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Provider Alerts - Practice Guidelines and Tips - 2023
Provider Credentialing

This Provider Alert announces Healthfirst's new partnership with Andros, an industry leading, NCQA-Certified, CVO (Credentials Verification Organization), effective October 1, 2023.

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Credentialing
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2023
Provider Alert - Cost Sharing for Medicare Part B Drugs

Details regarding cost sharing policy changes due to the Inflation Reduction Act.

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Cost Sharing
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2023
Healthfirst to Manage Some Outpatient Authorization Requests Formerly Handled by OrthoNet

Effective Jan. 1, 2024, Healthfirst will resume responsibility for management of prior authorization (PA) requests for all Physical, Occupational, and Speech Therapies; Podiatry Services, and Vascular Surgery. This Provider Alert will help you understand how this change might affect you...

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Prior Authorization
  
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.

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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.

Open document
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
  
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