CommercialOctober 1, 2020
October 2020 Empire Provider News
Administrative
CommercialSeptember 30, 2020
Keep up with important news from Empire and receive notifications by emailCommercialSeptember 30, 2020
New Digital Provider Enrollment tool added to Availity for New YorkCommercialSeptember 30, 2020
New Blue HPN® network included in plans available for employee open enrollment Fall 2020CommercialSeptember 30, 2020
Charges for Personal Protective Equipment by Participating ProvidersCommercialSeptember 30, 2020
Electronic member ID cards available on the Availity PortalCommercialSeptember 30, 2020
Empire Chat: A fast, easy way to have your questions answeredCommercialSeptember 30, 2020
Interactive Care Reviewer adds outpatient medical authorization requests for Empire local, State and City plansCommercialSeptember 30, 2020
Request referrals for Empire Individual Network Plan through Interactive Care ReviewerCommercialSeptember 30, 2020
New Medical Claim Attachment Webinars: Register TodayCommercialSeptember 30, 2020
National Accounts 2021 Pre-certification listCommercialSeptember 30, 2020
CRA Reporting Update: New guidance on telephone-only service CPT codes for Risk Adjustment ProgramCommercialSeptember 30, 2020
What Matters Most: Improving the Patient ExperiencePolicy Updates
CommercialSeptember 30, 2020
Clinical Criteria updates for specialty pharmacy are availableCommercialSeptember 30, 2020
Transition to AIM Rehabilitative Service Clinical Appropriateness GuidelinesCommercialSeptember 30, 2020
Reimbursement Policy Update: Emergency Department: Leveling of Evaluation and Management Services (Facility)CommercialSeptember 30, 2020
Reimbursement Policy Update: Laboratory and Venipuncture (Professional)Products & Programs
CommercialSeptember 30, 2020
Site of Care medical necessity reviews for a wide range of surgical procedures beginning January 1, 2021CommercialSeptember 30, 2020
REMINDER: Expansion of AIM Musculoskeletal Program Effective November 1, 2020CommercialSeptember 30, 2020
Federal Employee Program® Expands Specialty Pharmacy Prior Authorization ListCommercialSeptember 30, 2020
Empire updates formulary lists for commercial health plan pharmacy benefitCommercialSeptember 30, 2020
National Drug Code requirement on outpatient claimsCommercialSeptember 30, 2020
Prior authorization updates for specialty pharmacy are availableCommercialSeptember 30, 2020
Updated Coverage for Breast Cancer prevention medicationsCommercialSeptember 30, 2020
FDA approvals and expedited pathways used - New Molecular Entities (NMEs)CommercialSeptember 30, 2020
Pharmacy information available on empireblue.comState & Federal
MedicaidSeptember 30, 2020
Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinationsMedicaidSeptember 30, 2020
SOMOS to manage delegated functions effective October 1, 2020MedicaidSeptember 30, 2020
Prior authorization requirements for E0482MedicaidSeptember 30, 2020
Asthma controller medicationsMedicaidSeptember 30, 2020
Patient360 enhancement for medical providersMedicaidSeptember 30, 2020
Coding spotlight: providers guide to coding for behavioral health disordersMedicaidSeptember 30, 2020
Keep up with Medicaid newsMedicare AdvantageSeptember 30, 2020
Prior authorization requirements for the below codes (December 1, 2020)Medicare AdvantageSeptember 30, 2020
Prior authorization requirements for the below codes (January 1, 2021)Medicare AdvantageSeptember 30, 2020
Patient360 enhancement for medical providersMedicare AdvantageSeptember 30, 2020
Social determinants of health support expanding with GroundGame HealthMedicare AdvantageSeptember 30, 2020
Evaluation and management services correct codingMedicare AdvantageSeptember 30, 2020
Provider transparency updateMedicare AdvantageSeptember 30, 2020
Medical drug benefit Clinical Criteria updatesMedicare AdvantageSeptember 30, 2020
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