Healthfirst Provider Toolkit: Patient Recertification
Easy as 1-2-3
This recertification toolkit includes educational resources for your practice and easy-to-use guides to help you inform your patients on how to maintain their access to healthcare.
Availity Essentials Update
Availity Essentials is Healthfirst's New Provider Portal
Access Healthfirst tools through Availity Essentials, our new provider portal designed to help make your work with us easier.
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What's New
View allPrior Authorization No Longer Required for Antiretroviral Prescription Medications
Healthfirst has removed prior authorization requirements from all antiretroviral medications prescribed for the treatment or prevention of Human Immunodeficiency Virus (HIV) or Acquired Immunodeficiency Syndrome (AIDS) for all Healthfirst plans.
View postCrisis Residence and Mobile Crisis Services Now Covered for Healthfirst Essential Plan, Leaf, and Leaf Premier Members
Starting January 1, 2025, Healthfirst will cover Crisis Residence Services and Mobile Crisis Services for our Essential Plan (EP), Leaf & Leaf Premier Plan members (also known as our Qualified Health Plans).
View postChanges to the Special Enrollment Period for Dual-Eligible and Low-Income Subsidy Recipients Beginning in 2025
The 2025 Centers for Medicare & Medicaid Services (CMS) Medicare Advantage and Part D Final Rule includes several changes to enrollment for our dual-eligible and Low-Income Subsidy (LIS) members. Learn more about the changes impacting our members...
View postTwo Additional Prior Authorization Codes Managed by EyeMed Effective Jan. 1, 2025
EyeMed manages Healthfirst’s prior authorization for surgical and therapeutic vision services as well as network management, related member and provider service calls, and claims payment for routine vision and medical optometry services.
View postMedications Requiring Prior Authorization Under the Medical Benefit
Ensure you remain current on the most recent changes
View postProvider Education Events - new events added
Together, we can improve patient outcomes. Join us at a provider education workshop, training, or event.
View postFoster Care Provider Education Letter
This updated provider education letter outlines key guidance providers should be mindful of when delivering care to Medicaid enrolled children/youth in direct placement foster care and in the care of Voluntary Foster Care Agencies.
View postDocumentation and Coding Updates
We're committed to helping providers and clinical coders with the accurate coding of patients’ health records.
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Provider Resources
Provider Alerts
Coding
Plans & Benefits
