CommercialDecember 1, 2020

December 2020 Empire Provider News

Administrative

AdministrativeCommercialNovember 30, 2020

Case Management Program

AdministrativeCommercialNovember 30, 2020

Anthem, Inc. and Quest Diagnostics Form Strategic Relationship

AdministrativeCommercialNovember 30, 2020

Access to claim denial information is now self-service

AdministrativeCommercialNovember 30, 2020

New Blue HPN® plans go live January 1, 2021

AdministrativeCommercialNovember 30, 2020

PCP after-hours access requirements

AdministrativeCommercialNovember 30, 2020

Empire contracted Air Ambulance providers

AdministrativeCommercialNovember 30, 2020

Coordination of Care

AdministrativeCommercialNovember 30, 2020

Members’ Rights and Responsibilities

AdministrativeCommercialNovember 30, 2020

Important Information about Utilization Management

Behavioral Health

Behavioral HealthCommercialNovember 30, 2020

Access requirements for behavioral healthcare services

Policy Updates

Medical Policy & Clinical GuidelinesCommercialNovember 30, 2020

Updates to AIM Cardiology Clinical Appropriateness Guidelines
Material Adverse Change (MAC) Notification

Medical Policy & Clinical GuidelinesCommercialNovember 30, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline
Material Adverse Change (MAC) Notification

Medical Policy & Clinical GuidelinesCommercialNovember 30, 2020

Updates to AIM Radiation Oncology Clinical Appropriateness Guideline
Material Adverse Change (MAC) Notification

Medical Policy & Clinical GuidelinesCommercialNovember 30, 2020

Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines

Reimbursement PoliciesCommercialNovember 30, 2020

Bundled Services and Supplies (Professional)

Reimbursement PoliciesCommercialNovember 30, 2020

Empire expands hospice policy

Products & Programs

PharmacyCommercialNovember 30, 2020

Prior authorization updates for specialty pharmacy - effective March 1, 2021
Material Adverse Change (MAC) Notification

PharmacyCommercialNovember 30, 2020

Clinical Criteria updates for specialty pharmacy are available
Material Adverse Change (MAC) Notification

PharmacyCommercialNovember 30, 2020

Reminder: Company requires National Drug Code for professional and facility outpatient claims effective December 11, 2020
Material Adverse Change (MAC) Notification

PharmacyCommercialNovember 30, 2020

Pharmacy information available on empireblue.com

State & Federal

State & FederalMedicaidNovember 30, 2020

Notifications on the Availity Portal

State & FederalMedicaidNovember 30, 2020

Digital transactions cut administrative tasks in half

State & FederalMedicaidNovember 30, 2020

Sign up to receive email from Empire BlueCross BlueShield HealthPlus

State & FederalMedicaidNovember 30, 2020

CAHPS education for providers

State & FederalMedicaidNovember 30, 2020

Flu vaccination reimbursement

State & FederalMedicaidNovember 30, 2020

Update to reimbursement policy usage

State & FederalMedicaidNovember 30, 2020

Keep up with Medicaid news

State & FederalMedicare AdvantageNovember 30, 2020

Digital transactions cut administrative tasks in half

State & FederalMedicare AdvantageNovember 30, 2020

Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ

State & FederalMedicare AdvantageNovember 30, 2020

2021 Medicare Advantage individual benefits and formularies

State & FederalMedicare AdvantageNovember 30, 2020

Medical Policies and Clinical Utilization Management Guidelines update

State & FederalMedicare AdvantageNovember 30, 2020

Keep up with Medicare news