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Provider Communications

Provider Spotlight

Jul 28, 2021

Register for upcoming August CME webinars

Join us in a new CME webinar series as we share practices and success stories to overcoming barriers in achieving clinical quality goals, attaining better patient outcomes and improving Stars ratings.

Motivating Patients to Adhere to Cervical Cancer Prevention and Screening Recommendations
Tuesday, August 3, 2021, 12:00 p.m. ET


10 Best Practices for Improving Pharmacy Quality Measures
Thursday, August 12, 2021, 1:00 p.m. or 3:00 p.m. ET


6 Ways to Improve Risk Adjustment Documentation Accuracy
Tuesday, August 17, 2021, 12:00 p.m. or 3:00 p.m. ET


Register Now!



Articles Recent

Title Publication Category Date

Register for upcoming August CME webinars

Join us in a new CME webinar series as we share practices and success stories to overcoming barriers in achieving clinical quality goals, attaining better patient outcomes and improving Stars ratings.

Motivating Patients to Adhere to Cervical Cancer Prevention and Screening Recommendations
Tuesday, August 3, 2021, 12:00 p.m. ET


10 Best Practices for Improving Pharmacy Quality Measures
Thursday, August 12, 2021, 1:00 p.m. or 3:00 p.m. ET


6 Ways to Improve Risk Adjustment Documentation Accuracy
Tuesday, August 17, 2021, 12:00 p.m. or 3:00 p.m. ET


Register Now!


Clinical Quality CME Webinar Series Continues - New York Administrative Jul 28, 2021

Surgical Clinical Site of Care review updates

July 2021 Newsletter Administrative Jul 1, 2021

Proper coding for in-home monitoring can make a measurable difference for INR

July 2021 Newsletter Administrative Jul 1, 2021

Another mark of the pandemic: an increase in childhood obesity

July 2021 Newsletter Administrative Jul 1, 2021

Timely receipt of primary payer’s EOB can help reduce timely filing denials for secondary claims

July 2021 Newsletter Administrative Jul 1, 2021

Register now to learn strategies to help you and your practice improve clinical quality

July 2021 Newsletter Administrative Jul 1, 2021

Commercial Repapering: Important update

July 2021 Newsletter Administrative Jul 1, 2021

How to enroll in electronic fund transfer (EFT) for faster remittance

July 2021 Newsletter Digital Tools Jul 1, 2021

Electronic claim response files

July 2021 Newsletter Digital Tools Jul 1, 2021

Interactive Care Reviewer (ICR): New search option for cases submitted through ICR

July 2021 Newsletter Digital Tools Jul 1, 2021

Blue Precision program to be retired at the end of the year

July 2021 Newsletter Products & Programs Jul 1, 2021

Update: Site of Care medical necessity reviews for long-acting colony-stimulating factors will not be implemented on August 1, 2021

Material adverse change (MAC) notification

July 2021 Newsletter Products & Programs Jul 1, 2021

AIM Rehabilitative program - initial evaluations and site of service reviews

July 2021 Newsletter Products & Programs Jul 1, 2021

Certain specialty medication precertification requests may require additional documentation

July 2021 Newsletter Pharmacy Jul 1, 2021

Clinical Criteria updates for specialty pharmacy

Material adverse change (MAC) notification
July 2021 Newsletter Pharmacy Jul 1, 2021

Updates for specialty pharmacy are effective October 1, 2021

Material adverse change (MAC) notification
July 2021 Newsletter Pharmacy Jul 1, 2021

Designated specialty pharmacy network updates effective October 1, 2021

Material adverse change (MAC) notification
July 2021 Newsletter Pharmacy Jul 1, 2021

Medical policy updates and clinical guideline updates

Material adverse change (MAC) notification
July 2021 Newsletter Medical Policy & Clinical Guidelines Jul 1, 2021

New reimbursement policy: Non-patient Laboratory Services (Facility)

Material adverse change (MAC) notification
July 2021 Newsletter Reimbursement Policies Jul 1, 2021

Reimbursement policy update: Consultations (Professional)

Material adverse change (MAC) notification
July 2021 Newsletter Reimbursement Policies Jul 1, 2021

Federal Employee Program® AIM Radiology prior authorization review

Material adverse change (MAC) notification
July 2021 Newsletter Federal Employee Plan (FEP) Jul 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Empire results in improved care management for patients

July 2021 Newsletter Medicaid Jul 1, 2021

Let’s Vaccinate

July 2021 Newsletter Medicaid Jul 1, 2021

New reimbursement policy: Modifier 90: Reference (Outside) Laboratory and Pass-Through Billing (Effective 10/01/21)

July 2021 Newsletter Medicaid Jul 1, 2021

Prior authorization requirement changes effective September 1, 2021

July 2021 Newsletter Medicaid Jul 1, 2021

Certain specialty medication precertification requests may require additional documentation

