New York
Provider Communications

Provider Spotlight

Jan 11, 2021

Information from Empire for Care Providers about COVID-19 (Updated January 11, 2021)

We recently updated FAQs about prior authorization requirements suspended for patient transfers from acute IP hospitals to certain facilities.

Articles Recent

Title	Publication	Category	Date
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
Information from Empire for Care Providers about COVID-19 (Updated January 11, 2021) We recently updated FAQs about prior authorization requirements suspended for patient transfers from acute IP hospitals to certain facilities.	COVID-19 Information	Administrative	Jan 11, 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
It is almost CAHPS survey time	January 2021 Empire Provider News	Administrative	Jan 1, 2021
MCG Care Guidelines 24th edition customization Material Adverse Change (MAC) Notification	January 2021 Empire Provider News	Medical Policy & Clinical Guidelines	Jan 1, 2021
Medical Policy updates Material Adverse Change (MAC) Notification	January 2021 Empire Provider News	Medical Policy & Clinical Guidelines	Jan 1, 2021
Multiple Diagnostic Imaging procedures (Professional) Material Adverse Change (MAC) Notification	January 2021 Empire Provider News	Reimbursement Policies	Jan 1, 2021
Frequency Editing (Professional) Material Adverse Change (MAC) Notification	January 2021 Empire Provider News	Reimbursement Policies	Jan 1, 2021
Guidelines for reporting timed units for Physical Medicine and Rehabilitation (Professional) Material Adverse Change (MAC) Notification	January 2021 Empire Provider News	Reimbursement Policies	Jan 1, 2021
Modifier Rules (Professional) Material Adverse Change (MAC) Notification	January 2021 Empire Provider News	Reimbursement Policies	Jan 1, 2021
Unit Frequency Maximum for Drugs and Biologicals (Professional) Material Adverse Change (MAC) Notification	January 2021 Empire Provider News	Reimbursement Policies	Jan 1, 2021
Evaluation and Management changes 2021	January 2021 Empire Provider News	Reimbursement Policies	Jan 1, 2021
2021 FEP® Benefit information available online	January 2021 Empire Provider News	Federal Employee Plan (FEP)	Jan 1, 2021
Updates to AIM Clinical Appropriateness Guidelines for Advanced Imaging	January 2021 Empire Provider News	Medicaid	Jan 1, 2021
FDA approvals and expedited pathways used — new molecular entities (NMEs)	January 2021 Empire Provider News	Medicaid	Jan 1, 2021
Medical drug benefit Clinical Criteria updates	January 2021 Empire Provider News	Medicaid	Jan 1, 2021
Coding spotlight: HEDIS MY 2021	January 2021 Empire Provider News	Medicaid	Jan 1, 2021
Disease Management/Population Health program	January 2021 Empire Provider News	Medicaid	Jan 1, 2021
Keep up with Medicaid news	January 2021 Empire Provider News	Medicaid	Jan 1, 2021
Updates to AIM Clinical Appropriateness Guidelines for Advanced Imaging	January 2021 Empire Provider News	Medicare	Jan 1, 2021
Medical drug benefit Clinical Criteria updates	January 2021 Empire Provider News	Medicare	Jan 1, 2021
2020 Medicare risk adjustment provider trainings	January 2021 Empire Provider News	Medicare	Jan 1, 2021
Keep up with Medicare news	January 2021 Empire Provider News	Medicare	Jan 1, 2021
AIM IVR changes for non-oncology medical specialty drug reviews effective on January 1, 2021	December 2020 Empire Provider News	Products & Programs	Dec 1, 2020
Access requirements for behavioral healthcare services	December 2020 Empire Provider News	Behavioral Health	Dec 1, 2020
Prior authorization updates for specialty pharmacy - effective March 1, 2021 Material Adverse Change (MAC) Notification	December 2020 Empire Provider News	Pharmacy	Dec 1, 2020
Clinical Criteria updates for specialty pharmacy are available Material Adverse Change (MAC) Notification	December 2020 Empire Provider News	Pharmacy	Dec 1, 2020
Reminder: Company requires National Drug Code for professional and facility outpatient claims effective December 11, 2020 Material Adverse Change (MAC) Notification	December 2020 Empire Provider News	Pharmacy	Dec 1, 2020
