CommercialFebruary 1, 2019

February 2019 Empire Provider Newsletter

Administrative

AdministrativeCommercialJanuary 31, 2019

Clinical practice and preventive health guidelines available online

AdministrativeCommercialJanuary 31, 2019

Empire to enhance claim edits for outpatient facility claims

Policy Updates

Medical Policy & Clinical GuidelinesCommercialJanuary 31, 2019

Update to AIM Musculoskeletal Program Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialJanuary 31, 2019

Un-adopted clinical guidelines effective February 1, 2019

Medical Policy & Clinical GuidelinesCommercialJanuary 31, 2019

New and adopted clinical guidelines effective May 1, 2019

Reimbursement PoliciesCommercialJanuary 31, 2019

Reminder Review ICD-10-CM Coding Guidelines - Professional

Reimbursement PoliciesCommercialJanuary 31, 2019

Body Mass Index (BMI) - Facility

Reimbursement PoliciesCommercialJanuary 31, 2019

Injectable Substances with Related Injection Services - (Professional)

Products & Programs

Federal Employee Program (FEP)CommercialJanuary 31, 2019

HEDIS 2019 Federal Employee Program medical record request requirements

PharmacyCommercialJanuary 31, 2019

Pharmacy information available on empireblue.com

PharmacyCommercialJanuary 31, 2019

Clinical criteria updates for specialty pharmacy

PharmacyCommercialJanuary 31, 2019

Empire expands specialty pharmacy prior authorization list

State & Federal

State & FederalMedicaidJanuary 31, 2019

Diabetes Coding

State & FederalMedicaidJanuary 31, 2019

New specialty pharmacy medical step therapy requirements

State & FederalMedicare AdvantageJanuary 31, 2019

Keep up with Medicare news

State & FederalMedicare AdvantageJanuary 31, 2019

New specialty Medicare Part B device preferred product program

State & FederalMedicare AdvantageJanuary 31, 2019

Empire eye refraction and routine eye exam billing information

State & FederalMedicare AdvantageJanuary 31, 2019

Use grouped CPT codes for AIM Specialty Health authorizations

State & FederalMedicare AdvantageJanuary 31, 2019

Reminder - Empire follows Original Medicare policies