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Provider Spotlight

Apr 28, 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.

Articles Recent

Title	Publication	Category	Date
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
Update: Site of Care medical necessity reviews for long-acting colony-stimulating factors begin August 1, 2021 Material adverse change (MAC) notification	April 2021 Newsletter	Products & Programs	Apr 1, 2021
Interactive bilingual website acting for our health Exclusively developed for the latino community.	April 2021 Newsletter	Products & Programs	Apr 1, 2021
The heath of millennials: Trends in behavioral health conditions	April 2021 Newsletter	Behavioral Health	Apr 1, 2021
Correction: Updated formulary lists for commercial health plan pharmacy benefit effective April 1, 2021	April 2021 Newsletter	Pharmacy	Apr 1, 2021
Updates for specialty pharmacy are available Material adverse change (MAC) notification	April 2021 Newsletter	Pharmacy	Apr 1, 2021
Clinical criteria updates for specialty pharmacy Material adverse change (MAC) notification	April 2021 Newsletter	Pharmacy	Apr 1, 2021
Pharmacy information available on empireblue.com	April 2021 Newsletter	Pharmacy	Apr 1, 2021
Keeping up with routine vaccination during COVID-19: Well-child visits and vaccinations are essential services	April 2021 Newsletter	Administrative	Apr 1, 2021
Does your practice offer telehealth services? Let us know!	April 2021 Newsletter	Administrative	Apr 1, 2021
Join Empire in talking about racism and its impact on health	April 2021 Newsletter	Administrative	Apr 1, 2021
Reminder: Site of care medical necessity reviews for a wide range of surgical procedures began January 1, 2021	April 2021 Newsletter	Administrative	Apr 1, 2021
State of Connecticut employer group and Connecticut partnership plan	April 2021 Newsletter	Administrative	Apr 1, 2021
Updated provider agreement	April 2021 Newsletter	Administrative	Apr 1, 2021
New utilization management tool now available on Availity Payer Spaces: Authorization Rules Lookup tool	April 2021 Newsletter	Administrative	Apr 1, 2021
Payer Spaces - Education and Reference Center has been replaced by Information Center	April 2021 Newsletter	Administrative	Apr 1, 2021
Understanding Availity Roles for Electronic Data Interchange (EDI)	April 2021 Newsletter	Administrative	Apr 1, 2021
Make the change to digital authorization/referral and hospital admission notifications using EDI	April 2021 Newsletter	Administrative	Apr 1, 2021
Submit appeals for clinically denied appeals via ICR	April 2021 Newsletter	Administrative	Apr 1, 2021
Attention facilities: Sending admission, discharge and transfer data to Empire results in improved care management for patients	April 2021 Newsletter	Administrative	Apr 1, 2021
Chat directly with a prior authorization specialist	April 2021 Newsletter	Administrative	Apr 1, 2021
Update for commercial providers regarding the AIM Sleep Program CPT Code E1399, NOC: Durable medical equipment, miscellaneous	April 2021 Newsletter	Medical Policy & Clinical Guidelines	Apr 1, 2021
MCG Care Guidelines 25th Edition	April 2021 Newsletter	Medical Policy & Clinical Guidelines	Apr 1, 2021
Medical policy updates Material adverse change (MAC) notification	April 2021 Newsletter	Medical Policy & Clinical Guidelines	Apr 1, 2021
Claims editing update for ICD-10-CM Excludes 1 notes	April 2021 Newsletter	Reimbursement Policies	Apr 1, 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
Maximizing efficient, high quality COVID-19 screenings	COVID-19 Information	Administrative	Apr 1, 2021
Site of Care medical necessity reviews for long-acting colony-stimulating factors begin June 1, 2021 Material Adverse Change (MAC) Notification	March 2021 Empire Provider News	Products & Programs	Mar 1, 2021
Clinical Criteria updates for specialty pharmacy Material Adverse Change (MAC) Notification	March 2021 Empire Provider News	Pharmacy	Mar 1, 2021
Some HIV medication combinations may require prior authorization	March 2021 Empire Provider News	Pharmacy	Mar 1, 2021
Updates for Specialty Pharmacy are available Material Adverse Change (MAC) Notification	March 2021 Empire Provider News	Pharmacy	Mar 1, 2021
Medical Attachment Capability: Itemized Bill and More	March 2021 Empire Provider News	Administrative	Mar 1, 2021
Update: Notice of changes to the AIM Small Joint Surgery Guideline	March 2021 Empire Provider News	Medical Policy & Clinical Guidelines	Mar 1, 2021
Access to more claim denial information is now self-service	March 2021 Empire Provider News	Medicaid	Mar 1, 2021
