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Showing 13-24 of 671
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-034 Flow Cytometry

Flow cytometry is a technique for live cell analysis that measures optical light scattering features to determine physical characteristics.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-030 Salivary Hormone Testing

Testing of saliva has been proposed as a non-invasive method to measure free (unbound to carrier proteins) steroid hormones, including estrogen, progesterone, androgens, and cortisol, for diagnosis of hormonal imbalance and administration of individualized hormone replacement therapy

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-026 Prostate Specific Antigen (PSA) Testing

Prostate-specific antigen (PSA) is a glycoprotein that is produced by both normal and neoplastic prostate tissue.

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-025 Pediatric Preventive Screening

Preventive screening is a healthcare service with the goal of illness prevention and health management.

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-020 Onychomycosis Testing

Onychomycosis, also known as tinea unguium, is a fungal infection of the nail typically caused by pathogenic fungal dermatophytes, such as Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccossum; onychomycosis may also be caused by yeasts, including Candida parapsilosis and Candida guilliermondii, or non-dermatophyte molds, including Neoscytalidium dimidiatum, Onychocola canadensis, the Aspergillus species, Scopulariopsis species, Alternaria species, Acremonium species, and Fusarium species.

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-018 Diagnosis of Vaginitis

Vaginitis is defined as inflammation of the vagina with symptoms of discharge, itching, and discomfort often due to a disruption of the vaginal microflora.

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-011 Lyme Disease Testing

Lyme disease is a common multisystem inflammatory disease caused by spirochetes of the family Borreliaceae transmitted through the bite of an infected tick of the genus Ixodes.

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-008 Venous and Arterial Thrombosis Risk Testing

A thrombosis, also known as a blood clot, occurs within blood vessels in the body.

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-002 Thyroid Disease Testing

Thyroid hormones are necessary for both prenatal and postnatal development, as well as metabolic activity in adults.

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Reimbursement Policy
  
Provider Alerts - Pharmacy Resources & Formularies - Claims & Billing - Policy, Billing, or Coverage Update - 2025
New Physician Dispenser Policy

New York State Department of Health has requested that Healthfirst notify practitioners of this change and inform them that they will need to bill claims through the Medical benefit after September 1, 2022, to be reimbursed.

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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-144 Advanced Primary Care Management (APCM) Services

This reimbursement policy outlines the guidelines and procedures for billing and reimbursement of Advanced Primary Care Management (APCM) services.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-141 Interprofessional Consultation for Behavioral Health Services

This reimbursement policy outlines the guidelines for billing and reimbursement of interprofessional consultations in behavioral health services as established by the Centers for Medicare & Medicaid Services (CMS) starting in 2025.

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Reimbursement Policy
  
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