July 2021 Newsletter Medicaid Jul 1, 2021

Medical drug benefit Clinical Criteria updates

July 2021 Newsletter Medicaid Jul 1, 2021

Retraction: AIM Rehabilitative program — initial evaluations and site of service reviews

July 2021 Newsletter Medicaid Jul 1, 2021

Updates to AIM Specialty Health Musculoskeletal program clinical appropriateness guidelines

July 2021 Newsletter Medicaid Jul 1, 2021

Coding spotlight: mental disorders in childhood

July 2021 Newsletter Medicaid Jul 1, 2021

What Matters Most: Improving the Patient Experience

July 2021 Newsletter Medicaid Jul 1, 2021

Resources to support your diverse patient panel

July 2021 Newsletter Medicaid Jul 1, 2021

Keep up with Medicaid news

July 2021 Newsletter Medicaid Jul 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Empire results in improved care management for patients

July 2021 Newsletter Medicare Jul 1, 2021

Let’s Vaccinate

July 2021 Newsletter Medicare Jul 1, 2021

New reimbursement policy: Modifier 90: Reference (Outside) Laboratory and Pass-Through Billing (Effective 10/01/21)

July 2021 Newsletter Medicare Jul 1, 2021

Prior authorization requirement changes effective October 1, 2021, for codes A0426 and A0428

July 2021 Newsletter Medicare Jul 1, 2021

Medical drug benefit Clinical Criteria updates

July 2021 Newsletter Medicare Jul 1, 2021

Voluntary recall of Philips Respironics CPAP machine, BiPAP machine, and ventilators

Voluntary recall of Philips Respironics CPAP machine, BiPAP machine, and ventilators Administrative Jun 25, 2021

Let’s Vaccinate

Help increase your vaccination rates and close gaps-in-care with these tools and strategies.
June 2021 Newsletter Products & Programs Jun 1, 2021

Updates for specialty pharmacy effective September 1, 2021

Material adverse change (MAC) notification
June 2021 Newsletter Pharmacy Jun 1, 2021

Designated specialty pharmacy network updates

June 2021 Newsletter Pharmacy Jun 1, 2021

Pharmacy information available on empireblue.com

June 2021 Newsletter Pharmacy Jun 1, 2021

Regular check-ins with your clearinghouse could affect timely filing

June 2021 Newsletter Administrative Jun 1, 2021

Keep your contact information current

June 2021 Newsletter Administrative Jun 1, 2021

Physicians and clinical care teams: Imaging for lower back pain does not improve outcomes, study finds

June 2021 Newsletter Administrative Jun 1, 2021

Two great learning resources on One Secure Portal

June 2021 Newsletter Digital Tools Jun 1, 2021

Submit EDI corrected claims via Availity or EDI

June 2021 Newsletter Digital Tools Jun 1, 2021

Digital Solution Options with Availity

June 2021 Newsletter Digital Tools Jun 1, 2021

Interactive Care Reviewer’s new copy feature decreases time to submit authorization request

June 2021 Newsletter Digital Tools Jun 1, 2021

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

Material adverse change (MAC) notification
June 2021 Newsletter Medical Policy & Clinical Guidelines Jun 1, 2021

Updates to AIM Musculoskeletal Program Clinical Appropriateness Guidelines

Material adverse change (MAC) notification
June 2021 Newsletter Medical Policy & Clinical Guidelines Jun 1, 2021

Clinical Criteria updates for specialty pharmacy

Material adverse change (MAC) notification
June 2021 Newsletter Medical Policy & Clinical Guidelines Jun 1, 2021

Empire to enhance claim edits for Outpatient Facility Claims

June 2021 Newsletter Reimbursement Policies Jun 1, 2021

DEXA bone scan criteria for the Federal Employee Program

June 2021 Newsletter Federal Employee Plan (FEP) Jun 1, 2021

Provider education program survey: Your Voice Counts

June 2021 Newsletter Medicaid Jun 1, 2021

MCG Care Guidelines 25th Edition

June 2021 Newsletter Medicaid Jun 1, 2021

Keeping up with routine vaccination during COVID-19

June 2021 Newsletter Medicaid Jun 1, 2021

Aspire Health for members in need of palliative care

June 2021 Newsletter Medicaid Jun 1, 2021

Complex Case Management program

June 2021 Newsletter Medicaid Jun 1, 2021

Important information about utilization management

June 2021 Newsletter Medicaid Jun 1, 2021

Members’ Rights and Responsibilities Statement

June 2021 Newsletter Medicaid Jun 1, 2021

Keep up with Medicaid news

June 2021 Newsletter Medicaid Jun 1, 2021

MCG Care Guidelines 25th Edition

June 2021 Newsletter Medicare Jun 1, 2021

Medical Policies and Clinical Utilization Management Guidelines update

June 2021 Newsletter Medicare Jun 1, 2021

Reminders for Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

June 2021 Newsletter Medicare Jun 1, 2021

Keep up with Medicare news

June 2021 Newsletter Medicare Jun 1, 2021

Register for upcoming CME webinars

Join us in a new CME webinar series as we share practices and success stories to overcoming barriers in achieving clinical quality goals, attaining better patient outcomes and improving Stars ratings.

