New York
Provider Communications

December 2020 Empire Provider News

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Title	Category
AIM IVR changes for non-oncology medical specialty drug reviews effective on January 1, 2021	Products & Programs
Access requirements for behavioral healthcare services	Behavioral Health
Prior authorization updates for specialty pharmacy - effective March 1, 2021 Material Adverse Change (MAC) Notification	Pharmacy
Clinical Criteria updates for specialty pharmacy are available Material Adverse Change (MAC) Notification	Pharmacy
Reminder: Company requires National Drug Code for professional and facility outpatient claims effective December 11, 2020 Material Adverse Change (MAC) Notification	Pharmacy
Pharmacy information available on empireblue.com	Pharmacy
Empire makes going digital easy with the Provider Digital Engagement Supplement	Administrative
Access to claim denial information is now self-service	Administrative
New Blue HPN® plans go live January 1, 2021	Administrative
Empire to change ID numbers for Building Service 32BJ Health Fund members	Administrative
Anthem, Inc. and Quest Diagnostics Form Strategic Relationship	Administrative
Prior authorization updates for commercial business effective March 1, 2021	Administrative
PCP after-hours access requirements	Administrative
Empire contracted Air Ambulance providers	Administrative
Videos to engage patients about preventive care available on empireblue.com	Administrative
Clinical practice and preventive health guidelines available on empireblue.com	Administrative
Coordination of Care	Administrative
Members’ Rights and Responsibilities	Administrative
Important Information about Utilization Management	Administrative
Case Management Program	Administrative
Updates to AIM Cardiology Clinical Appropriateness Guidelines Material Adverse Change (MAC) Notification	Medical Policy & Clinical Guidelines
Updates to AIM Advanced Imaging Clinical Appropriateness Guideline Material Adverse Change (MAC) Notification	Medical Policy & Clinical Guidelines
Updates to AIM Radiation Oncology Clinical Appropriateness Guideline Material Adverse Change (MAC) Notification	Medical Policy & Clinical Guidelines
Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines	Medical Policy & Clinical Guidelines
Bundled Services and Supplies (Professional)	Reimbursement Policies
Empire expands hospice policy	Reimbursement Policies
Digital transactions cut administrative tasks in half	Medicaid
Sign up to receive email from Empire BlueCross BlueShield HealthPlus	Medicaid
CAHPS education for providers	Medicaid
Notifications on the Availity Portal	Medicaid
Resources to support your pregnant and postpartum patients and their families	Medicaid
Flu vaccination reimbursement	Medicaid
Update to reimbursement policy usage	Medicaid
Keep up with Medicaid news	Medicaid
Digital transactions cut administrative tasks in half	Medicare
Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ	Medicare
2021 Medicare Advantage individual benefits and formularies	Medicare
Medical Policies and Clinical Utilization Management Guidelines update	Medicare
Keep up with Medicare news	Medicare

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