New York
Provider Communications

Articles Month: May 2018

Title Publication Category Date

Important Update: June 15, 2018 - Access to the Empire Facility / Professional Secure Portals Only on the Availity Portal

June 2018 Empire Provider Newsletter Administrative May 30, 2018

Availity is now our designated EDI Gateway

June 2018 Empire Provider Newsletter Administrative May 30, 2018

Introducing Interactive Care Reviewer for Online Authorizations

June 2018 Empire Provider Newsletter Administrative May 30, 2018

Empire streamlines member identification cards

June 2018 Empire Provider Newsletter Administrative May 30, 2018

Updated Provider Manual now available

June 2018 Empire Provider Newsletter Administrative May 30, 2018

Receive Direct Deposit of Patient Payments with Healthcare Bill Payments

June 2018 Empire Provider Newsletter Administrative May 30, 2018

Reminder: Miscellaneous durable medical equipment billing guideline:

June 2018 Empire Provider Newsletter Administrative May 30, 2018

Update to claim processing for services requiring AIM prior authorization

June 2018 Empire Provider Newsletter Products & Programs May 30, 2018

Updates to AIM Musculoskeletal Program Clinical Appropriateness Guidelines

June 2018 Empire Provider Newsletter Products & Programs May 30, 2018

Coverage Guideline not implemented - Cervical Cancer Screening Using Cytology and Human Papillomavirus Testing (CG-MED-53)

June 2018 Empire Provider Newsletter Products & Programs May 30, 2018

Empire expands Specialty Pharmacy Clinical Site of Care (Level of Care) drug list

June 2018 Empire Provider Newsletter Pharmacy May 30, 2018

Empire expands specialty pharmacy prior authorization list

June 2018 Empire Provider Newsletter Pharmacy May 30, 2018

Reminder: Empire accepts prior authorization requests for prescription medications online

June 2018 Empire Provider Newsletter Pharmacy May 30, 2018

Pharmacy information available on empireblue.com/provider

June 2018 Empire Provider Newsletter Pharmacy May 30, 2018

Verifying eligibility for expanded hospice benefits

June 2018 Empire Provider Newsletter Products & Programs May 30, 2018

Empire’s Individualized Care Program to support palliative care for commercial members

June 2018 Empire Provider Newsletter Products & Programs May 30, 2018

Empire Adopts MCG Care Guidelines for Behavioral Health Services

June 2018 Empire Provider Newsletter Behavioral Health May 30, 2018

Outpatient visits

June 2018 Empire Provider Newsletter Behavioral Health May 30, 2018

Policy Updates

June 2018 Empire Provider Newsletter Policy Updates May 30, 2018

Medical Policy Updates

June 2018 Empire Provider Newsletter Medical Policy & Clinical Guidelines May 30, 2018

Clinical Guideline Updates

June 2018 Empire Provider Newsletter Medical Policy & Clinical Guidelines May 30, 2018

Professional Reimbursement Policy Update

June 2018 Empire Provider Newsletter Reimbursement Policies May 30, 2018

Reimbursement Policy Reminder - Durable Medical Equipment (Professional)

June 2018 Empire Provider Newsletter Reimbursement Policies May 30, 2018

Making a change for the better - FEP® system migration information

June 2018 Empire Provider Newsletter Federal Employee Plan (FEP) May 30, 2018

Cologuard covered for Medicare Advantage

June 2018 Empire Provider Newsletter Medicare May 30, 2018

Peer-to-peer process can help clarify clinical record

June 2018 Empire Provider Newsletter Medicare May 30, 2018

Motion Picture Industry Pension and Health Plans Offers Medicare Advantage Option

June 2018 Empire Provider Newsletter Medicare May 30, 2018

Connecticut Teachers’ Retirement Board Offers Medicare Advantage Option

June 2018 Empire Provider Newsletter Medicare May 30, 2018

MA home health network to be delegated to myNEXUS

June 2018 Empire Provider Newsletter Medicare May 30, 2018

Medication adherence incentive offered to EPHC providers

June 2018 Empire Provider Newsletter Medicare May 30, 2018

Keep up with Medicare news

June 2018 Empire Provider Newsletter Medicare May 30, 2018

Empire to conduct post-payment reviews of distinct procedural services modifiers

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Miscellaneous durable medical equipment billing guidelines

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Prior authorization requirement update for Mylotarg (gemtuzumab ozogamicin)

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Electrical stimulation device to require prior authorization

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Chimeric antigen receptor T-cell therapy requires prior authorization for all places of service

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Lower extremity vascular intervention codes require prior authorization

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Prior authorization requirements for Darzalex (daratumumab) drug

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Services requiring prior authorization

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Medical Policies and Clinical Utilization Management Guidelines update

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Behavioral health network provider training

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Behavioral health Discharge Action Plan: improving care transitions

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Provider surveys

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Use the Provider Maintenance Form to update your information

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Complex Case Management program

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

What Matters Most: Improving the Patient Experience

June 2018 Empire Provider Newsletter Medicaid May 30, 2018

Coding Spotlight: Pregnancy, A provider’s guide to diagnose and code for pregnancy

June 2018 Empire Provider Newsletter Medicaid May 30, 2018
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