Management Clinical Appropriateness Guidelines

January 2023 Newsletter Medical Policy & Clinical Guidelines Dec 30, 2022

Monkeypox and smallpox vaccines: Product code on claims

January 2023 Newsletter Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

January 2023 Newsletter Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines

Material Adverse Change (MAC)
January 2023 Newsletter Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines* Material adverse change

Material Adverse Change (MAC)
January 2023 Newsletter Medical Policy & Clinical Guidelines Dec 30, 2022

Medical Policy and Clinical Guidelines updates

Material Adverse Change (MAC)
January 2023 Newsletter Medical Policy & Clinical Guidelines Dec 30, 2022

Notification regarding reimbursement changes to COVID-19 laboratory services codes

Material Adverse Change (MAC)
January 2023 Newsletter Reimbursement Policies Dec 30, 2022

Specialty pharmacy updates

Material Adverse Change (MAC)
January 2023 Newsletter Pharmacy Dec 30, 2022

Federal Employee Program observation conversion for musculoskeletal cases

Material Adverse Change (MAC)
January 2023 Newsletter Federal Employee Plan (FEP) Dec 30, 2022

Use of modifier 25 when billing for visits that include preventive services and problem-oriented evaluation and management services

January 2023 Newsletter Medicaid Dec 30, 2022

Keep up with Medicaid news - January 2023

View these Medicaid articles:
January 2023 Newsletter Medicaid Dec 30, 2022

Keep up with Medicare news - January 2023

View these Medicare articles:
January 2023 Newsletter Medicare Dec 30, 2022

Attention lab providers: COVID-19 update regarding reimbursement

Material Adverse Change (MAC)
December 2022 Newsletter Administrative Dec 1, 2022

Important information about utilization management

December 2022 Newsletter Administrative Dec 1, 2022

State of Connecticut employer group - BlueCare Prime update

December 2022 Newsletter Administrative Dec 1, 2022

IngenioRx will become CarelonRx on January 1, 2023

December 2022 Newsletter Administrative Dec 1, 2022

CAA: Timely updates help keep our provider directories current

December 2022 Newsletter Administrative Dec 1, 2022

Member assessment of PCP after-hours messaging in 2022

December 2022 Newsletter Administrative Dec 1, 2022

Clinical practice and preventive health guidelines available on empireblue.com

December 2022 Newsletter Administrative Dec 1, 2022

Signature requirements for laboratory orders or requisitions

December 2022 Newsletter Administrative Dec 1, 2022

Case management program

December 2022 Newsletter Administrative Dec 1, 2022

Coordination of care

December 2022 Newsletter Administrative Dec 1, 2022

Member’s assessment of behavioral healthcare after-hours messaging in 2022

December 2022 Newsletter Administrative Dec 1, 2022

Members’ rights and responsibilities

December 2022 Newsletter Administrative Dec 1, 2022

Clinical Criteria updates for specialty pharmacy

Material Adverse Change (MAC)
December 2022 Newsletter Pharmacy Dec 1, 2022

Pharmacy information available on the provider website

December 2022 Newsletter Pharmacy Dec 1, 2022

Specialty pharmacy updates - December 2022

Material Adverse Change (MAC)
December 2022 Newsletter Pharmacy Dec 1, 2022

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update

Material Adverse Change (MAC)
December 2022 Newsletter Medical Policy & Clinical Guidelines Dec 1, 2022

AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines CPT Code List update

Material Adverse Change (MAC)
December 2022 Newsletter Medical Policy & Clinical Guidelines Dec 1, 2022

Reimbursement policy update: Bundled Services and Supplies - Professional

Material Adverse Change (MAC)
December 2022 Newsletter Reimbursement Policies Dec 1, 2022
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