Empire BlueCross BlueShield HealthPlus (Empire) is migrating to InterQual medical necessity criteria for inpatient, partial, and intensive outpatient mental health authorizations, effective September 1, 2022. We are pleased to share that Empire will be using an integrated version of InterQual that functions in concert with the OMH Dimensions of Health. Empire will be outreaching in-network providers to initiate quarterly meetings to introduce and further discuss to allow for a smooth transition for our members and providers alike.


The InterQual criteria transition will allow us to initiate a targeted focus on high-risk members, integrate social drivers of health, increase provider collaboration, and most importantly improve member outcomes.


If you have questions about this communication or need assistance with any other item, visit the Contact Us section at the bottom of our provider website (https://providerpublic.empireblue.com) for up-to-date contact information or call Provider Services at 800-450-8753.


NYE-NU-0431-22 April 2022


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June 2022 Newsletter