Dec 1, 2021 • Administrative

Contracted facilities may request to electronically receive Utilization Management (UM) verbal notices. These notices are required under Article 49 of the Public Health Law and Insurance Law for preauthorization and concurrent utilization review determinations, rather than via phone calls.  Electronic notices are transmitted via the daily Last Approved Day (LAD) report and/or Availity, which are also in addition to UM determination written letter notices.

 

Facilities may update their preference for UM verbal notices by completing Empire’s “Verbal UM Notifications Preference” form with the appropriate authorized signature.  Facilities may access Empire’s “Verbal UM Notifications Preference” form here.

 

By updating preference to receive UM notices electronically, rather than by phone call,

  • Facilities will still receive a daily LAD report, if they receive currently
  • Facilities will still receive UM determination written letter notifications
  • Facilities will still have access to UM decisions via Availity / Provider Portals
  • Facilities may contact Network Management to opt back into phone notices, at any time

 

1457-1221-PN-NY

 

 


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December 2021 Newsletter