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Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2024
Reimbursement Policy: PO-RE-080 Colorectal Cancer Screening

Colorectal cancer (CRC) is the term used to describe the development of cancer in the colon or the rectum.

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Reimbursement Policy
  
Coding - Practice Guidelines and Tips - 2020
CDC - Classification of Diseases, Functioning and Disability

WHAT TO KNOW: The International Classification of Diseases, Tenth Revision (ICD-10) is a worldwide system. ICD-10 is used to code and classify disease, injury, and death information. It is made up of several coding systems that standardize medical data.

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General ICD-10/ICD-11 Information
  
Provider Alerts - Practice Guidelines and Tips - 2024
Availity Essentials™: Healthfirst’s New Provider Portal Launching July 2024

We are excited to announce that Healthfirst is transitioning to Availity Essentials as our new secure provider portal platform. This transition represents our commitment to continually improving our services and enhancing your overall experience with Healthfirst.

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Administration
  
Provider Alerts - Practice Guidelines and Tips - 2024
Availity Essentials™: Provider Portal Transition FAQ

Starting July 2024, Healthfirst will begin launching our new Provider Portal through Availity Essentials. To ensure a smooth transition, we will continue to update our Frequently Asked Questions (FAQ) document to help you understand how this change will affect you and your practice.

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Administration
  
Diabetes & Prediabetes Care for Your Patients - General Update - 2023
Healthfirst Cares powered by Welldoc® App Provider Alert

Healthfirst, in collaboration with Welldoc, has developed the Healthfirst Cares powered by Welldoc App. The app is completely free and available to all Healthfirst members ages 18 and older with a diagnosis of Type 2 Diabetes. The Healthfirst Cares App delivers personalized, real-time feedback and self-management tips to help patients track their diabetes, while sharing crucial health data and insights with their provider care teams. This alert toplines valuable insights on the member and provider benefits of using the Healthfirst Cares App.

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HF Cares
  
Diabetes & Prediabetes Care for Your Patients - General Update - 2023
Healthfirst Cares powered by Welldoc® App FAQs

View this document to see answers to some of the most frequently asked questions about the Healthfirst Cares powered by Welldoc App for diabetes self-management and prevention.

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HF Cares
  
Diabetes & Prediabetes Care for Your Patients - Practice Guidelines and Tips - 2023
Healthfirst Cares Powered by Welldoc App Patient Referral Form

Providers can use the Healthfirst Cares Powered by Welldoc App Referral Form to refer any Healthfirst member who may benefit from the app’s diabetes and prediabetes self-management tips tools and program resources. Completed forms should be submitted via email to: welldocreferrals@healthfirst.org. Please contact your Network Account Manager with questions.

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HF Cares
  
Diabetes & Prediabetes Care for Your Patients - Practice Guidelines and Tips - 2023
Healthfirst Cares powered by Welldoc® App SMART Visit Report

The Healthfirst Cares powered by Welldoc App SMART Visit Report (SVR) is a comprehensive report that consolidates patient-generated data to show self-management patterns and trends over time. View this document for tips to use the SVR.

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HF Cares
  
Diabetes & Prediabetes Care for Your Patients - General Update - 2023
Introduction to the Healthfirst Cares powered by Welldoc® App Provider Capabilities Overview

The Capabilities Overview document provides an in depth look at the many self-management features and benefits of the Healthfirst Cares powered by Welldoc App including: Personalized Digital Coaching, Personalized Reports, Clinically Based Education, Nutritional Guidance, and more! The document also includes a QR Code to make it easy for your patients to scan and download the Healthfirst Cares App.

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HF Cares
  
Diabetes & Prediabetes Care for Your Patients - Practice Guidelines and Tips - 2023
Healthfirst Cares powered by Welldoc® App Prediabetes Provider Alert

Healthfirst, in collaboration with Welldoc, has developed the Healthfirst Cares powered by Welldoc® App. The app is completely free and available to all Healthfirst members ages 18 and older diagnosed with prediabetes. The Healthfirst Cares App delivers personalized, real-time feedback and self-management tips to help patients track their prediabetes, while sharing crucial health data and insights with their provider care teams. This alert toplines valuable insights on the patient and provider benefits of the Healthfirst Cares App.

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HF Cares
  
Coding - Practice Guidelines and Tips - 2024
Medical Record Requests for the HHS-operated Risk Adjustment Data Validation (HHS-RADV) Audit

The current HHS-RADV audit pertains to services provided during the 2023 calendar year. The requesting entity has determined that one or more of your patients are included in the HHS-RADV audit sample for services rendered during 2023. Because 2023 HHS-RADV medical record review is time sensitive, your immediate attention to this request is appreciated.

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Risk Adjustment Data Validation Audit
  
Coding - Practice Guidelines and Tips - 2024
Documentation and Coding: Specified Heart Arrhythmia, CMS-HCC_V28 Model Updates

This tip sheet is intended to assist providers and coding staff with the documentation and ICD-10-CM selection, along with the Centers for Medicare & Medicaid Services (CMS) Hierarchical Condition Category (HCC) Version 28 Model Updates, specifically for common types of Specified Heart Arrhythmia.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
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