New York
Provider Communications

Articles

Title	Publication	Category	Date
Keep up with Medicaid news - February 2023 View these Medicaid articles:	February 2023 Newsletter	Medicaid	Feb 1, 2023
Keep up with Medicare news - February 2023 View these Medicare articles: Introducing the Provider Learning Hub Empire BlueCross expands specialty pharmacy precertification list (Fylnetra) Empire BlueCross expands specialty pharmacy precertification list (Spevigo, Xenpozyme) Specialty pharmacy precertification list expansion (Rolvedon, Stimufend) New specialty pharmacy medical step therapy requirements (Infed, Injectafer, Monoferric) AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update Prior authorization requirement changes effective April 1, 2023 Medical Policies and Clinical Utilization Management Guidelines update Revised program implementation date prior authorizations for post-acute care Updates to AIM Specialty Health Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines Name change announcement: myNEXUS will transition to Carelon Post Acute Solutions on March 1, 2023	February 2023 Newsletter	Medicare	Feb 1, 2023
Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List	February 2023 Newsletter	Medical Policy & Clinical Guidelines	Feb 1, 2023
AIM Specialty Health will transition to Carelon Medical Benefits Management Inc.	February 2023 Newsletter	Administrative	Feb 1, 2023
Enhancing Provider News website and email communications	February 2023 Newsletter	Digital Tools	Feb 1, 2023
Controlling High Blood Pressure and Submitting Compliant Readings	February 2023 Newsletter	Administrative	Feb 1, 2023
Participating provider contractual obligations: Advanced patient notice policy for non-participating provider referrals	February 2023 Newsletter	Administrative	Feb 1, 2023
Medical Policy and Clinical Guideline updates Material Adverse Change (MAC)	February 2023 Newsletter	Medical Policy & Clinical Guidelines	Feb 1, 2023
Clinical Criteria updates for specialty pharmacy Material Adverse Change (MAC)	February 2023 Newsletter	Pharmacy	Feb 1, 2023
Have you reviewed your online provider directory information lately?	February 2023 Newsletter	Administrative	Feb 1, 2023
Helping to reduce delays when submitting attachments: Make sure your correspondence includes one of these elements	February 2023 Newsletter	Digital Tools	Feb 1, 2023
Specialty pharmacy updates - February 2023 Material Adverse Change (MAC)	February 2023 Newsletter	Pharmacy	Feb 1, 2023
Mutual of America New York moves to the Empire BlueCross BlueShield retiree solutions Medicare Advantage plan	February 2023 Newsletter	Medicare	Feb 1, 2023
City of Manchester Offers Medicare Advantage Option	February 2023 Newsletter	Medicare	Feb 1, 2023
New policy for clinical data sharing and ADT notifications Material Adverse Change (MAC)	February 2023 Newsletter	Administrative	Feb 1, 2023
Important reminder: New ID cards for many of our Empire BlueCross BlueShield members	New ID cards for Empire BlueCross BlueShield members	Administrative	Jan 19, 2023
Engagement with your patient counts	January 2023 Newsletter	Administrative	Dec 30, 2022
Empire BlueCross BlueShield local precertification change in New York Material Adverse Change (MAC)	January 2023 Newsletter	Administrative	Dec 30, 2022
Keep up with Medicaid news - January 2023 View these Medicaid articles: This is Quitting: Helping teens and young adults quit vaping *Update to AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines* CPT code list** AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update	January 2023 Newsletter	Medicaid	Dec 30, 2022
Keep up with Medicare news - January 2023 View these Medicare articles: Prior authorization requirement changes New specialty pharmacy medical step therapy requirements Empire BlueCross BlueShield expands specialty pharmacy precertification list	January 2023 Newsletter	Medicare	Dec 30, 2022
Notification regarding reimbursement changes to COVID-19 laboratory services codes Material Adverse Change (MAC)	January 2023 Newsletter	Reimbursement Policies	Dec 30, 2022
Monkeypox and smallpox vaccines: Product code on claims	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Use of modifier 25 when billing for visits that include preventive services and problem-oriented evaluation and management services	January 2023 Newsletter	Medicaid	Dec 30, 2022
Childhood Immunization Status and Lead Screening in Children for HEDIS	January 2023 Newsletter	Administrative	Dec 30, 2022
Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Empire BlueCross BlueShield local precertification change in New York Material Adverse Change (MAC)	January 2023 Newsletter	Administrative	Dec 30, 2022
Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines* Material adverse change Material Adverse Change (MAC)	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Medical Policy and Clinical Guidelines updates Material Adverse Change (MAC)	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Specialty pharmacy updates Material Adverse Change (MAC)	January 2023 Newsletter	Pharmacy	Dec 30, 2022
Outpatient facility revenue code billing requirements	January 2023 Newsletter	Administrative	Dec 30, 2022
Remittance advice message enhancements: Providing clear descriptions and actionable next steps	January 2023 Newsletter	Administrative	Dec 30, 2022
Outpatient system updates for 2023	January 2023 Newsletter	Administrative	Dec 30, 2022
Federal Employee Program observation conversion for musculoskeletal cases Material Adverse Change (MAC)	January 2023 Newsletter	Federal Employee Plan (FEP)	Dec 30, 2022
Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines Material Adverse Change (MAC)	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Updates to AIM Specialty Health Musculoskeletal - Interventional Pain Management Clinical Appropriateness Guidelines	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Professional system updates for 2023	January 2023 Newsletter	Administrative	Dec 30, 2022
Keep up with Medicaid news - December 2022 View these Medicaid articles: 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	December 2022 Newsletter	Medicaid	Dec 1, 2022
Update to the Pregnancy Notification Form	December 2022 Newsletter	Medicaid	Dec 1, 2022
Oral health equity	December 2022 Newsletter	Medicaid	Dec 1, 2022
Signature requirements for laboratory orders or requisitions	December 2022 Newsletter	Administrative	Dec 1, 2022
Courtesy notification of specialty pharmacy medical step therapy updates	December 2022 Newsletter	Medicare	Dec 1, 2022
2023 Medicare Advantage service area and benefit updates	December 2022 Newsletter	Medicare	Dec 1, 2022
Personal home helper benefit ending	December 2022 Newsletter	Medicare	Dec 1, 2022
IngenioRx will become CarelonRx on January 1, 2023	December 2022 Newsletter	Administrative	Dec 1, 2022
Attention lab providers: COVID-19 update regarding reimbursement Material Adverse Change (MAC)	December 2022 Newsletter	Administrative	Dec 1, 2022
AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update Material Adverse Change (MAC)	December 2022 Newsletter	Medical Policy & Clinical Guidelines	Dec 1, 2022
AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines CPT Code List update Material Adverse Change (MAC)	December 2022 Newsletter	Medical Policy & Clinical Guidelines	Dec 1, 2022
Important information about utilization management	December 2022 Newsletter	Administrative	Dec 1, 2022
State of Connecticut employer group - BlueCare Prime update	December 2022 Newsletter	Administrative	Dec 1, 2022
Clinical Criteria updates for specialty pharmacy Material Adverse Change (MAC)	December 2022 Newsletter	Pharmacy	Dec 1, 2022
CAA: Timely updates help keep our provider directories current	December 2022 Newsletter	Administrative	Dec 1, 2022
Member assessment of PCP after-hours messaging in 2022	December 2022 Newsletter	Administrative	Dec 1, 2022
Pharmacy information available on the provider website	December 2022 Newsletter	Pharmacy	Dec 1, 2022
Clinical practice and preventive health guidelines available on empireblue.com	December 2022 Newsletter	Administrative	Dec 1, 2022
Specialty pharmacy updates - December 2022 Material Adverse Change (MAC)	December 2022 Newsletter	Pharmacy	Dec 1, 2022
Reimbursement policy update: Bundled Services and Supplies - Professional Material Adverse Change (MAC)	December 2022 Newsletter	Reimbursement Policies	Dec 1, 2022
Members’ rights and responsibilities	December 2022 Newsletter	Administrative	Dec 1, 2022
Member’s assessment of behavioral healthcare after-hours messaging in 2022	December 2022 Newsletter	Administrative	Dec 1, 2022
Coordination of care	December 2022 Newsletter	Administrative	Dec 1, 2022
Case management program	December 2022 Newsletter	Administrative	Dec 1, 2022
Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility Material Adverse Change (MAC)	December 2022 Newsletter	Reimbursement Policies	Dec 1, 2022
Keep up with Medicare news - December 2022 View these Medicaid articles: Clinical Criteria updates Medical Policies and Clinical Utilization Management Guidelines update AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update Empire BlueCross BlueShield expands specialty pharmacy precertification list	December 2022 Newsletter	Medicare	Dec 1, 2022
Transition to AIM Specialty Health Perirectal Hydrogel Spacer for Prostate Radiotherapy Clinical Appropriateness Guideline	November 2022 Newsletter	Medical Policy & Clinical Guidelines	Nov 1, 2022
Support documentation for AIM prior authorization requests	November 2022 Newsletter	Administrative	Nov 1, 2022
