New York
Provider Communications

Articles Month: December 2022

Title	Publication	Category	Date
Empire BlueCross BlueShield local precertification change in New York Material Adverse Change (MAC)	January 2023 Newsletter	Administrative	Dec 30, 2022
Professional system updates for 2023	January 2023 Newsletter	Administrative	Dec 30, 2022
Engagement with your patient counts	January 2023 Newsletter	Administrative	Dec 30, 2022
Childhood Immunization Status and Lead Screening in Children for HEDIS	January 2023 Newsletter	Administrative	Dec 30, 2022
Outpatient system updates for 2023	January 2023 Newsletter	Administrative	Dec 30, 2022
Remittance advice message enhancements: Providing clear descriptions and actionable next steps	January 2023 Newsletter	Administrative	Dec 30, 2022
Empire BlueCross BlueShield local precertification change in New York Material Adverse Change (MAC)	January 2023 Newsletter	Administrative	Dec 30, 2022
Outpatient facility revenue code billing requirements	January 2023 Newsletter	Administrative	Dec 30, 2022
Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Updates to AIM Specialty Health Musculoskeletal - Interventional Pain Management Clinical Appropriateness Guidelines	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Monkeypox and smallpox vaccines: Product code on claims	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines Material Adverse Change (MAC)	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines* Material adverse change Material Adverse Change (MAC)	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Medical Policy and Clinical Guidelines updates Material Adverse Change (MAC)	January 2023 Newsletter	Medical Policy & Clinical Guidelines	Dec 30, 2022
Notification regarding reimbursement changes to COVID-19 laboratory services codes Material Adverse Change (MAC)	January 2023 Newsletter	Reimbursement Policies	Dec 30, 2022
Specialty pharmacy updates Material Adverse Change (MAC)	January 2023 Newsletter	Pharmacy	Dec 30, 2022
Federal Employee Program observation conversion for musculoskeletal cases Material Adverse Change (MAC)	January 2023 Newsletter	Federal Employee Plan (FEP)	Dec 30, 2022
Use of modifier 25 when billing for visits that include preventive services and problem-oriented evaluation and management services	January 2023 Newsletter	Medicaid	Dec 30, 2022
Keep up with Medicaid news - January 2023 View these Medicaid articles: This is Quitting: Helping teens and young adults quit vaping *Update to AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines* CPT code list** AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update	January 2023 Newsletter	Medicaid	Dec 30, 2022
Keep up with Medicare news - January 2023 View these Medicare articles: Prior authorization requirement changes New specialty pharmacy medical step therapy requirements Empire BlueCross BlueShield expands specialty pharmacy precertification list	January 2023 Newsletter	Medicare	Dec 30, 2022
Attention lab providers: COVID-19 update regarding reimbursement Material Adverse Change (MAC)	December 2022 Newsletter	Administrative	Dec 1, 2022
Important information about utilization management	December 2022 Newsletter	Administrative	Dec 1, 2022
State of Connecticut employer group - BlueCare Prime update	December 2022 Newsletter	Administrative	Dec 1, 2022
IngenioRx will become CarelonRx on January 1, 2023	December 2022 Newsletter	Administrative	Dec 1, 2022
CAA: Timely updates help keep our provider directories current	December 2022 Newsletter	Administrative	Dec 1, 2022
Member assessment of PCP after-hours messaging in 2022	December 2022 Newsletter	Administrative	Dec 1, 2022
Clinical practice and preventive health guidelines available on empireblue.com	December 2022 Newsletter	Administrative	Dec 1, 2022
Signature requirements for laboratory orders or requisitions	December 2022 Newsletter	Administrative	Dec 1, 2022
Case management program	December 2022 Newsletter	Administrative	Dec 1, 2022
Coordination of care	December 2022 Newsletter	Administrative	Dec 1, 2022
Member’s assessment of behavioral healthcare after-hours messaging in 2022	December 2022 Newsletter	Administrative	Dec 1, 2022
Members’ rights and responsibilities	December 2022 Newsletter	Administrative	Dec 1, 2022
Clinical Criteria updates for specialty pharmacy Material Adverse Change (MAC)	December 2022 Newsletter	Pharmacy	Dec 1, 2022
Pharmacy information available on the provider website	December 2022 Newsletter	Pharmacy	Dec 1, 2022
Specialty pharmacy updates - December 2022 Material Adverse Change (MAC)	December 2022 Newsletter	Pharmacy	Dec 1, 2022
AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update Material Adverse Change (MAC)	December 2022 Newsletter	Medical Policy & Clinical Guidelines	Dec 1, 2022
AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines CPT Code List update Material Adverse Change (MAC)	December 2022 Newsletter	Medical Policy & Clinical Guidelines	Dec 1, 2022
Reimbursement policy update: Bundled Services and Supplies - Professional Material Adverse Change (MAC)	December 2022 Newsletter	Reimbursement Policies	Dec 1, 2022
Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility Material Adverse Change (MAC)	December 2022 Newsletter	Reimbursement Policies	Dec 1, 2022
Update to the Pregnancy Notification Form	December 2022 Newsletter	Medicaid	Dec 1, 2022
Oral health equity	December 2022 Newsletter	Medicaid	Dec 1, 2022
Keep up with Medicaid news - December 2022 View these Medicaid articles: Clinical Criteria updates Prior authorization requirement changes effective January 1, 2023 Prior authorization updates for medications billed under the medical benefit Medical Policies and Clinical Utilization Management Guidelines update AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update	December 2022 Newsletter	Medicaid	Dec 1, 2022
Courtesy notification of specialty pharmacy medical step therapy updates	December 2022 Newsletter	Medicare	Dec 1, 2022
2023 Medicare Advantage service area and benefit updates	December 2022 Newsletter	Medicare	Dec 1, 2022
Personal home helper benefit ending	December 2022 Newsletter	Medicare	Dec 1, 2022
Keep up with Medicare news - December 2022 View these Medicaid articles: Clinical Criteria updates Medical Policies and Clinical Utilization Management Guidelines update AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update Empire BlueCross BlueShield expands specialty pharmacy precertification list	December 2022 Newsletter	Medicare	Dec 1, 2022

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