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Provider Alerts - Policy, Billing, or Coverage Update - 2023
Provider Alert: Prohibiting Copays at OTP Facilities (1205 23)

Effective Jan. 1, 2023, New York law (S.5690/A.372) prohibits commercial health insurance plans from imposing copayments and coinsurance for treatment delivered at an Opioid Treatment Program (OTP). This impacts Qualified Health Plan (QHP), commercial, and Essential Plan products

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QHP
  
Provider Alerts - Behavioral Health and Foster Care - Practice Guidelines and Tips - 2023
Behavioral Health Utilization Review Implementation

In response to a requirement by the New York State Office of Mental Health (OMH), Healthfirst has implemented a new, trigger-based approach to utilization review (UR) for certain acute mental health services (MH) for all of our health plans, except for Medicare Advantage plans.

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Behavioral Health
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Patient Renewal Email (Chinese)

This email text explains recertification to your Healthfirst patients. You can copy and paste it into your practice’s patient emails.

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Documentation
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Patient Renewal Reminder (Spanish)

This short note explains recertification to your Healthfirst patients. You can copy and paste the text into your practice’s patient communications such as patient billing statements, paperwork, and more.

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Documentation
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Patient Renewal Reminder (Chinese)

This short note explains recertification to your Healthfirst patients. You can copy and paste the text into your practice’s patient communications such as patient billing statements, paperwork, and more.

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Documentation
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Patient Renewal Letter (Spanish)

An easy-to-read letter that explains recertification to your Healthfirst patients. You can copy and paste it into your patient mailings.

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Documentation
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Patient Renewal Letter (Chinese)

An easy-to-read letter that explains recertification to your Healthfirst patients. You can copy and paste it into your patient mailings.

Open document
Documentation
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Patient Renewal Email (Spanish)

This email text explains recertification to your Healthfirst patients. You can copy and paste it into your practice’s patient emails.

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Documentation
  
Provider Alerts - Pharmacy Resources & Formularies - Practice Guidelines and Tips - 2023
Obtaining Physician-Administered Drugs through a Specialty Pharmacy

As a Healthfirst provider, you can get Physician-Administered Drugs (PADs) delivered to your office at no cost through White Bagging when the medication is obtained from a Healthfirst in-network specialty pharmacy provider.

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Pharmacy
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2023
Medical Nutrition Therapy Added to the Article 29-I VFCA Health Facilities

In accordance with the approved Medicaid State Plan Amendment: Medical Nutrition Therapy (MNT) has been added to the Article 29-I VFCA Health Facilities (29-I) Other Limited Health Related Services (OLHRS) Fee Schedule. View for more details.

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Billing
  
Provider Alerts - Claims & Billing - Provider Resources - 2023
Pharmacist-Administered Human Papillomavirus (HPV) Vaccine Now Available to Healthfirst Patients Aged 18+

New York law has expanded the types of immunizations licensed pharmacists can administer to patients 18 years or older, including the HPV vaccine.

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Vaccines
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2024
Medicare now covers more family and mental health counseling services

As of January 1, 2024, Medicare covers marriage and family therapy (MFT), mental health counseling (MHC), and intensive outpatient program (IOP) services for all Healthfirst Medicare plans.

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Medicare
  
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