New York
Provider Communications

Making a change for the better - FEP system migration information

2020 FEP Benefit information available online

Radiology prior authorization review transitioning to AIM

Process change for Federal Employee Program® third-party correspondence requests

HEDIS 2021 Federal Employee Program® medical record request requirements

DEXA bone scan criteria for the Federal Employee Program

Making a change for the better - FEP® system migration information

Federal Employee Program® AIM Radiology prior authorization review

Save time by using CPT II codes: Introducing FEP Quality Reimbursement Program for PPO providers

Coordination of Benefits for an FEP® member

Federal Employee Program change for medical dental reimbursement

Federal Employee Program® AIM Radiology prior authorization review transition delayed until November

Material adverse change (MAC) notification

Admission review process for Empire Federal Employee Program® (FEP) members

Empire Federal Employee Health Benefit Program® (FEP) PPO Members will now require prior approval for specific Specialty Drugs and Site of Care

HEDIS 2019 Federal Employee Program medical record request requirements

Change in email submission of service requests for Federal Employee Program members

OBRA 93 claim filing for Federal Employee Program

Making a change for the better - FEP system migration information.

Availity Provider Chat - a fast, easy way to get your UM questions answered for Federal Employees

Change to the Federal Employee Program® Clinical Grievance and Appeal Address

HEDIS 2022 Federal Employee Program® medical record request requirements

Federal Employee Program® Specialty Pharmacy Clinical Site-of-Care prior authorization review

Pre-certification information for the Federal Employee Program

US Antibiotic Awareness Week is November 11-18, 2019

Correct Mailing Address for Federal Employee Program Paper Claims and Claims Related Correspondence

2021 FEP® Benefit information available online

Federal Employee Program® Expands Specialty Pharmacy Prior Authorization List

Federal Employee Program observation conversion for musculoskeletal cases

2022 FEP® Benefit information available online

Join us for an FEP Quality Learning program live webinar

CORRECTION: Save time tomorrow by using CPT II codes today: Introducing the FEP® Quality Reimbursement Program for PPO providers

Federal Employee Program® AIM radiology prior authorization review reminder

HEDIS 2020 Federal Employee Program® medical record request requirements

Coordination of Benefits for an FEP member

Benefit change for Infliximab for Federal Employee Program

2019 FEP Benefit information available online

Keep up with Medicaid news - December 2022

• Clinical Criteria updates
• Prior authorization requirement changes effective January 1, 2023
• Prior authorization updates for medications billed under the medical benefit
• Medical Policies and Clinical Utilization Management Guidelines update
• AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update

Update to the Pregnancy Notification Form

Update to corrected claims filing guidelines

Oral health equity

Electronic data interchange gateway update

Empire HealthPlus adopts MCG Care Guidelines for clinical reviews of mental health services

Prior authorization requirements for Sublocade

Prior authorization requirements for Subcutaneous Implantable Defibrillator system

Verifying and updating your provider information

UPDATE: Prior authorization requirements for high-level, definitive drug testing delayed

Improving the patient experience

Viral suppression rates improve in patients with HIV in the US,while disparities continue to exist

Medical drug benefit Clinical Criteria updates - August 2019

Reimbursement Policy Update: Claims Requiring Additional Documentation (Policy 06-031, effective 03/01/19)

Medical drug benefit Clinical Criteria - September 2019

Transition of Outpatient Rehabilitation Utilization Management Program effective January 1, 2019

Medical Policies and Clinical Utilization Management Guidelines update

Medical Policies and Clinical Utilization Management Guidelines update

Coding spotlight - provider’s guide to coding respiratory diseases

Prior authorization requirement changes effective August 1, 2022

Electronic Data Interchange migration to Availity

Coding spotlight: substance use disorders and smoking

What Matters Most online training course: improving patient experience

MCG care guidelines 26th edition

New pregnancy notification process using the Availity Portal Benefit Look-Up tool

Pharmacy management information

Medical drug benefit Clinical Criteria updates

Provider notice for COVID-19 testing

Update to electronic verification visit key points

Normal newborn diagnosis-related group claims processing update

Practitioners’ rights during credentialing process

InterQual migration

Prior authorization requirements for Cabazitaxel (Jevtana)

Medical Policies and Clinical Utilization Management Guidelines update

Medical Policies and Clinical Utilization Management Guidelines update

Provider reimbursement for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Counseling program

Prior authorization requirements for injectable/infusible drugs: mepolizumab (Nucala) and reslizumab (Cinqair)

Keep up with Medicaid news

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

Keep up with Medicaid news- July 2022

View these Medicaid articles:

• Three-point match verification for professional claims payment
• Prior authorization updates for medications billed under the medical benefit
• Updates for medication codes billed under the medical benefit

Coding Spotlight - Obesity

Keep up with Medicaid news- June 2022

View these Medicaid articles:

• Prior authorization update for select durable medical equipment (DME) items
• Prior authorization updates for medications billed under the medical benefit
• Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines
• Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines
• Medical drug benefit Clinical Criteria updates

Reimbursement Policy Update: Medical Recalls

Controlling High Blood Pressure (CBP)

New HEDIS/QARR measures for 2018

Medical drug benefit Clinical Criteria updates

Provider data update

Home- and community-based services for Health and Recovery Plan beneficiaries

Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines

Keep up with Medicaid news

Important information about utilization management

Reimbursement Policy Update: Early and Periodic Screening, Diagnosis and Treatment (EPSDT) (Effective 05/01/20)

Keep up with Medicaid news

Member’s Rights and Responsibilities Statement

Resources to support your diverse patient panel

Non-covered codes for Medicaid Managed Care (MMC) providers

Keep up with Medicaid news

Empire to conduct post-payment reviews of distinct procedural services modifiers

Miscellaneous durable medical equipment billing guidelines

Prior authorization requirement update for Mylotarg (gemtuzumab ozogamicin)

Electrical stimulation device to require prior authorization

Chimeric antigen receptor T-cell therapy requires prior authorization for all places of service

Provider education program survey: Your Voice Counts

Lower extremity vascular intervention codes require prior authorization