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Provider Communications

Articles Category: State & Federal

Title Publication Category Date

Medicare Advantage: New service types added to Availity

August 2019 Empire Provider News Medicare Aug 1, 2019

Medicare Advantage: New Reimbursement Policy: Drug Screen Testing (Policy 19-001, effective 10/01/19)

August 2019 Empire Provider News Medicare Aug 1, 2019

Medicare Advantage: Special needs plans - provider training required

August 2019 Empire Provider News Medicare Aug 1, 2019

Keep up with Medicare news

August 2019 Empire Provider News Medicare Aug 1, 2019

AIM Specialty Health programs may require documentation

August 2019 Empire Provider News Medicaid Aug 1, 2019

Pharmacy management information

August 2019 Empire Provider News Medicaid Aug 1, 2019

Use the Provider Maintenance Form to update your information

August 2019 Empire Provider News Medicaid Aug 1, 2019

Prepayment clinical validation review process

August 2019 Empire Provider News Medicaid Aug 1, 2019

Keep up with Medicaid news

August 2019 Empire Provider News Medicaid Aug 1, 2019

Medicare Advantage: AIM Specialty Health programs may require documentation

August 2019 Empire Provider News Medicare Aug 1, 2019

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

July 2019 Empire Provider News Federal Employee Plan (FEP) Jul 1, 2019

Medicare Advantage: Electronic claim payment reconsideration

July 2019 Empire Provider News Medicare Jul 1, 2019

Medicare Advantage: Sepsis diagnosis coding and billing reminder

July 2019 Empire Provider News Medicare Jul 1, 2019

Home health billing guidelines for contracted providers

July 2019 Empire Provider News Medicare Jul 1, 2019

Medical Policies and Clinical Utilization Management Guidelines update

July 2019 Empire Provider News Medicare Jul 1, 2019

Keep up with Medicare news

July 2019 Empire Provider News Medicare Jul 1, 2019

New service types added to Availity

July 2019 Empire Provider News Medicaid Jul 1, 2019

Trauma-informed care

July 2019 Empire Provider News Medicaid Jul 1, 2019

Sepsis diagnosis coding and billing reminder

July 2019 Empire Provider News Medicaid Jul 1, 2019

Unspecified diagnosis code update

July 2019 Empire Provider News Medicaid Jul 1, 2019

Coding Spotlight: Hypertension, A providers’ guide for coding

July 2019 Empire Provider News Medicaid Jul 1, 2019

Health Homes - a valuable provider of community-based care coordination

July 2019 Empire Provider News Medicaid Jul 1, 2019

Reimbursement Policy Update: Multiple Radiology Payment Reduction (Policy 12-002)

July 2019 Empire Provider News Medicaid Jul 1, 2019

Pharmacy benefit manager change

July 2019 Empire Provider News Medicaid Jul 1, 2019

New York City Department of Health advisory: HIV outbreak risk factors are present in New York City

July 2019 Empire Provider News Medicaid Jul 1, 2019

Electronic claim payment reconsideration

July 2019 Empire Provider News Medicaid Jul 1, 2019

Remittance Inquiry tool now available

June 2019 Empire Provider Newsletter Medicare Jun 1, 2019

Keep up with Medicare news

June 2019 Empire Provider Newsletter Medicare Jun 1, 2019

Why do patients stop taking their prescribed medications and what can you do to help them?

June 2019 Empire Provider Newsletter Medicare Jun 1, 2019

Review of professional claims with emergency department level 5 E&M codes

June 2019 Empire Provider Newsletter Medicare Jun 1, 2019

Prior authorization requirement update

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Remittance Inquiry tool now available

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Why do patients stop taking their prescribed medications and what can you do to help them?

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Intervention for blood sugar control in pregnant women with diabetes

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Review of professional claims with emergency department level 5 E&M codes

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Complex Case Management program

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Important information about utilization management

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Members’ Rights and Responsibilities Statement

June 2019 Empire Provider Newsletter Medicaid Jun 1, 2019

Partial hospitalization services

May 2019 Empire Provider Newsletter Medicare May 1, 2019

Keep up with Medicare news

May 2019 Empire Provider Newsletter Medicare May 1, 2019

Clinical Criteria updates

May 2019 Empire Provider Newsletter Medicaid May 1, 2019

Update regarding evaluation and management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred

April 2019 Empire Provider Newsletter Medicare Apr 1, 2019

Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members

April 2019 Empire Provider Newsletter Medicare Apr 1, 2019

Keep up with Medicare news

April 2019 Empire Provider Newsletter Medicare Apr 1, 2019

Online registration processes for electronic funds transfers and electronic remittance advices

April 2019 Empire Provider Newsletter Medicare Apr 1, 2019

Clinical Criteria updates

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Help prevent preeclampsia with prenatal aspirin

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Correction: Cervical length measurement by transvaginal ultrasound

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Medical necessity review for appropriate level of care

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Online registration processes for electronic funds transfers and electronic remittance advices

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Medical Policies and Clinical Utilization Management Guidelines update

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Provider surveys

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Practitioners’ rights during credentialing process

