CommercialJuly 1, 2021
July 2021 Newsletter
Administrative
CommercialJune 30, 2021
Surgical Clinical Site of Care review updatesCommercialJune 30, 2021
Proper coding for in-home monitoring can make a measurable difference for INRCommercialJune 30, 2021
Another mark of the pandemic: an increase in childhood obesityCommercialJune 30, 2021
Timely receipt of primary payer’s EOB can help reduce timely filing denials for secondary claimsCommercialJune 30, 2021
Register now to learn strategies to help you and your practice improve clinical qualityCommercialJune 30, 2021
Commercial Repapering: Important updateCommercialJune 30, 2021
How to enroll in electronic fund transfer (EFT) for faster remittanceCommercialJune 30, 2021
Electronic claim response filesCommercialJune 30, 2021
Interactive Care Reviewer (ICR): New search option for cases submitted through ICRPolicy Updates
CommercialJune 30, 2021
Medical policy updates and clinical guideline updatesCommercialJune 30, 2021
New reimbursement policy: Non-patient Laboratory Services (Facility)CommercialJune 30, 2021
Reimbursement policy update: Consultations (Professional)Products & Programs
CommercialJune 30, 2021
Blue Precision program to be retired at the end of the yearCommercialJune 30, 2021
Update: Site of Care medical necessity reviews for long-acting colony-stimulating factors will not be implemented on August 1, 2021Material adverse change (MAC) notification
CommercialJune 30, 2021
AIM Rehabilitative program - initial evaluations and site of service reviewsCommercialJune 30, 2021
Federal Employee Program® AIM Radiology prior authorization reviewCommercialJune 30, 2021
Certain specialty medication precertification requests may require additional documentationCommercialJune 30, 2021
Clinical Criteria updates for specialty pharmacyCommercialJune 30, 2021
Updates for specialty pharmacy are effective October 1, 2021CommercialJune 30, 2021
Designated specialty pharmacy network updates effective October 1, 2021State & Federal
MedicaidJune 30, 2021
Attention facilities: Sending admission, discharge and transfer data to Empire results in improved care management for patientsMedicaidJune 30, 2021
Let’s VaccinateMedicaidJune 30, 2021
New reimbursement policy: Modifier 90: Reference (Outside) Laboratory and Pass-Through Billing (Effective 10/01/21)MedicaidJune 30, 2021
Prior authorization requirement changes effective September 1, 2021MedicaidJune 30, 2021
Certain specialty medication precertification requests may require additional documentationMedicaidJune 30, 2021
Medical drug benefit Clinical Criteria updatesMedicaidJune 30, 2021
Retraction: AIM Rehabilitative program — initial evaluations and site of service reviewsMedicaidJune 30, 2021
Updates to AIM Specialty Health Musculoskeletal program clinical appropriateness guidelinesMedicaidJune 30, 2021
Coding spotlight: mental disorders in childhoodMedicaidJune 30, 2021
What Matters Most: Improving the Patient ExperienceMedicaidJune 30, 2021
Resources to support your diverse patient panelMedicaidJune 30, 2021
Keep up with Medicaid newsMedicare AdvantageJune 30, 2021
Attention facilities: Sending admission, discharge and transfer data to Empire results in improved care management for patientsMedicare AdvantageJune 30, 2021
Let’s VaccinateMedicare AdvantageJune 30, 2021
New reimbursement policy: Modifier 90: Reference (Outside) Laboratory and Pass-Through Billing (Effective 10/01/21)Medicare AdvantageJune 30, 2021
Prior authorization requirement changes effective October 1, 2021, for codes A0426 and A0428Medicare AdvantageJune 30, 2021
Medical drug benefit Clinical Criteria updatesTo view this publication online:
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