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Oct 9, 2020

Information from Empire for Care Providers about COVID-19 (Updated October 9, 2020)

We recently updated FAQs about COVID-19 testing and visits associated with COVID-19 testing.

Oct 1, 2020

Keep up with important news from Empire and receive notifications by email

Articles Recent

Title	Publication	Category	Date
Register today for a Racial Trauma Forum hosted by Empire and Motivo on October 28, 2020	Racial Trauma Forum Invitation	Behavioral Health	Oct 14, 2020
Information from Empire for Care Providers about COVID-19 (Updated October 9, 2020) We recently updated FAQs about COVID-19 testing and visits associated with COVID-19 testing.	COVID-19 Information	Administrative	Oct 9, 2020
Site of Care medical necessity reviews for a wide range of surgical procedures beginning January 1, 2021 Material Adverse Change	October 2020 Empire Provider News	Products & Programs	Oct 1, 2020
REMINDER: Expansion of AIM Musculoskeletal Program Effective November 1, 2020	October 2020 Empire Provider News	Products & Programs	Oct 1, 2020
Empire updates formulary lists for commercial health plan pharmacy benefit	October 2020 Empire Provider News	Pharmacy	Oct 1, 2020
Designated Specialty Pharmacies in 2021 Material Adverse Change	October 2020 Empire Provider News	Pharmacy	Oct 1, 2020
National Drug Code requirement on outpatient claims Material Adverse Change	October 2020 Empire Provider News	Pharmacy	Oct 1, 2020
Prior authorization updates for specialty pharmacy are available	October 2020 Empire Provider News	Pharmacy	Oct 1, 2020
Updated Coverage for Breast Cancer prevention medications	October 2020 Empire Provider News	Pharmacy	Oct 1, 2020
FDA approvals and expedited pathways used - New Molecular Entities (NMEs)	October 2020 Empire Provider News	Pharmacy	Oct 1, 2020
Pharmacy information available on empireblue.com	October 2020 Empire Provider News	Pharmacy	Oct 1, 2020
Keep up with important news from Empire and receive notifications by email	October 2020 Empire Provider News	Administrative	Oct 1, 2020
New Digital Provider Enrollment tool added to Availity for New York	October 2020 Empire Provider News	Administrative	Oct 1, 2020
New Blue HPN® network included in plans available for employee open enrollment Fall 2020	October 2020 Empire Provider News	Administrative	Oct 1, 2020
Charges for Personal Protective Equipment by Participating Providers	October 2020 Empire Provider News	Administrative	Oct 1, 2020
Electronic member ID cards available on the Availity Portal	October 2020 Empire Provider News	Administrative	Oct 1, 2020
Empire Chat: A fast, easy way to have your questions answered	October 2020 Empire Provider News	Administrative	Oct 1, 2020
Interactive Care Reviewer adds outpatient medical authorization requests for Empire local, State and City plans	October 2020 Empire Provider News	Administrative	Oct 1, 2020
Request referrals for Empire Individual Network Plan through Interactive Care Reviewer	October 2020 Empire Provider News	Administrative	Oct 1, 2020
New Medical Claim Attachment Webinars: Register Today	October 2020 Empire Provider News	Administrative	Oct 1, 2020
National Accounts 2021 Pre-certification list	October 2020 Empire Provider News	Administrative	Oct 1, 2020
CRA Reporting Update: New guidance on telephone-only service CPT codes for Risk Adjustment Program	October 2020 Empire Provider News	Administrative	Oct 1, 2020
What Matters Most: Improving the Patient Experience	October 2020 Empire Provider News	Administrative	Oct 1, 2020
Medical Policy & Clinical Guideline updates Material Adverse Changes	October 2020 Empire Provider News	Medical Policy & Clinical Guidelines	Oct 1, 2020
Clinical Criteria updates for specialty pharmacy are available Material Adverse Change	October 2020 Empire Provider News	Medical Policy & Clinical Guidelines	Oct 1, 2020
Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines	October 2020 Empire Provider News	Medical Policy & Clinical Guidelines	Oct 1, 2020
Reimbursement Policy Update: Emergency Department: Leveling of Evaluation and Management Services (Facility) Material Adverse Change	October 2020 Empire Provider News	Reimbursement Policies	Oct 1, 2020
Reimbursement Policy Update: Laboratory and Venipuncture (Professional) Material Adverse Change	October 2020 Empire Provider News	Reimbursement Policies	Oct 1, 2020