5 Strategies to Improve Your Quality Measures - June 10th, 12 p.m. or 3 p.m. ET
7 Ways to Enhance Your Patients’ Experience - June 17th, 12 p.m. or 3 p.m. ET

Register now!



Clinical Quality CME Webinar Series - New York Administrative May 27, 2021

Register today for the In Pursuit of Racial Equity: Deconstructing Bias forum hosted by Empire and Motivo on June 9, 2021

Join us to hear from a diverse panel of experienced Motivo and Empire professionals about racial equity and implicit bias.

Deconstructing Bias Forum Invitation for Empire providers Administrative May 21, 2021

Modification to voluntary Cancer Care Quality Program (CCQP) enhanced reimbursement to begin July 1, 2021

May 2021 Newsletter Products & Programs May 1, 2021

Updates for Specialty pharmacy effective August 1, 2021

Material adverse change (MAC) notification
May 2021 Newsletter Pharmacy May 1, 2021

Specialty pharmacy prior authorization update - Certain drugs for treatment of ocular conditions continue to require prior authorization

Material adverse change (MAC) notification
May 2021 Newsletter Pharmacy May 1, 2021

Clinical criteria updates for specialty pharmacy

Material adverse change (MAC) notification
May 2021 Newsletter Pharmacy May 1, 2021

A helpful and complete guide to covered well-child visits

May 2021 Newsletter Administrative May 1, 2021

May is national high blood pressure education month

May 2021 Newsletter Administrative May 1, 2021

Provider bulletins for medical and itemized bill attachments

Electronic solutions @ your fingertips
May 2021 Newsletter Administrative May 1, 2021

Send larger digital attachments through Availity

May 2021 Newsletter Administrative May 1, 2021

Resources to support diverse patients and communities

May 2021 Newsletter Administrative May 1, 2021

Appointment scheduler application

May 2021 Newsletter Administrative May 1, 2021

Referring to network DME providers for negative pressure wound therapy helps members save on out-of-pocket costs

May 2021 Newsletter Administrative May 1, 2021

2021 affirmative statement regarding Utilization Management decisions

May 2021 Newsletter Administrative May 1, 2021

Clinical guideline updates

Material adverse change (MAC) notification

May 2021 Newsletter Medical Policy & Clinical Guidelines May 1, 2021

Update to AIM Specialty Health oncologic imaging clinical appropriateness guidelines

May 2021 Newsletter Medical Policy & Clinical Guidelines May 1, 2021

Reimbursement policy update: Frequency editing (Professional)

May 2021 Newsletter Reimbursement Policies May 1, 2021

Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

May 2021 Newsletter Medicaid May 1, 2021

Maximizing efficient, high quality COVID-19 screenings

May 2021 Newsletter Medicaid May 1, 2021

Updates to the AIM Specialty Health musculoskeletal program clinical appropriateness guidelines

May 2021 Newsletter Medicaid May 1, 2021

Continuing medical education/continuing education unit opportunities

May 2021 Newsletter Medicaid May 1, 2021

Keep up with Medicaid news

May 2021 Newsletter Medicaid May 1, 2021

Updates to the AIM Specialty Health musculoskeletal program clinical appropriateness guidelines

May 2021 Newsletter Medicare May 1, 2021

Maximizing efficient, high quality COVID-19 screenings

May 2021 Newsletter Medicare May 1, 2021

Keep up with Medicare news

May 2021 Newsletter Medicare May 1, 2021

Information from Empire for Care Providers about COVID-19 (Updated April 28, 2021)

We recently updated the effective date about reimbursement for the administration of the COVID-19 vaccine.

COVID-19 Information Administrative Apr 28, 2021

HEDIS 2021 Federal Employee Program® medical record request requirements

April 2021 Newsletter Federal Employee Plan (FEP) Apr 1, 2021

Keep up with Medicaid news

April 2021 Newsletter Medicaid Apr 1, 2021

Notify us of telehealth services

April 2021 Newsletter Medicare Apr 1, 2021

In-office assessment program

April 2021 Newsletter Medicare Apr 1, 2021

Oncology dose reduction program beginning July 1, 2021

April 2021 Newsletter Medicare Apr 1, 2021

Medical drug benefit clinical criteria updates – November 2020

April 2021 Newsletter Medicare Apr 1, 2021

Medical drug benefit clinical criteria updates – December 2020

April 2021 Newsletter Medicare Apr 1, 2021
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