New York
Provider Communications

Articles Month: July 2019

Title	Publication	Category	Date
Pharmacy Benefit Manager Change	July 2019 Empire Provider News	Pharmacy	Jul 1, 2019
Clinical criteria updates for specialty pharmacy	July 2019 Empire Provider News	Pharmacy	Jul 1, 2019
Clinical Criteria coding updates for specialty pharmacy are available	July 2019 Empire Provider News	Pharmacy	Jul 1, 2019
Clinical Validation - Professional	July 2019 Empire Provider News	Administrative	Jul 1, 2019
Changes to timely filing requirements for Medicare Advantage	July 2019 Empire Provider News	Administrative	Jul 1, 2019
Make the move to the Availity EDI Gateway today	July 2019 Empire Provider News	Administrative	Jul 1, 2019
CRA Reporting Update: 2019 Program Year Progression - What’s in it for you and your patients?	July 2019 Empire Provider News	Administrative	Jul 1, 2019
Empire Works to Simplify Payment Recovery Process for National Accounts Membership	July 2019 Empire Provider News	Administrative	Jul 1, 2019
Un-adopted clinical guidelines effective June 1, 2019	July 2019 Empire Provider News	Medical Policy & Clinical Guidelines	Jul 1, 2019
Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines	July 2019 Empire Provider News	Medical Policy & Clinical Guidelines	Jul 1, 2019
Reimbursement Policy updates	July 2019 Empire Provider News	Reimbursement Policies	Jul 1, 2019
Empire Federal Employee Health Benefit Program® (FEP) PPO Members will now require prior approval for specific Specialty Drugs and Site of Care	July 2019 Empire Provider News	Federal Employee Plan (FEP)	Jul 1, 2019
Medicare Advantage: Electronic claim payment reconsideration	July 2019 Empire Provider News	Medicare	Jul 1, 2019
Medicare Advantage: Sepsis diagnosis coding and billing reminder	July 2019 Empire Provider News	Medicare	Jul 1, 2019
Home health billing guidelines for contracted providers	July 2019 Empire Provider News	Medicare	Jul 1, 2019
Medical Policies and Clinical Utilization Management Guidelines update	July 2019 Empire Provider News	Medicare	Jul 1, 2019
Keep up with Medicare news	July 2019 Empire Provider News	Medicare	Jul 1, 2019
New service types added to Availity	July 2019 Empire Provider News	Medicaid	Jul 1, 2019
Trauma-informed care	July 2019 Empire Provider News	Medicaid	Jul 1, 2019
Sepsis diagnosis coding and billing reminder	July 2019 Empire Provider News	Medicaid	Jul 1, 2019
Unspecified diagnosis code update	July 2019 Empire Provider News	Medicaid	Jul 1, 2019
Coding Spotlight: Hypertension, A providers’ guide for coding	July 2019 Empire Provider News	Medicaid	Jul 1, 2019
Health Homes - a valuable provider of community-based care coordination	July 2019 Empire Provider News	Medicaid	Jul 1, 2019
Reimbursement Policy Update: Multiple Radiology Payment Reduction (Policy 12-002)	July 2019 Empire Provider News	Medicaid	Jul 1, 2019
Pharmacy benefit manager change	July 2019 Empire Provider News	Medicaid	Jul 1, 2019
New York City Department of Health advisory: HIV outbreak risk factors are present in New York City	July 2019 Empire Provider News	Medicaid	Jul 1, 2019
Electronic claim payment reconsideration	July 2019 Empire Provider News	Medicaid	Jul 1, 2019
UPDATE: New Rehabilitative Program now effective August 1, 2019	Important Update from Empire	Products & Programs	Jul 3, 2019
UPDATE: new Rehabilitative Program remains temporarily delayed	UPDATE: new Rehabilitative Program remains temporarily delayed	Products & Programs	Jul 16, 2019

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New York
Provider Communications

Articles Month: July 2019

Pharmacy Benefit Manager Change

Clinical criteria updates for specialty pharmacy

Clinical Criteria coding updates for specialty pharmacy are available

Clinical Validation - Professional

Changes to timely filing requirements for Medicare Advantage

Make the move to the Availity EDI Gateway today

CRA Reporting Update: 2019 Program Year Progression - What’s in it for you and your patients?

Empire Works to Simplify Payment Recovery Process for National Accounts Membership

Un-adopted clinical guidelines effective June 1, 2019

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines

Reimbursement Policy updates

Empire Federal Employee Health Benefit Program® (FEP) PPO Members will now require prior approval for specific Specialty Drugs and Site of Care

Medicare Advantage: Electronic claim payment reconsideration

Medicare Advantage: Sepsis diagnosis coding and billing reminder

Home health billing guidelines for contracted providers

Medical Policies and Clinical Utilization Management Guidelines update

Keep up with Medicare news

New service types added to Availity

Trauma-informed care

Sepsis diagnosis coding and billing reminder

Unspecified diagnosis code update

Coding Spotlight: Hypertension, A providers’ guide for coding

Health Homes - a valuable provider of community-based care coordination

Reimbursement Policy Update: Multiple Radiology Payment Reduction (Policy 12-002)

Pharmacy benefit manager change

New York City Department of Health advisory: HIV outbreak risk factors are present in New York City

Electronic claim payment reconsideration

UPDATE: New Rehabilitative Program now effective August 1, 2019

UPDATE: new Rehabilitative Program remains temporarily delayed

New YorkProvider Communications

Articles Month: July 2019

New York
Provider Communications