Pharmacy information available on empireblue.com	December 2020 Empire Provider News	Pharmacy	Dec 1, 2020
Empire makes going digital easy with the Provider Digital Engagement Supplement	December 2020 Empire Provider News	Administrative	Dec 1, 2020
Access to claim denial information is now self-service	December 2020 Empire Provider News	Administrative	Dec 1, 2020
New Blue HPN® plans go live January 1, 2021	December 2020 Empire Provider News	Administrative	Dec 1, 2020
Empire to change ID numbers for Building Service 32BJ Health Fund members	December 2020 Empire Provider News	Administrative	Dec 1, 2020
Anthem, Inc. and Quest Diagnostics Form Strategic Relationship	December 2020 Empire Provider News	Administrative	Dec 1, 2020
Prior authorization updates for commercial business effective March 1, 2021	December 2020 Empire Provider News	Administrative	Dec 1, 2020
PCP after-hours access requirements	December 2020 Empire Provider News	Administrative	Dec 1, 2020
Empire contracted Air Ambulance providers	December 2020 Empire Provider News	Administrative	Dec 1, 2020
Videos to engage patients about preventive care available on empireblue.com	December 2020 Empire Provider News	Administrative	Dec 1, 2020
Clinical practice and preventive health guidelines available on empireblue.com	December 2020 Empire Provider News	Administrative	Dec 1, 2020
Coordination of Care	December 2020 Empire Provider News	Administrative	Dec 1, 2020
Members’ Rights and Responsibilities	December 2020 Empire Provider News	Administrative	Dec 1, 2020
Important Information about Utilization Management	December 2020 Empire Provider News	Administrative	Dec 1, 2020
Case Management Program	December 2020 Empire Provider News	Administrative	Dec 1, 2020
Updates to AIM Cardiology Clinical Appropriateness Guidelines Material Adverse Change (MAC) Notification	December 2020 Empire Provider News	Medical Policy & Clinical Guidelines	Dec 1, 2020
Updates to AIM Advanced Imaging Clinical Appropriateness Guideline Material Adverse Change (MAC) Notification	December 2020 Empire Provider News	Medical Policy & Clinical Guidelines	Dec 1, 2020
Updates to AIM Radiation Oncology Clinical Appropriateness Guideline Material Adverse Change (MAC) Notification	December 2020 Empire Provider News	Medical Policy & Clinical Guidelines	Dec 1, 2020
Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines	December 2020 Empire Provider News	Medical Policy & Clinical Guidelines	Dec 1, 2020
Bundled Services and Supplies (Professional)	December 2020 Empire Provider News	Reimbursement Policies	Dec 1, 2020
Empire expands hospice policy	December 2020 Empire Provider News	Reimbursement Policies	Dec 1, 2020
Digital transactions cut administrative tasks in half	December 2020 Empire Provider News	Medicaid	Dec 1, 2020
Sign up to receive email from Empire BlueCross BlueShield HealthPlus	December 2020 Empire Provider News	Medicaid	Dec 1, 2020
CAHPS education for providers	December 2020 Empire Provider News	Medicaid	Dec 1, 2020
Notifications on the Availity Portal	December 2020 Empire Provider News	Medicaid	Dec 1, 2020
Resources to support your pregnant and postpartum patients and their families	December 2020 Empire Provider News	Medicaid	Dec 1, 2020
Flu vaccination reimbursement	December 2020 Empire Provider News	Medicaid	Dec 1, 2020
Update to reimbursement policy usage	December 2020 Empire Provider News	Medicaid	Dec 1, 2020
Keep up with Medicaid news	December 2020 Empire Provider News	Medicaid	Dec 1, 2020
Digital transactions cut administrative tasks in half	December 2020 Empire Provider News	Medicare	Dec 1, 2020
Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ	December 2020 Empire Provider News	Medicare	Dec 1, 2020
2021 Medicare Advantage individual benefits and formularies	December 2020 Empire Provider News	Medicare	Dec 1, 2020
Medical Policies and Clinical Utilization Management Guidelines update	December 2020 Empire Provider News	Medicare	Dec 1, 2020
Keep up with Medicare news	December 2020 Empire Provider News	Medicare	Dec 1, 2020
