New York
Provider Communications

Articles Month: December 2018

Title Publication Category Date

Empire accepts electronic prior authorization requests for prescription medications online

December 2018 Empire Provider Newsletter Pharmacy Dec 1, 2018

Introducing the new Clinical Criteria page for injectable, infused or implanted drugs

December 2018 Empire Provider Newsletter Pharmacy Dec 1, 2018

Pharmacy information available on empireblue.com

December 2018 Empire Provider Newsletter Pharmacy Dec 1, 2018

Empire announces a new network - Blue Access

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

Empire announces changes to the Individual Health Benefit Plans

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

Prepare NOW for Empire Facility and Physician Portal Retirement

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

Availity to serve as EDI entry point for electronic submissions

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

Explore new enhancements to the Education and Reference Center

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

Company works to simplify payment recovery process for National Accounts membership

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

HEDIS® 2018 Commercial Results Are In

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

Case Management Program

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

ConditionCare Program Benefits Patients and Physicians

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

Integrated Care Model for plans purchased on the Health Insurance Marketplace benefits patients and physicians

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

Coordination of Care

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

Important Information about Utilization Management

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

Members’ Rights and Responsibilities

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

Vaginal Birth after Cesarean (VBAC) Certified Shared Decision Making Aid Available on the Web

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

Clinical practice and preventive health guidelines available online

December 2018 Empire Provider Newsletter Administrative Dec 1, 2018

Policy updates

December 2018 Empire Provider Newsletter Policy Updates Dec 1, 2018

Medical Policy Updates

December 2018 Empire Provider Newsletter Medical Policy & Clinical Guidelines Dec 1, 2018

Clinical Guideline Updates

December 2018 Empire Provider Newsletter Medical Policy & Clinical Guidelines Dec 1, 2018

Review medical policy and clinical guidelines when referring services to a facility

December 2018 Empire Provider Newsletter Medical Policy & Clinical Guidelines Dec 1, 2018

Update to AIM Clinical Appropriateness Guidelines

December 2018 Empire Provider Newsletter Medical Policy & Clinical Guidelines Dec 1, 2018

Updates to AIM Musculoskeletal Surgery Clinical Appropriateness Guidelines

December 2018 Empire Provider Newsletter Medical Policy & Clinical Guidelines Dec 1, 2018

Restructure of AIM Advanced Imaging Clinical Appropriateness Guidelines

December 2018 Empire Provider Newsletter Medical Policy & Clinical Guidelines Dec 1, 2018

Reimbursement Policy Updates

December 2018 Empire Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement for Convenience Surgical Supply Kits - Professional

December 2018 Empire Provider Newsletter Reimbursement Policies Dec 1, 2018

Bundled Services and Supplies - Professional

December 2018 Empire Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement Policy Update - Scope of License (Professional)

December 2018 Empire Provider Newsletter Reimbursement Policies 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

2019 FEP Benefit information available online

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

New Medicare Advantage provider service phone number beginning January 1, 2019

December 2018 Empire Provider Newsletter Medicare Dec 1, 2018

2019 Medicare Advantage individual benefits and formularies

December 2018 Empire Provider Newsletter Medicare Dec 1, 2018

CMS Medicare Preclusion List effective April 1, 2019

December 2018 Empire Provider Newsletter Medicare Dec 1, 2018

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
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