New York
Provider Communications

April 2019 Empire Provider Newsletter

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Title Category

Reminder of New Referral Process

Products & Programs

New AIM Rehabilitative program effective July 1, 2019

Products & Programs

Empire expands specialty pharmacy prior authorization list

Pharmacy

Pharmacy information available on empireblue.com

Pharmacy

Empire CRA Reporting Update: Accurate coding helps provide a comprehensive picture of patients’ health and services provided

Administrative

New on Interactive Care Reviewer: Request Clinical Appeals

Administrative

Clinical practice and preventive health guidelines available online

Administrative

Why do patients stop taking their prescribed medications and what can you do to help them?

Administrative

Medical Policy and Clinical Guideline Updates

Medical Policy & Clinical Guidelines

Update to AIM Advanced Imaging of the Head and Neck Clinical Appropriateness Guidelines

Medical Policy & Clinical Guidelines

Update to AIM Advanced Imaging of the Heart Clinical Appropriateness Guidelines

Medical Policy & Clinical Guidelines

Update to AIM Sleep Disorder Management Clinical Appropriateness Guidelines

Medical Policy & Clinical Guidelines

Update to AIM Musculoskeletal Joint Surgery Clinical Appropriateness Guidelines

Medical Policy & Clinical Guidelines

New Reimbursement Policy - Partial Hospitalization Program and Intensive Outpatient Program Services Facility

Reimbursement Policies

Update regarding evaluation and management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred

Medicare

Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members

Medicare

Keep up with Medicare news

Medicare

Online registration processes for electronic funds transfers and electronic remittance advices

Medicare

Clinical Criteria updates

Medicaid

Help prevent preeclampsia with prenatal aspirin

Medicaid

Correction: Cervical length measurement by transvaginal ultrasound

Medicaid

Medical necessity review for appropriate level of care

Medicaid

Online registration processes for electronic funds transfers and electronic remittance advices

Medicaid

Medical Policies and Clinical Utilization Management Guidelines update

Medicaid

Provider surveys

Medicaid

Practitioners’ rights during credentialing process

Medicaid
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