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Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2025
Prior Authorization Guidelines for Select Remote Patient and Remote Therapeutic Monitoring Services

Prior Authorization Guidelines for Select Remote Patient (RPM) and Remote Therapeutic Monitoring (RTM) Services Effective September 1, 2025

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Reimbursement
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Administration
Authorization
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2025
OIG Targeted High Risk Condition Series Session 1

OIG Targeted High Risk Condition Series Session 1: Heart Failure, Chronic Kidney Disease (CKD), Hypertension (HTN) (February 6, 2025)

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2025
OIG Targeted High Risk Condition Series, Session 2

OIG Targeted High Risk Condition Series, Session 2: Heart Failure, AFIB, Angina - Part 2 (March 6, 2025)

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2025
OIG Targeted High Risk Condition Series, Session 3

Book for OIG Targeted High Risk Condition Series, Session 3: Major Depression Disorder, Anorexia & Bulimia (April 3, 2025)

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2025
OIG Targeted High Risk Condition Series, Session 4

Book for OIG Targeted High Risk Condition Series, Session 4: Pulmonary Embolism (PE) and Deep Vein Thrombosis (DVT), Hepatitis & Cirrhosis (May 1, 2025)

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2025
Agenda and Faculty Bios booklet - 2025 Spring Provider Symposium

Agenda and Faculty bios booklet for May 16, 2025, Spring Provider Symposium - Evolving Models of Care: Transforming Patient Care Through Lifestyle Management

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2025
Keynote Speaker and Panel 1 booklet - 2025 Spring Provider Symposium

Keynote Speaker and Panel 1 booklet for May 16, 2025, Spring Provider Symposium - Evolving Models of Care: Transforming Patient Care Through Lifestyle Management

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2025
Panel 2 booklet - 2025 Spring Provider Symposium

Panel 2 booklet for May 16, 2025, Spring Provider Symposium - Evolving Models of Care: Transforming Patient Care Through Lifestyle Management

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Provider Events
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-142 Home Sleep Test (HST)

A Home Sleep Test (HST) is designed to help diagnose sleep disordered breathing conditions in a home-setting.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2024
Reimbursement Policy: PO-RE-113 Doula Services

Effective January 1, 2025, Healthfirst will provide coverage of Doula Services provided in accordance with 42 CFR section 440.130(c). This policy outlines Healthfirst guidelines for the reimbursement of Doula Services.

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Reimbursement Policy
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2025
Authorization Requirements for Additional Physical and Occupational Therapy Visits for New Conditions or Body Parts

Providers are reminded that when submitting an authorization request for an existing patient to treat a new condition or body part, the submission will be considered a new prior authorization request.

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Administration
Authorization
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2025
Reimbursement Policy: PO-RE-074 Remote Patient Monitoring and Remote Therapeutic Monitoring

The purpose of this policy is to outline the reimbursement guidelines for Remote Patient Monitoring (RPM) services and Remote Therapeutic Monitoring (RTM) services offered by Healthfirst.

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Reimbursement Policy
  
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