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Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2021
Drug Testing Policy

Healthfirst aims to ensure that our policy standards are up to date and are compliant with state and national industry standards. Effective February 1, 2021, Healthfirst has limited the reimbursement of drug testing as outlined in this document.

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Reimbursement
  
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.

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Behavioral Health
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2024
Medicare Coverage Billing Guidance for Intensive Outpatient Programs

As of Jan. 1, 2024, Medicare now covers Intensive Outpatient Services. Learn more about the program and billing requirements here.

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Behavioral Health and Mental Health
Reimbursement
Medicare
  
Provider Alerts - Practice Guidelines and Tips - 2024
Availity Essentials™: Healthfirst’s New Provider Portal Launching July 2024

We are excited to announce that Healthfirst is transitioning to Availity Essentials as our new secure provider portal platform. This transition represents our commitment to continually improving our services and enhancing your overall experience with Healthfirst.

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Administration
  
Provider Alerts - Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023
Provider-Identified Overpayments

If a provider determines that Healthfirst has overpaid a claim, the provider shall, within 60 days of discovery, send a refund check made out to Healthfirst PHSP, Inc. in the amount of the overpayment. View the provider alert for details.

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Reimbursement
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Patient Renewal Email

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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Recertification
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Patient Renewal Reminder

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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Recertification
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Patient Renewal Letter

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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Recertification
  
Provider Alerts - Practice Guidelines and Tips - 2023
The Importance of Recertifications to Your Patients

New York State requires annual eligibility reviews and renewals for members enrolled in the following health insurance plans: - Medicaid - Essential Plan - Child Health Plus - Personal Wellness Plan (HARP) - Medicare Advantage plans with Medicaid or Medicare Savings Program - Managed Long-Term Care

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Recertification
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Waiting Room Material in Spanish

A helpful flyer that explains recertification to your Healthfirst patients. Print copies and leave them in the waiting room to help your Healthfirst patients navigate the renewal process.

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Recertification
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Waiting Room Material in English

A helpful flyer that explains recertification to your Healthfirst patients. Print copies and leave them in the waiting room to help your Healthfirst patients navigate the renewal process.

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Recertification
  
Provider Alerts - Provider Resources - 2023
Recertification 101 for Healthfirst Providers (slides)

Learn how your practice can identify Healthfirst members eligible for recertification.

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Recertification