April 2019 Empire Provider Newsletter Medicaid Apr 1, 2019

Introducing a new clinical criteria web page for injectable, infused or implanted drugs covered under the medical benefit

March 2019 Empire Provider Newsletter Medicare Mar 1, 2019

Dual Eligible Special Needs Plans - provider training required

March 2019 Empire Provider Newsletter Medicare Mar 1, 2019

Change to 835 ERA for all D-SNP MA members for 2019

March 2019 Empire Provider Newsletter Medicare Mar 1, 2019

Clinical criteria updates for specialty pharmacy

March 2019 Empire Provider Newsletter Medicare Mar 1, 2019

Keep up with Medicare news

March 2019 Empire Provider Newsletter Medicare Mar 1, 2019

Update: evaluation and management with Modifier 25

March 2019 Empire Provider Newsletter Medicaid Mar 1, 2019

Reimbursement Policy Update

March 2019 Empire Provider Newsletter Medicaid Mar 1, 2019

Coding Spotlight: Cancer A provider’s guide to properly code cancers

March 2019 Empire Provider Newsletter Medicaid Mar 1, 2019

Access patient-specific drug benefit information through electronic medical records

March 2019 Empire Provider Newsletter Medicaid Mar 1, 2019

Neonatal intensive care unit post-traumatic stress disorder program

March 2019 Empire Provider Newsletter Medicaid Mar 1, 2019

HEDIS 2019 Federal Employee Program medical record request requirements

February 2019 Empire Provider Newsletter Federal Employee Plan (FEP) Feb 1, 2019

Reminder - Empire follows Original Medicare policies

February 2019 Empire Provider Newsletter Medicare Feb 1, 2019

Use grouped CPT codes for AIM Specialty Health authorizations

February 2019 Empire Provider Newsletter Medicare Feb 1, 2019

Empire eye refraction and routine eye exam billing information

February 2019 Empire Provider Newsletter Medicare Feb 1, 2019

New specialty Medicare Part B device preferred product program

February 2019 Empire Provider Newsletter Medicare Feb 1, 2019

Keep up with Medicare news

February 2019 Empire Provider Newsletter Medicare Feb 1, 2019

New specialty pharmacy medical step therapy requirements

February 2019 Empire Provider Newsletter Medicaid Feb 1, 2019

Introducing a new clinical criteria web page for injectable, infused or implanted drugs covered under the medical benefit

February 2019 Empire Provider Newsletter Medicaid Feb 1, 2019

Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service

February 2019 Empire Provider Newsletter Medicaid Feb 1, 2019

Diabetes Coding

February 2019 Empire Provider Newsletter Medicaid Feb 1, 2019

Empire offers risk adjustment and documentation training

January 2019 Empire Provider Newsletter Medicare Jan 1, 2019

Medicare Advantage member Explanation of Benefits redesigned

January 2019 Empire Provider Newsletter Medicare Jan 1, 2019

Keep up with Medicare news

January 2019 Empire Provider Newsletter Medicare Jan 1, 2019

Transition of Outpatient Rehabilitation Utilization Management program

January 2019 Empire Provider Newsletter Medicaid Jan 1, 2019

My Diverse Patients: A website to support your diverse patients

January 2019 Empire Provider Newsletter Medicaid Jan 1, 2019

Medical Policies and Clinical Utilization Management Guidelines update

January 2019 Empire Provider Newsletter Medicaid Jan 1, 2019

New Provider Learning Opportunity: Put the ProviderPortal to Work for You

January 2019 Empire Provider Newsletter Medicaid Jan 1, 2019

When and how to initiate Medicare Advantage reopenings

December 2018 Empire Provider Newsletter Medicare Dec 1, 2018

Individual Medicare plans move compound drugs off formulary beginning January 1, 2019

December 2018 Empire Provider Newsletter Medicare Dec 1, 2018

Medicare Part B drugs may include Step Therapy beginning January 1, 2019

December 2018 Empire Provider Newsletter Medicare Dec 1, 2018

MediBlue Select HMO Network expands effective January 1, 2019

December 2018 Empire Provider Newsletter Medicare Dec 1, 2018

Medical Policies updated

December 2018 Empire Provider Newsletter Medicare Dec 1, 2018

Keep up with Medicare news

December 2018 Empire Provider Newsletter Medicare Dec 1, 2018

Electronic data interchange gateway update

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

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

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Prior authorization requirements for Sublocade

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Prior authorization requirements for Subcutaneous Implantable Defibrillator system

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

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

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

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

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

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

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

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

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Medical Policies and Clinical Utilization Management Guidelines update

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Coding spotlight: substance use disorders and smoking

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Pharmacy management information

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Practitioners’ rights during credentialing process

December 2018 Empire Provider Newsletter Medicaid Dec 1, 2018

Coordination of Benefits for an FEP member

December 2018 Empire Provider Newsletter Federal Employee Plan (FEP) Dec 1, 2018

Benefit change for Infliximab for Federal Employee Program

December 2018 Empire Provider Newsletter Federal Employee Plan (FEP) Dec 1, 2018
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