Federal Employee Program® Expands Specialty Pharmacy Prior Authorization List Material Adverse Change	October 2020 Empire Provider News	Federal Employee Plan (FEP)	Oct 1, 2020
Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations	October 2020 Empire Provider News	Medicaid	Oct 1, 2020
SOMOS to manage delegated functions effective October 1, 2020	October 2020 Empire Provider News	Medicaid	Oct 1, 2020
Prior authorization requirements for E0482	October 2020 Empire Provider News	Medicaid	Oct 1, 2020
Asthma controller medications	October 2020 Empire Provider News	Medicaid	Oct 1, 2020
Patient360 enhancement for medical providers	October 2020 Empire Provider News	Medicaid	Oct 1, 2020
Coding spotlight: providers guide to coding for behavioral health disorders	October 2020 Empire Provider News	Medicaid	Oct 1, 2020
Keep up with Medicaid news	October 2020 Empire Provider News	Medicaid	Oct 1, 2020
Prior authorization requirements for the below codes (December 1, 2020)	October 2020 Empire Provider News	Medicare	Oct 1, 2020
Prior authorization requirements for the below codes (January 1, 2021)	October 2020 Empire Provider News	Medicare	Oct 1, 2020
Patient360 enhancement for medical providers	October 2020 Empire Provider News	Medicare	Oct 1, 2020
Social determinants of health support expanding with GroundGame Health	October 2020 Empire Provider News	Medicare	Oct 1, 2020
Evaluation and management services correct coding	October 2020 Empire Provider News	Medicare	Oct 1, 2020
Provider transparency update	October 2020 Empire Provider News	Medicare	Oct 1, 2020
Medical drug benefit Clinical Criteria updates	October 2020 Empire Provider News	Medicare	Oct 1, 2020
Keep up with Medicare news	October 2020 Empire Provider News	Medicare	Oct 1, 2020
Empire to update formulary lists for commercial health plan pharmacy benefit	September 2020 Empire Provider News	Pharmacy	Sep 1, 2020
New provider directory indicators for medication assisted treatment (MAT) providers	September 2020 Empire Provider News	Administrative	Sep 1, 2020
EDI gateway migration deadline is September 15, 2020	September 2020 Empire Provider News	Administrative	Sep 1, 2020
Patient360 adds care gap alert feedback for medical providers	September 2020 Empire Provider News	Administrative	Sep 1, 2020
Enhanced medical records submission process to support claims processing	September 2020 Empire Provider News	Administrative	Sep 1, 2020
Providers can now receive and respond to medical record requests for postpay audit via Change Healthcare’s Assurance Attach Assist module	September 2020 Empire Provider News	Administrative	Sep 1, 2020
CRA reporting update: 2020 prospective program continues	September 2020 Empire Provider News	Administrative	Sep 1, 2020
Predictive Analytics guide proactive support to patients undergoing chemo, resulting in lowered admissions	September 2020 Empire Provider News	Administrative	Sep 1, 2020
Distinct Procedural Services- Modifiers 59, XE, XP, XS, XU (Professional)	September 2020 Empire Provider News	Reimbursement Policies	Sep 1, 2020
Frequency Editing (Professional)	September 2020 Empire Provider News	Reimbursement Policies	Sep 1, 2020
What Matters Most online training course: improving patient experience	September 2020 Empire Provider News	Medicaid	Sep 1, 2020
Medical drug benefit Clinical Criteria updates	September 2020 Empire Provider News	Medicaid	Sep 1, 2020
Medical Policies and Clinical Utilization Management Guidelines update	September 2020 Empire Provider News	Medicaid	Sep 1, 2020
Keep up with Medicaid news	September 2020 Empire Provider News	Medicaid	Sep 1, 2020
Update: Notice of changes to the AIM musculoskeletal program	September 2020 Empire Provider News	Medicare	Sep 1, 2020
Medical drug benefit Clinical Criteria updates	September 2020 Empire Provider News	Medicare	Sep 1, 2020
Keep up with Medicare news	September 2020 Empire Provider News	Medicare	Sep 1, 2020
Updates for specialty pharmacy are available	September 2020 Empire Provider News	Pharmacy	Sep 1, 2020
New York Department of Financial Services Circular Letter on PPE The New York Department of Financial Services (“DFS”) recently issued a circular letter, “Charges for Personal Protective Equipment by Participating Providers”. In support with the letter, Empire is sharing with participating providers their responsibilities and working with providers to report the findings to DFS.	COVID-19 Information	Administrative	Aug 25, 2020
