HF Logo HF Logo
Resource Type
Clear All
Filter
Year
Sort By
Showing 1-12 of 113
Provider Alerts - General Update - 2024
Healthfirst Availity Clearinghouse Update

Review our Frequently Asked Questions (FAQ) resource dedicated to the Availity Clearinghouse release on March 1st, 2024. We recognize that navigating through new processes and procedures can pose challenges, which is why we've curated this comprehensive list of frequently asked questions to provide you with assistance.

Open document
Availity
  
Provider Alerts - Policy, Billing, or Coverage Update - 2024
Healthfirst CompleteCare and Senior Health Partners Changes to Non-Emergency Transportation Benefits

Healthfirst CompleteCare (HMO D-SNP) and Senior Health Partners (SHP) Changes to Non-Emergency Transportation Benefits, Effective March 1, 2024. Services now available through NYS Medical Answering Services (MAS).

Open document
Healthfirst Plans
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2024
Mobile Crisis and Crisis Residence Services: Important Updates and FAQs

New York State received federal approval to consolidate and align its Mobile Crisis and Crisis Residence services effective March 1, 2024.

Open document
Preventative Measures
  
Provider Alerts - Policy, Billing, or Coverage Update - 2024
Mobile Crisis and Crisis Residence Service Changes

To improve access to crisis care, New York State received federal approval to consolidate and align its Mobile Crisis and Crisis Residence services. These Crisis Intervention State Plan Amendment (SPA) changes will start March 1, 2024.

Open document
Preventative Measures
  
Provider Alerts - Practice Guidelines and Tips - 2023
Tips to Increase Colorectal Screenings

Remind patients to schedule their colorectal cancer screening which can help detect cancer in its earliest stages and improve screening rates. Review these tips.

Open document
HEDIS
  
Provider Alerts - Provider Resources - 2024
Instructions for Accessing Clinical Guidelines

Beginning Jan. 1, 2024, Healthfirst members and participating network providers may access clinical guidelines for prior authorization (PA) requests for all Medicare basic healthcare services.

Open document
Authorization
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2024
New York State Medicaid Guidance for Billing Respiratory Syncytial Virus (RSV) Vaccines

As of Oct. 1, 2023, New York State (NYS) Medicaid began reimbursing NYS Medicaid-enrolled providers for administration or dispensing of Respiratory Syncytial Virus (RSV) vaccines for adults and for the administration of nirsevimab for infants.

Open document
Billing
  
Provider Alerts - Behavioral Health and Foster Care - Practice Guidelines and Tips - 2023
Cultural Competency Training for Participating Providers

New York State Department of Health requires providers and their office staff who have regular and substantial contact with Healthfirst members certify annually the completion of Cultural Competency Training.

Open document
Behavioral Health
  
Provider Alerts - Compliance, Regulatory & Policies - Practice Guidelines and Tips - 2024
New State Requirements for Provider Compliance Programs

New York State has made changes to provider requirements for starting and maintaining compliance programs.

Open document
Quality and Compliance
  
Provider Alerts - Provider Resources - 2022
Healthfirst Connection Plan (HMO D-SNP) Announcement

Starting Jan. 1, 2024, Healthfirst will begin covering members in Healthfirst Connection Plan (HMO D-SNP), our newest Medicare Advantage Dual-Eligible Special Needs Plan. Read the Provider Alert for more details...

Open document
Connection Plan
  
Provider Alerts - Claims & Billing - Pharmacy Resources & Formularies - Plans & Benefits - Provider Resources - 2023
Inflation Reduction Act Changes to Member Inflation Reduction Act Changes to Member

Healthfirst would like to alert you to new requirements around the Inflation Reduction Act of 2022 (IRA) provisions applicable for 2023 regarding cost sharing for Part B and Part D drugs

Open document
Quality and Compliance
  
Provider Alerts - Plans & Benefits - Policy, Billing, or Coverage Update - 2023
Signature Medicare by Healthfirst - Out-of-Network Providers’ QRG

This Medicare Advantage plan offers additional benefits on top of Original Medicare, like dental, vision, hearing, and fitness. Members have the option of going in-network or out-of-network and visiting any doctor and hospital in the U.S. that accepts Medicare. Out-of-network providers may reference this QRG for more information.

Open document
Signature (PPO)