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Provider Alerts - Policy, Billing, or Coverage Update - 2020
Healthfirst Reimbursement Policies for Nurse Practitioners and Physician Assistants
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Reimbursement
  
Provider Alerts - Policy, Billing, or Coverage Update - 2020
Healthfirst Reimbursement Policy for Elective Deliveries
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Reimbursement
  
Provider Alerts - Policy, Billing, or Coverage Update - 2020
New Prior Authorization Requirement for Select Pathology Codes
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Authorization
  
Provider Alerts - Practice Guidelines and Tips - 2020
Coding for Risk Adjustment

Create January 2019

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Clinical Documentation Improvement
  
Provider Alerts - Practice Guidelines and Tips - 2020
Documentation and Coding Tips: Cancer

Created December 2019

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Clinical Documentation Improvement
  
Provider Alerts - Practice Guidelines and Tips - 2020
Documentation and Coding Tips: Stroke

Created December 2019

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Clinical Documentation Improvement
  
Provider Alerts - Practice Guidelines and Tips - 2020
Documentation and Coding Tips: Myocardial Infarction

Created December 2019

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Clinical Documentation Improvement
  
Provider Alerts - Practice Guidelines and Tips - 2022
Acceptable Codes for Chlamydia Screening

Created December 2019

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Clinical Documentation Improvement
  
Provider Alerts - Policy, Billing, or Coverage Update - 2022
Healthfirst Reimbursement of Developmental Screening in Primary Care

Effective April 1, 2022, Healthfirst will begin to reimburse Developmental Screening (CPT 96110) in primary care as per New York State Medicaid guidance.

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Reimbursement
  
Provider Alerts - Policy, Billing, or Coverage Update - 2022
Prior Authorization Waiver Expiration: Post-Acute Discharge

Effective December 31, 2021, Healthfirst has waived authorization requirements for transfers or discharges from an acute inpatient facility to another acute inpatient facility, a skilled nursing facility (SNF), acute rehabilitation facility (AR), or long-term acute care hospital (LTACH).

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Prior Authorization
  
Provider Alerts - Policy, Billing, or Coverage Update - 2022
1713 22 Provider Alert Pharmacy Exceptions Guidance v3 Final WR

Details of the two exceptions to the New York State (NYS) Medicaid program's provider enrollment requirements allowed under the Medicaid Provider Enrollment Compendium (MPEC).

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Provider Enrollment
  
Provider Alerts - Policy, Billing, or Coverage Update - 2023
Inflation Reduction Act Impacts Cost Sharing for Medicare Part B Drugs

Beginning April 1, 2023, cost sharing for Medicare Part B Drugs will be impacted in accordance with §11101 and §11407 of the Inflation Reduction Act (IRA, P.L. 117-169)*

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Quality and Compliance
  
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