Mental Health Services for Fully Insured New York Members including Essential Workers Effective May 2, 2020, Empire began waiving cost sharing for in-network outpatient mental health services for all New York fully-insured members, including essential workers. This waiver will be in effect until September 28, 2020, unless further extended.	COVID-19 Information	Administrative	Aug 13, 2020
Expansion of AIM Musculoskeletal Program effective November 1, 2020	August 2020 Empire Provider News	Products & Programs	Aug 1, 2020
Prior authorization updates for specialty pharmacy are available	August 2020 Empire Provider News	Pharmacy	Aug 1, 2020
Empire to update formulary lists for commercial health plan pharmacy benefit	August 2020 Empire Provider News	Pharmacy	Aug 1, 2020
Voluntary Site of Care outreach for Oncology Checkpoint Inhibitors beginning August 1, 2020	August 2020 Empire Provider News	Pharmacy	Aug 1, 2020
Clinical Criteria updates for specialty pharmacy are available	August 2020 Empire Provider News	Pharmacy	Aug 1, 2020
Pharmacy information available on empireblue.com	August 2020 Empire Provider News	Pharmacy	Aug 1, 2020
Migrate Your EDI Transactions to Availity Today	August 2020 Empire Provider News	Administrative	Aug 1, 2020
Electronic Claims Submission - Clinical Laboratory Improvement Amendments (CLIA)	August 2020 Empire Provider News	Administrative	Aug 1, 2020
Empire Electronic Attachments - X12 275 5010	August 2020 Empire Provider News	Administrative	Aug 1, 2020
Coming Soon: Enhance your Prior Authorization and Inpatient Admission	August 2020 Empire Provider News	Administrative	Aug 1, 2020
Medical Record Standards	August 2020 Empire Provider News	Administrative	Aug 1, 2020
Appropriate coding helps provide a comprehensive picture of patients’ health	August 2020 Empire Provider News	Administrative	Aug 1, 2020
Resources to support diverse patients and communities	August 2020 Empire Provider News	Administrative	Aug 1, 2020
Controlling High Blood Pressure (CBP)	August 2020 Empire Provider News	Medicaid	Aug 1, 2020
Medical drug benefit Clinical Criteria updates	August 2020 Empire Provider News	Medicaid	Aug 1, 2020
Provider data update	August 2020 Empire Provider News	Medicaid	Aug 1, 2020
Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines	August 2020 Empire Provider News	Medicaid	Aug 1, 2020
Keep up with Medicaid news	August 2020 Empire Provider News	Medicaid	Aug 1, 2020
2020 Medicare risk adjustment provider trainings	August 2020 Empire Provider News	Medicare	Aug 1, 2020
AIM Musculoskeletal program expansion	August 2020 Empire Provider News	Medicare	Aug 1, 2020
Medical drug benefit Clinical Criteria updates	August 2020 Empire Provider News	Medicare	Aug 1, 2020
Provider data update	August 2020 Empire Provider News	Medicare	Aug 1, 2020
Waived copays, deductibles and coinsurance for CCM, complex CCM and TCM	August 2020 Empire Provider News	Medicare	Aug 1, 2020
Keep up with Medicare news	August 2020 Empire Provider News	Medicare	Aug 1, 2020
Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and Setting determinations	July 2020 Empire Provider News	Products & Programs	Jul 1, 2020
Updated Coverage for HIV PrEP medications	July 2020 Empire Provider News	Pharmacy	Jul 1, 2020
Prior authorization updates for specialty pharmacy are available	July 2020 Empire Provider News	Pharmacy	Jul 1, 2020
Changes to Annual Verification Process	July 2020 Empire Provider News	Administrative	Jul 1, 2020
Suffolk County Lab Network	July 2020 Empire Provider News	Administrative	Jul 1, 2020
New MCG 24th Edition Guidelines	July 2020 Empire Provider News	Administrative	Jul 1, 2020
Claims Status Listing & Remittance Inquiry Updates for Atypical Providers	July 2020 Empire Provider News	Administrative	Jul 1, 2020
Welcome to the Custom Learning Center in Availity	July 2020 Empire Provider News	Administrative	Jul 1, 2020
CRA Reporting Update: 2020 Program Year Progression - What’s in it for you and your patients?	July 2020 Empire Provider News	Administrative	Jul 1, 2020
Medical Policy and Clinical Guideline updates	July 2020 Empire Provider News	Medical Policy & Clinical Guidelines	Jul 1, 2020
Clinical Criteria updates for specialty pharmacy are available	July 2020 Empire Provider News	Medical Policy & Clinical Guidelines	Jul 1, 2020
Admission review process for Empire Federal Employee Program® (FEP) members	July 2020 Empire Provider News	Federal Employee Plan (FEP)	Jul 1, 2020

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