New York
Provider Communications

Articles Month: December 2021

Title Publication Category Date

Empire is transitioning to the Availity Authorization App

Availity Authorization App improvements based on your feedback

Availity Authorization App improvements Administrative Dec 28, 2021

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

December 2021 Newsletter Administrative Dec 1, 2021

Facility option to receive verbal UM Notifications electronically

December 2021 Newsletter Administrative Dec 1, 2021

Submitting prior authorizations is getting easier

Empire is transitioning to the Availity Authorization app

December 2021 Newsletter Administrative Dec 1, 2021

Is prior authorization required?

Answering your questions about the new Availity Authorization app

December 2021 Newsletter Administrative Dec 1, 2021

Chlamydia screening for teens and young adults

December 2021 Newsletter Administrative Dec 1, 2021

Outpatient system updates for 2022

December 2021 Newsletter Administrative Dec 1, 2021

Professional system updates for 2022

December 2021 Newsletter Administrative Dec 1, 2021

Clinical practice and preventive health guidelines available on empireblue.com

December 2021 Newsletter Administrative Dec 1, 2021

Coordination of care

December 2021 Newsletter Administrative Dec 1, 2021

Member rights and responsibilities

December 2021 Newsletter Administrative Dec 1, 2021

Important information about utilization management

December 2021 Newsletter Administrative Dec 1, 2021

Case management program

December 2021 Newsletter Administrative Dec 1, 2021

Importance of PCP after-hours messaging

December 2021 Newsletter Administrative Dec 1, 2021

Behavioral healthcare appointment access requirements

December 2021 Newsletter Administrative Dec 1, 2021

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

December 2021 Newsletter Administrative Dec 1, 2021

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

EnrollSafe replaced CAQH Enrollhub effective November 1, 2021
December 2021 Newsletter Digital Tools Dec 1, 2021

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

December 2021 Newsletter Digital Tools Dec 1, 2021

Empire to retire Blue Precision program on December 31, 2021

December 2021 Newsletter Products & Programs Dec 1, 2021

Clinical Criteria updates for specialty pharmacy

Material Adverse Change (MAC)
December 2021 Newsletter Pharmacy Dec 1, 2021

Specialty pharmacy updates - December 2021

Material Adverse Change (MAC)
December 2021 Newsletter Pharmacy Dec 1, 2021

Pharmacy information available on empireblue.com

December 2021 Newsletter Pharmacy Dec 1, 2021

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

Material Adverse Change (MAC)
December 2021 Newsletter Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Cardiology clinical appropriateness guidelines

Material Adverse Change (MAC)
December 2021 Newsletter Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Radiation Oncology clinical appropriateness guideline

Material Adverse Change (MAC)
December 2021 Newsletter Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Advanced Imaging clinical appropriateness guideline

Material Adverse Change (MAC)
December 2021 Newsletter Medical Policy & Clinical Guidelines Dec 1, 2021

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

Material Adverse Change (MAC)

December 2021 Newsletter Reimbursement Policies Dec 1, 2021

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

Material Adverse Change (MAC)

December 2021 Newsletter Reimbursement Policies Dec 1, 2021

Reimbursement policy update: Virtual Visits - professional and facility

December 2021 Newsletter Reimbursement Policies Dec 1, 2021

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

December 2021 Newsletter Medicaid Dec 1, 2021

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

December 2021 Newsletter Medicaid Dec 1, 2021

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

December 2021 Newsletter Medicaid Dec 1, 2021

Claims editing update for ICD-10-CM Excludes1 notes

December 2021 Newsletter Medicaid Dec 1, 2021

Updates to AIM Specialty Health Advanced Imaging clinical appropriateness guidelines

December 2021 Newsletter Medicaid Dec 1, 2021

Medical Policies and Clinical Utilization Management Guidelines update

December 2021 Newsletter Medicaid Dec 1, 2021

Good news: Non-payment remittance advice enhancements are here

December 2021 Newsletter Medicaid Dec 1, 2021

Submitting prior authorizations is getting easier

December 2021 Newsletter Medicaid Dec 1, 2021

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
December 2021 Newsletter Medicaid Dec 1, 2021

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

December 2021 Newsletter Medicare Dec 1, 2021

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

December 2021 Newsletter Medicare Dec 1, 2021

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

December 2021 Newsletter Medicare Dec 1, 2021

Updates to AIM Specialty Health Advanced Imaging clinical appropriateness guidelines

December 2021 Newsletter Medicare Dec 1, 2021

2022 Medicare Advantage service area and benefit updates

December 2021 Newsletter Medicare Dec 1, 2021

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

December 2021 Newsletter Medicare Dec 1, 2021

Good news: Non-payment remittance advice enhancements are here

December 2021 Newsletter Medicare Dec 1, 2021

Submitting prior authorizations is getting easier

December 2021 Newsletter Medicare Dec 1, 2021

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
December 2021 Newsletter Medicare Dec 1, 2021
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