New York
Provider Communications

November 2022 Newsletter

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Title Category

Alcohol use disorders often coexist with psychiatric disorders

Medicaid

Antipsychotic medications and diabetes

Medicaid

Authorization application enhancements: Faster, easier, and more efficient

Digital Tools

CAA: Keep your provider directory information up to date

Administrative

Claims status message enhancements: Providing clear descriptions and actionable next steps

Digital Tools

Correction to reimbursement policy: Place of Service (Facility)

Material Adverse Change (MAC)
Reimbursement Policies

Guidance for coding evaluation and management services for new and established patients

Medicaid

Important information about utilization management

Medicaid

Keep up with Medicaid news - November 2022

View these Medicaid articles:
  • Medical drug benefit Clinical Criteria updates
  • Prior authorization requirement changes effective November 1, 2022
Medicaid

Keep up with Medicare news - November 2022

View these Medicare articles:
  • Medical drug benefit Clinical Criteria updates
  • New specialty pharmacy medical step therapy requirements (Avastin, Mvasi)
  • New specialty pharmacy medical step therapy requirements (Zarxio)
Medicare

Mail is being forwarded to new post office box addresses for one year

Administrative

Medical Policy and Clinical Guideline updates

Material Adverse Change (MAC)
Medical Policy & Clinical Guidelines

Now, you can submit one electronic claim dispute for multiple claims and access correspondence digitally, too

Digital Tools

Physician Office Lab (POL) Listing - Updates Effective February 1, 2023

Administrative

Remote EMR access service for HEDIS

Digital Tools

Specialty pharmacy updates - November 2022

Material Adverse Change (MAC)
Pharmacy

Submit digital attachments within 7 calendar days for claims filed with a PWK segment indicator

Digital Tools

Support documentation for AIM prior authorization requests

Administrative

Transition to AIM Specialty Health Perirectal Hydrogel Spacer for Prostate Radiotherapy Clinical Appropriateness Guideline

Medical Policy & Clinical Guidelines

Visit the Provider Learning Hub to view our latest learning opportunities

Digital Tools

Webinars for New York Department of Health behavioral health carve-in for Medicaid Advantage Plus

Medicaid

Webinars for New York Department of Health behavioral health carve-in for Medicaid Advantage Plus

Medicare
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