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Provider Forms - Form - 2025
Provider Attestation for OTC Plus Special Supplemental Benefits

Submit this form so your patient can use their OTC benefits for food and utilities.

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Forms
  
Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Diabetes Mellitus

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst—specifically for Diabetes Mellitus.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Pulmonary Fibrosis

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst —specifically for common types of Pulmonary Fibrosis.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Chronic Obstructive Pulmonary Disease

This tip sheet is intended to assist providers and coding staff with the documentation and on services submitted to Healthfirst—specifically for Chronic Obstructive Pulmonary Disease (COPD).

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Breast Cancer

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst —specifically for breast cancer.

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Clinical Documentation Improvement
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-150 Cardiac Event Detection - External Mobile Telemetry

This reimbursement policy outlines the guidelines for Mobile Cardiac Telemetry (MCT), a critical service for monitoring cardiac activity in patients with suspected or paroxysmal dysrhythmias.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-078 Telemedicine

This policy outlines the guidelines for telemedicine and telehealth services eligible for reimbursement by Healthfirst.

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Reimbursement Policy
  
Coding - Video - 2024
Video - Documentation and Coding of Breast Cancer

This 5-minute video offers guidance on proper clinical documentation and coding of breast cancer

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Clinical Documentation Improvement
Video
  
Provider Forms - Form - 2025
Podiatry and Peripheral Vascular Disease Prior Authorization Request

Use this form when requesting prior authorization of Podiatry and Peripheral Vascular Disease services for Healthfirst members

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Forms
  
Provider Forms - Form - 2025
Outpatient Physical Therapy, Occupational Therapy, and Speech Therapy Prior Authorization Request

Use this form when requesting prior authorization of physical, occupational, or speech therapy services for Healthfirst members.

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Forms
  
Provider Forms - Form - 2025
Children and Family Treatment Support Services (CFTSS) Continuing Authorization Request Form

Healthfirst is requesting concurrent review at the fourth visit for Community Psychiatric Supports & Treatment (CPST) and Psychosocial Rehabilitation (PSR). The CFTSS provider should complete this form when requesting continuation of services and submit the current CFTSS Treatment Plan, if available.

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Forms
  
Provider Forms - Form - 2025
Children's HCBS Authorization and Care Manager Notification Form

The Children’s Waiver HCBS Provider must complete this form for Children’s Waiver HCBS beyond the initial service period of 24 hours/96 units/60 days.

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Forms
  
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