CommercialAugust 1, 2018
August 2018 Empire Provider Newsletter
Administrative
CommercialAugust 1, 2018
Vaginal Birth after Cesarean (VBAC) Certified Shared Decision Making Aid Available on the WebCommercialAugust 1, 2018
New precertification requirement for EGD services begins November 1, 2018CommercialAugust 1, 2018
Attention: Updated or New Fee Schedules for Commercial productsCommercialAugust 1, 2018
Empire to enhance automated claim edits for professional claimsCommercialAugust 1, 2018
Member Explanation of Benefits gets a makeoverCommercialAugust 1, 2018
Important billing update for professional delivery claimsCommercialAugust 1, 2018
Online Authorizations through the Availity Portal on Interactive Care ReviewerCommercialAugust 1, 2018
Empire transitioning to Availity EDI GatewayCommercialAugust 1, 2018
Webinar: Introduction to Availity EDI Gateway services for Empire provider organizationsCommercialAugust 1, 2018
New pregnancy notification process using the Availity Web Portal Benefit Look-up ToolCommercialAugust 1, 2018
Important information about billing colonoscopy and related anesthesia servicesCommercialAugust 1, 2018
MyDiversePatients.com: A website to support your diverse patientsCommercialAugust 1, 2018
Additional Support Available for Members with Rare ConditionsCommercialAugust 1, 2018
Provider Transparency UpdateBehavioral Health
CommercialAugust 1, 2018
Empire engages with Alliant Health SolutionsCommercialAugust 1, 2018
New Eating Disorder Service Available to Empire MembersPolicy Updates
CommercialAugust 1, 2018
Policy UpdatesCommercialAugust 1, 2018
Medical Policy UpdatesCommercialAugust 1, 2018
Clinical Guideline UpdatesCommercialAugust 1, 2018
Review medical policy and clinical guidelines when referring services to a facilityCommercialAugust 1, 2018
Update to Venipuncture Services Medical Policy effective March 1, 2018CommercialAugust 1, 2018
Archived medical policyCommercialAugust 1, 2018
Reimbursement Policy UpdatesProducts & Programs
CommercialAugust 1, 2018
Updates to AIM Advanced Imaging Clinical Appropriateness GuidelinesCommercialAugust 1, 2018
Updates to AIM Level of Care Musculoskeletal Surgery Clinical Appropriateness GuidelinesCommercialAugust 1, 2018
Update to AIM Radiation Oncology Clinical Appropriateness GuidelinesCommercialAugust 1, 2018
Making a change for the better - FEP system migration informationCommercialAugust 1, 2018
Empire expands specialty pharmacy prior authorization listCommercialAugust 1, 2018
Empire expands specialty pharmacy clinical site of care (level of care) drug listCommercialAugust 1, 2018
Empire removes drugs from specialty pharmacy clinical site of careCommercialAugust 1, 2018
Empire to update drug lists supporting commercial health plansCommercialAugust 1, 2018
Empire accepts prior authorization requests for prescription medications onlineCommercialAugust 1, 2018
Empire applies daily morphine equivalent dosing limitCommercialAugust 1, 2018
Pharmacy information available on empireblue.comState & Federal
Medicare AdvantageAugust 1, 2018
MyDiversePatients.com addresses health care disparitiesMedicare AdvantageAugust 1, 2018
MA members receive incentives for completing screeningsMedicare AdvantageAugust 1, 2018
DME providers and physicians: important wheelchair prior authorization informationMedicare AdvantageAugust 1, 2018
Submit PA medication requests electronically; new phone number for MA prescription PAs effective Sept. 1Medicare AdvantageAugust 1, 2018
CMS issues regulatory changes for short- and long-acting narcotics; days’ supply limits effective Jan. 1, 2019Medicare AdvantageAugust 1, 2018
Keep up with Medicare newsMedicaidAugust 1, 2018
Electronic Data Interchange migration to AvailityMedicaidAugust 1, 2018
New pregnancy notification process using the Availity Portal Benefit Look-Up toolMedicaidAugust 1, 2018
Normal newborn diagnosis-related group claims processing updateMedicaidAugust 1, 2018
Prior authorization requirements for Cabazitaxel (Jevtana)MedicaidAugust 1, 2018
Prior authorization requirements for injectable/infusible drugs: mepolizumab (Nucala) and reslizumab (Cinqair)MedicaidAugust 1, 2018
Coding Spotlight - ObesityMedicaidAugust 1, 2018
Reimbursement Policy Update: Medical RecallsMedicaidAugust 1, 2018
New HEDIS/QARR measures for 2018MedicaidAugust 1, 2018
Home- and community-based services for Health and Recovery Plan beneficiariesMedicaidAugust 1, 2018
Important information about utilization managementMedicaidAugust 1, 2018
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