MCG Care Guidelines 24th edition customization	March 2021 Empire Provider News	Medicaid	Mar 1, 2021
Coding spotlight: Overview of the 2021 evaluation and management changes	March 2021 Empire Provider News	Medicaid	Mar 1, 2021
Ocrevus/Vyepti Medical Step Therapy Notice	March 2021 Empire Provider News	Medicaid	Mar 1, 2021
New provider directory indicator for telehealth services	March 2021 Empire Provider News	Medicare	Mar 1, 2021
Medical Policies and Clinical Utilization Management Guidelines update	March 2021 Empire Provider News	Medicare	Mar 1, 2021
Access to more claim denial information is now self-service	March 2021 Empire Provider News	Medicare	Mar 1, 2021
Keep up with Medicare news	March 2021 Empire Provider News	Medicare	Mar 1, 2021
Prior authorization updates for specialty pharmacy are available Material Adverse Change (MAC) Notification	February 2021 Empire Provider News	Pharmacy	Feb 1, 2021
Empire to update formulary lists for commercial health plan pharmacy benefit	February 2021 Empire Provider News	Pharmacy	Feb 1, 2021
Pharmacy information available on empireblue.com	February 2021 Empire Provider News	Pharmacy	Feb 1, 2021
Procedure Searches in Find Care - New Sort Option	February 2021 Empire Provider News	Administrative	Feb 1, 2021
New provider directory indicator for telehealth services	February 2021 Empire Provider News	Administrative	Feb 1, 2021
Emergency Room Transfers (Facility) Material Adverse Change (MAC) Notification	February 2021 Empire Provider News	Reimbursement Policies	Feb 1, 2021
Treatment Rooms with Office Evaluation and Management Services (Facility) Material Adverse Change (MAC) Notification	February 2021 Empire Provider News	Reimbursement Policies	Feb 1, 2021
Prior authorization requirements for 55899	February 2021 Empire Provider News	Medicaid	Feb 1, 2021
Provider notification for Utilization Management Authorization Rule Operations Workgroup Item 1326	February 2021 Empire Provider News	Medicaid	Feb 1, 2021
Updated AIM Rehabilitative program effective August 1, 2021 - Initial evaluations and site of care reviews	February 2021 Empire Provider News	Medicaid	Feb 1, 2021
New specialty pharmacy medical step therapy requirements	February 2021 Empire Provider News	Medicaid	Feb 1, 2021
Colorectal Cancer Screening (COL) - ensuring quality of care	February 2021 Empire Provider News	Medicaid	Feb 1, 2021
CAHPS® survey	February 2021 Empire Provider News	Medicaid	Feb 1, 2021
HEDIS Measurement Year 2020: Medicaid summary of changes from NCQA	February 2021 Empire Provider News	Medicaid	Feb 1, 2021
Medical drug benefit Clinical Criteria updates	February 2021 Empire Provider News	Medicaid	Feb 1, 2021
Availity Portal eligibility and benefits provides both additional benefit notes and digital member ID Cards	February 2021 Empire Provider News	Medicaid	Feb 1, 2021
Keep up with Medicaid news	February 2021 Empire Provider News	Medicaid	Feb 1, 2021
Medical drug benefit Clinical Criteria updates	February 2021 Empire Provider News	Medicare	Feb 1, 2021
Keep up with Medicare news	February 2021 Empire Provider News	Medicare	Feb 1, 2021
Register today for The Road to Allyship Forum hosted by Empire and Motivo on February 3, 2021 Join us to hear from a diverse panel of experienced Empire and Motivo professionals about racial equity and the importance of allies.	The Road to Allyship Forum Invite	Administrative	Jan 21, 2021
IngenioRx introduces new pharmacy network in 2021	January 2021 Empire Provider News	Pharmacy	Jan 1, 2021
Prior Authorization updates for specialty pharmacy are available Material Adverse Change (MAC) Notification	January 2021 Empire Provider News	Pharmacy	Jan 1, 2021
Clinical Criteria updates for specialty pharmacy are available Material Adverse Change (MAC) Notification	January 2021 Empire Provider News	Pharmacy	Jan 1, 2021
Empire's new digital online scheduling feature is now available	January 2021 Empire Provider News	Administrative	Jan 1, 2021
Find out in seconds why your claim denied	January 2021 Empire Provider News	Administrative	Jan 1, 2021
Self-service, digital transactions are fast and easy	January 2021 Empire Provider News	Administrative	Jan 1, 2021
Availity Attachment tools for Empire and affiliate payers – Live webinars	January 2021 Empire Provider News	Administrative	Jan 1, 2021
New features added to Interactive Care Reviewer	January 2021 Empire Provider News	Administrative	Jan 1, 2021
Professional system updates for 2021	January 2021 Empire Provider News	Administrative	Jan 1, 2021
Outpatient system updates for 2021 (Facility)	January 2021 Empire Provider News	Administrative	Jan 1, 2021

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