Mail is being forwarded to new post office box addresses for one year	November 2022 Newsletter	Administrative	Nov 1, 2022
CAA: Keep your provider directory information up to date	November 2022 Newsletter	Administrative	Nov 1, 2022
Specialty pharmacy updates - November 2022 Material Adverse Change (MAC)	November 2022 Newsletter	Pharmacy	Nov 1, 2022
Medical Policy and Clinical Guideline updates Material Adverse Change (MAC)	November 2022 Newsletter	Medical Policy & Clinical Guidelines	Nov 1, 2022
Correction to reimbursement policy: Place of Service (Facility) Material Adverse Change (MAC)	November 2022 Newsletter	Reimbursement Policies	Nov 1, 2022
Physician Office Lab (POL) Listing - Updates Effective February 1, 2023	November 2022 Newsletter	Administrative	Nov 1, 2022
Guidance for coding evaluation and management services for new and established patients	November 2022 Newsletter	Medicaid	Nov 1, 2022
Important information about utilization management	November 2022 Newsletter	Medicaid	Nov 1, 2022
Antipsychotic medications and diabetes	November 2022 Newsletter	Medicaid	Nov 1, 2022
Alcohol use disorders often coexist with psychiatric disorders	November 2022 Newsletter	Medicaid	Nov 1, 2022
Webinars for New York Department of Health behavioral health carve-in for Medicaid Advantage Plus	November 2022 Newsletter	Medicaid	Nov 1, 2022
Webinars for New York Department of Health behavioral health carve-in for Medicaid Advantage Plus	November 2022 Newsletter	Medicare	Nov 1, 2022
Remote EMR access service for HEDIS	November 2022 Newsletter	Digital Tools	Nov 1, 2022
Keep up with Medicaid news - November 2022 View these Medicaid articles: Medical drug benefit Clinical Criteria updates Prior authorization requirement changes effective November 1, 2022	November 2022 Newsletter	Medicaid	Nov 1, 2022
Claims status message enhancements: Providing clear descriptions and actionable next steps	November 2022 Newsletter	Digital Tools	Nov 1, 2022
Authorization application enhancements: Faster, easier, and more efficient	November 2022 Newsletter	Digital Tools	Nov 1, 2022
Submit digital attachments within 7 calendar days for claims filed with a PWK segment indicator	November 2022 Newsletter	Digital Tools	Nov 1, 2022
Now, you can submit one electronic claim dispute for multiple claims and access correspondence digitally, too	November 2022 Newsletter	Digital Tools	Nov 1, 2022
Visit the Provider Learning Hub to view our latest learning opportunities	November 2022 Newsletter	Digital Tools	Nov 1, 2022
Keep up with Medicare news - November 2022 View these Medicare articles: Medical drug benefit Clinical Criteria updates New specialty pharmacy medical step therapy requirements (Avastin, Mvasi) New specialty pharmacy medical step therapy requirements (Zarxio)	November 2022 Newsletter	Medicare	Nov 1, 2022
Register for our upcoming CME webinar about low back pain management	CME webinar about low back pain management	Administrative	Oct 7, 2022
Physician Office Lab (POL) List - October updates postponed	October 2022 Newsletter	Administrative	Oct 1, 2022
IngenioRx will become CarelonRx on January 1, 2023	October 2022 Newsletter	Pharmacy	Oct 1, 2022
Precertification list change Material Adverse Change (MAC)	October 2022 Newsletter	Administrative	Oct 1, 2022
National Accounts 2023 Pre-certification list	October 2022 Newsletter	Administrative	Oct 1, 2022
CAA: Review your online provider directory information	October 2022 Newsletter	Administrative	Oct 1, 2022
The Provider Learning Hub is here	October 2022 Newsletter	Digital Tools	Oct 1, 2022
Monkeypox and smallpox vaccines: Product code on claims	October 2022 Newsletter	Administrative	Oct 1, 2022
Specialty pharmacy updates - October 2022 Material Adverse Change (MAC)	October 2022 Newsletter	Pharmacy	Oct 1, 2022
Clinical Criteria updates for specialty pharmacy Material Adverse Change (MAC)	October 2022 Newsletter	Pharmacy	Oct 1, 2022
Pharmacy information available on empireblue.com	October 2022 Newsletter	Pharmacy	Oct 1, 2022
Reimbursement policy update: Three-Dimensional (3D) Radiology Services - Professional and Facility Material Adverse Change (MAC)	October 2022 Newsletter	Reimbursement Policies	Oct 1, 2022
Reimbursement policy update: Multiple and Bilateral Surgery Processing - Professional Material Adverse Change (MAC)	October 2022 Newsletter	Reimbursement Policies	Oct 1, 2022
Availity Provider Chat - a fast, easy way to get your UM questions answered for Federal Employees	October 2022 Newsletter	Federal Employee Plan (FEP)	Oct 1, 2022
Webinars for New York Department of Health behavioral health carve-in for Medicaid Advantage Plus	October 2022 Newsletter	Medicaid	Oct 1, 2022

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