Reminder: Specialty Pharmacy Program expands Level of Care Reviews to NYC Hospital PPO Members Material Adverse Change (MAC) notification	November 2020 Empire Provider News	Products & Programs	Nov 1, 2020
Prior authorization updates for specialty pharmacy are available Material Adverse Change (MAC) notification	November 2020 Empire Provider News	Pharmacy	Nov 1, 2020
IngenioRx Introduces New Pharmacy Network in 2021	November 2020 Empire Provider News	Pharmacy	Nov 1, 2020
Clinical Criteria updates for specialty pharmacy are available Material Adverse Change (MAC) notification	November 2020 Empire Provider News	Pharmacy	Nov 1, 2020
Digital transactions cut administrative tasks in half	November 2020 Empire Provider News	Administrative	Nov 1, 2020
Clinical Laboratory Improvement Amendments (CLIA) Number – Additional Information	November 2020 Empire Provider News	Administrative	Nov 1, 2020
Availity Attachment Tools for Empire and Affiliate Payers – Live Webinars	November 2020 Empire Provider News	Administrative	Nov 1, 2020
US Antibiotic Awareness Week	November 2020 Empire Provider News	Administrative	Nov 1, 2020
Get the full picture of your patient’s health through their smartphone	November 2020 Empire Provider News	Administrative	Nov 1, 2020
Clinical Guideline Updates Material Adverse Change (MAC) notification	November 2020 Empire Provider News	Medical Policy & Clinical Guidelines	Nov 1, 2020
Reminder: Post-service reviews using AIM	November 2020 Empire Provider News	Medical Policy & Clinical Guidelines	Nov 1, 2020
Documentation Standards for Episodes of Care (Professional) Material Adverse Change (MAC) notification	November 2020 Empire Provider News	Reimbursement Policies	Nov 1, 2020
Modifier Rules (Professional) Material Adverse Change (MAC) notification	November 2020 Empire Provider News	Reimbursement Policies	Nov 1, 2020
Bundled Services and Supplies (Professional) Material Adverse Change (MAC) notification	November 2020 Empire Provider News	Reimbursement Policies	Nov 1, 2020
Attention: Updated laboratory fee schedule	November 2020 Empire Provider News	Medicaid	Nov 1, 2020
Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines	November 2020 Empire Provider News	Medicaid	Nov 1, 2020
Digital transactions cut administrative tasks in half	November 2020 Empire Provider News	Medicaid	Nov 1, 2020
Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations	November 2020 Empire Provider News	Medicaid	Nov 1, 2020
Aspire Health telehealth palliative care program for Medicaid members in need of telephonic palliative care	November 2020 Empire Provider News	Medicaid	Nov 1, 2020
Medical drug benefit Clinical Criteria updates	November 2020 Empire Provider News	Medicaid	Nov 1, 2020
Reimbursement Policy: Nurse Practitioner and Physician Assistant Services (Professional)	November 2020 Empire Provider News	Medicaid	Nov 1, 2020
Coding spotlight: tips and best practices for compliance	November 2020 Empire Provider News	Medicaid	Nov 1, 2020
Inhaled nitric oxide reviews for diagnosis-related group admissions	November 2020 Empire Provider News	Medicaid	Nov 1, 2020
Provider transparency update	November 2020 Empire Provider News	Medicaid	Nov 1, 2020
New specialty pharmacy medical step therapy requirements (Herceptin)	November 2020 Empire Provider News	Medicaid	Nov 1, 2020
New specialty pharmacy medical step therapy requirements (Avastin)	November 2020 Empire Provider News	Medicaid	Nov 1, 2020
Keep up with Medicaid news	November 2020 Empire Provider News	Medicaid	Nov 1, 2020
Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines	November 2020 Empire Provider News	Medicare	Nov 1, 2020
Provider Chat — A fast, easy way to get your questions answered	November 2020 Empire Provider News	Medicare	Nov 1, 2020

Page 1 of 9

Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc. licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans, serving residents and businesses in the 28 eastern and southeastern counties of New York State. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. All external sites will open in a new browser window. Please view our Website Privacy Policy for more information.