Empire reviews and updates our online Provider Manuals annually.  The updated manual is now available online at empireblue.com/provider > Click “Find Resources in New York” > Provider Home >  Communications > Empire’s Provider Manual. The following changes are effective July 1, 2018:

 

New Content for 2018

  • Pharmacy Home
  • Availity Portal
  • AIM Specialty Health
  • Claims Filing Tips
  • Online Provider Directories and Demographic Data Integrity

 

Updated for 2018:

  • Misrouted PHI
  • Risk Adjustments
  • Overview of CAHPS
  • EDI
  • Overpayment-Cost Containment
  • Medicare Crossover
  • Implants
  • Medical Care Provided to or by a Family Member
  • Test or Procedures Prior to Admission(s) or Outpatient Services
  • Preventable Adverse Events (PAE)
  • Credentialing
  • Utilization Management
  • Member Rights and Responsibilities
  • Quality Improvement
  • Cultural Diversity
  • Continuity and Coordination of Care 
  • Continuity of Care/Transition of Care Program
  • Quality of Care Investigations
  • Clinical Practice Guidelines
  • Preventive Health Guidelines
  • Performance Data
  • Medical Policy (excluding CA)
  • Centers of Medical Excellence
  • Member Health & Wellness
  • Blue Card Overview
  • FEHBP
  • HIX
  • Audit  -excluding CA
  • Fraud Waste and Abuse Detection

 



Featured In:
June 2018 Empire Provider Newsletter