CommercialJanuary 1, 2021

January 2021 Empire Provider News

Administrative

AdministrativeCommercialDecember 31, 2020

It is almost CAHPS survey time

AdministrativeCommercialDecember 31, 2020

Outpatient system updates for 2021 (Facility)

AdministrativeCommercialDecember 31, 2020

Professional system updates for 2021

AdministrativeCommercialDecember 31, 2020

New features added to Interactive Care Reviewer

AdministrativeCommercialDecember 31, 2020

Self-service, digital transactions are fast and easy

AdministrativeCommercialDecember 31, 2020

Find out in seconds why your claim denied

AdministrativeCommercialDecember 31, 2020

Empire's new digital online scheduling feature is now available

Policy Updates

Medical Policy & Clinical GuidelinesCommercialDecember 31, 2020

Medical Policy updates
Material Adverse Change (MAC) Notification

Medical Policy & Clinical GuidelinesCommercialDecember 31, 2020

MCG Care Guidelines 24th edition customization
Material Adverse Change (MAC) Notification

Reimbursement PoliciesCommercialDecember 31, 2020

Guidelines for reporting timed units for Physical Medicine and Rehabilitation (Professional)
Material Adverse Change (MAC) Notification

Reimbursement PoliciesCommercialDecember 31, 2020

Evaluation and Management changes 2021

Reimbursement PoliciesCommercialDecember 31, 2020

Unit Frequency Maximum for Drugs and Biologicals (Professional)
Material Adverse Change (MAC) Notification

Reimbursement PoliciesCommercialDecember 31, 2020

Modifier Rules (Professional)
Material Adverse Change (MAC) Notification

Reimbursement PoliciesCommercialDecember 31, 2020

Frequency Editing (Professional)
Material Adverse Change (MAC) Notification

Reimbursement PoliciesCommercialDecember 31, 2020

Multiple Diagnostic Imaging procedures (Professional)
Material Adverse Change (MAC) Notification

Products & Programs

Federal Employee Program (FEP)CommercialDecember 31, 2020

2021 FEP® Benefit information available online

PharmacyCommercialDecember 31, 2020

IngenioRx introduces new pharmacy network in 2021

PharmacyCommercialDecember 31, 2020

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

PharmacyCommercialDecember 31, 2020

Prior Authorization updates for specialty pharmacy are available
Material Adverse Change (MAC) Notification

State & Federal

State & FederalMedicare AdvantageDecember 31, 2020

Keep up with Medicare news

State & FederalMedicare AdvantageDecember 31, 2020

2020 Medicare risk adjustment provider trainings

State & FederalMedicare AdvantageDecember 31, 2020

Medical drug benefit Clinical Criteria updates

State & FederalMedicare AdvantageDecember 31, 2020

Updates to AIM Clinical Appropriateness Guidelines for Advanced Imaging

State & FederalMedicaidDecember 31, 2020

Keep up with Medicaid news

State & FederalMedicaidDecember 31, 2020

Disease Management/Population Health program

State & FederalMedicaidDecember 31, 2020

Coding spotlight: HEDIS MY 2021

State & FederalMedicaidDecember 31, 2020

Medical drug benefit Clinical Criteria updates