New York
Provider Communications

Empire is transitioning to the Availity Authorization App

Availity Authorization App improvements based on your feedback

Prepare for the Consolidated Appropriations Act: Keep your provider directory information up to date

Facility option to receive verbal UM Notifications electronically

Submitting prior authorizations is getting easier

Empire is transitioning to the Availity Authorization app

Is prior authorization required?

Answering your questions about the new Availity Authorization app

Chlamydia screening for teens and young adults

Outpatient system updates for 2022

Professional system updates for 2022

Clinical practice and preventive health guidelines available on empireblue.com

Coordination of care

Member rights and responsibilities

Important information about utilization management

Case management program

Importance of PCP after-hours messaging

Behavioral healthcare appointment access requirements

Reminder: The 32BJ Health Fund Centers of Excellence for Bariatric and Joint Replacement Surgery program begins January 1, 2022

Reminder: EnrollSafe is available - electronic funds transfer enrollment portal for Empire providers

Utilization management tool available on Availity Payer Spaces: Authorization Rules Lookup tool

Empire to retire Blue Precision program on December 31, 2021

Clinical Criteria updates for specialty pharmacy

Specialty pharmacy updates - December 2021

Pharmacy information available on empireblue.com

Updates to AIM Specialty Health Musculoskeletal Interventional Pain Management clinical appropriateness guideline

Updates to AIM Specialty Health Cardiology clinical appropriateness guidelines

Updates to AIM Specialty Health Radiation Oncology clinical appropriateness guideline

Updates to AIM Advanced Imaging clinical appropriateness guideline

Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) - professional

Material Adverse Change (MAC)

New reimbursement policy update: Modifier 62: Co-Surgeon Services and Modifier 66: Surgical Teams - professional

Material Adverse Change (MAC)

Reimbursement policy update: Virtual Visits - professional and facility

Reimbursement policy update: Drug Screen Testing (effective March 1, 2022)

Reimbursement policy update: Multiple and Bilateral Surgery - Professional and Facility (effective 03/01/22)

HEDIS measures: Follow-Up After ED Visits for Mental Illness and Alcohol and Drug Dependency

Claims editing update for ICD-10-CM Excludes1 notes

Updates to AIM Specialty Health Advanced Imaging clinical appropriateness guidelines

Medical Policies and Clinical Utilization Management Guidelines update

Good news: Non-payment remittance advice enhancements are here

Submitting prior authorizations is getting easier

Keep up with Medicaid news - December 2021

View these Medicaid articles:

• Durable medical equipment prior authorization requirement changes effective December 1, 2021
• Cancer Care Navigator
• Medical drug benefit Clinical Criteria updates
• Prior authorization updates for medications billed under the medical
  benefit
• Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines
• Updates to AIM Specialty Health musculoskeletal interventional pain management
  clinical appropriateness guideline

City of New York GRS Alliance Program (Updated 12/3/21)

Webinars for City of New York retirees transitioning to new Medicare Advantage plan (Updated 12/3/21)

Reimbursement Policy Update: Drug Screen Testing (effective March 1, 2022)

Updates to AIM Specialty Health Advanced Imaging clinical appropriateness guidelines

2022 Medicare Advantage service area and benefit updates

Adjudicating claims for COVID-19 vaccines, their administration and COVID-19 monoclonal antibodies

Good news: Non-payment remittance advice enhancements are here

Submitting prior authorizations is getting easier

Keep up with Medicare news - December 2021

View these Medicare articles:

• Medical drug benefit Clinical Criteria updates
• FAQ: NYC Medicare Advantage Plus
• Protocol for providers serving members with hearing aid
  coverage administered by Hearing Care Solutions
• Medical Policies and Clinical Utilization Management Guidelines update
• Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines
• Updates to AIM Specialty Health musculoskeletal interventional pain management
  clinical appropriateness guideline