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Showing 145-156 of 774
Documentation & Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Annual Wellness Visits, Initial Preventive Physical Examinations, and Problem Oriented Visit

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 distinguishing between Annual Wellness Visits (AWV), Initial Preventive Physical Examinations (IPPE), and Problem Oriented Visit.

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Clinical Documentation Improvement
  
Documentation & Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Cerebral Palsy

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 Cerebral Palsy.

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Clinical Documentation Improvement
  
Documentation & Coding - Video - 2026
Video - Documentation and Coding of Anorexia Nervosa and Bulimia Nervosa

This video offers guidance on proper clinical documentation and coding of Anorexia Nervosa and Bulimia Nervosa.

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Clinical Documentation Improvement
Video
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026
Reimbursement Policy: PO-RE-128 Part B Custodial Services-Skilled Therapy and Vaccine Services

This policy outlines the guidelines for the reimbursement of Skilled Therapy and Vaccine services provided under Medicare Part B for custodial Healthfirst Medicare members.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-134 Prenatal and Postpartum Services Cost-Sharing Waiver

Starting January 1, 2025, a new NY State of Health (NYSOH) program under New York’s Section 1332 waiver will enhance access and affordability for pregnant and postpartum Qualified Health Plan (QHP) members.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026
Reimbursement Policy: PO-RE-126 Diabetes Cost-sharing Waiver

This policy outlines Healthfirst’s reimbursement guidelines regarding the waiver of cost-sharing for Essential Plan (EP) and Qualified Health Plan (QHP) members diagnosed with Type 1, Type 2, or Gestational Diabetes.

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Reimbursement Policy
  
Provider Alerts - Claims & Billing - Practice Guidelines and Tips - 2026
Request a Continuous Glucose Monitoring Device for Healthfirst Medicare, Essential Plan, and Qualified Health Plan Members

Healthfirst members with Type 1 or Type 2 diabetes may qualify for a Continuous Glucose Monitoring (CGM) device if eligible. Available to Medicare, Essential Plan, and QHP members through an in-network DMEPOS provider, not a pharmacy.

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Administration
Healthfirst Plans
Authorization
Reimbursement
  
Documentation & Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Aneurysm

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 an Aneurysm.

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Clinical Documentation Improvement
  
Education Events & Patient Care Resources - Plans & Benefits - Practice Guidelines and Tips - 2026
2026 Special Needs Plan Model of Care Provider Training

This presentation will help educate providers, delegated vendors, and appropriate staff on the Healthfirst Special Needs Plan (SNP) Model of Care (MOC), the goal of which is to enhance member health outcomes through the use of an integrated care delivery system

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Administration
  
Education Events & Patient Care Resources - Plans & Benefits - Practice Guidelines and Tips - 2025
2025 Special Needs Plan Model of Care Provider Training

This presentation will help educate providers, delegated vendors, and appropriate staff on the Healthfirst Special Needs Plan (SNP) Model of Care (MOC), the goal of which is to enhance member health outcomes through the use of an integrated care delivery system.

Open external link
Administration
  
Documentation & Coding - Video - 2026
Video - Documentation and Coding of Myocardial Infarction

This video offers guidance on proper clinical documentation and coding of Myocardial Infarction.

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Clinical Documentation Improvement
Video
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026
Reimbursement Policy: PO-RE-162 Diagnostic Laboratory

This policy outlines Healthfirst's standards and requirements for the reimbursement of diagnostic laboratory services.

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Reimbursement Policy
  
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