Provider Alerts

Check out the latest provider alerts and updates from Healthfirst

Documentation & Coding

Review documentation and coding tips, ICD-10 and ICD-11 resources, and other documentation and coding information.

Education Events & Patient Care Resources

See our calendar of provider education events and view previously recorded sessions. This section also has resources to help your patients improve their health.

Compliance, Regulatory & Policies

Healthfirst promotes a culture of compliance and is committed to maintaining an ethical work environment for all of our employees, members, providers, and vendors.

Pharmacy Resources & Formularies

Find the most updated formulary and medical and pharmacy benefit information here. Tips and resources for pharmacies are also available.

Claims & Billing

Learn more below about how to enroll for claims processing, submit claims electronically, and more. Whether you’re a provider or in-office staff, you’ll also find everything you need on billing and reimbursement right here.

Behavioral Health and Foster Care

Use these resources to find out more about billing, authorization guidelines, and Home and Community Based Services (HCBS) training available to you and your practice.

Plans & Benefits

Access this section for information on Healthfirst plans and benefits.

Provider Forms

Access this section to find forms most frequently used by Healthfirst providers.

Quality Program Resources

Information and resources to help you with your participation in the Healthfirst Quality Incentive Program (HQIP) and federal and state quality incentive programs such as CAHPS, HEDIS, and QARR, are available here.

Telehealth

The transition to telehealth can be challenging. Visit this section for billing, coding, best practices, and other great resources on telehealth.

Coronavirus (COVID-19)

Visit this section and stay current on the latest guidance in billing, telehealth and more as it relates to COVID-19.