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Claims & Billing - Form - 2020
Waiver of Liability Form 2020
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Documentation
  
Education Events & Patient Care Resources - Video - 2020
Pillars of Wellness for New Yorkers Seeking Longevity & Quality During COVID–19 (Video)

Healthfirst’s semiannual Provider Symposium, held on November 13, 2020, offered a unique opportunity for experts from healthcare delivery, public health, and the community to share prevention-based initiatives in the health delivery system for vulnerable patients. Featured speakers highlighted early successes in engaging Healthfirst members, practices, and communities in innovative programs that address the health trajectory of New Yorkers.

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Provider Events
  
Coding - Practice Guidelines and Tips - 2021
Documentation and Coding: Benign Brain Neoplasm

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 benign brain neoplasm.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2021
Documentation and Coding: Rheumatoid Arthritis

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 rheumatoid arthritis.

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Clinical Documentation Improvement
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Alcohol and Drug Related Disorders, 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, on services submitted to Healthfirst—specifically for common types of alcohol- and drug-related disorders.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Pulmonary Embolism, 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, on services submitted to Healthfirst—specifically for Pulmonary Embolism.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Provider Alerts - Behavioral Health and Foster Care - Practice Guidelines and Tips - 2023
Cultural Competency Training for Participating Providers

New York State Department of Health requires providers and their office staff who have regular and substantial contact with Healthfirst members certify annually the completion of Cultural Competency Training.

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Behavioral Health
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Fractures, 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, on services submitted to Healthfirst—specifically for fractures.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2024
Reimbursement Policy: PO-RE-004 Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing

Parathyroid hormone (PTH), along with calcitriol and fibroblast growth factor 23 (FGF23), regulate calcium and phosphate homeostasis.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2024
Reimbursement Policy: PO-RE-007 Intracellular Micronutrient Analysis

Micronutrients are dietary components, often referred to as vitamins and minerals, which although only required by the body in small amounts, are vital to development, disease prevention, and wellbeing.

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2024
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 (Barbour, 2022).

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Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2024
Reimbursement Policy: PO-RE-019 Human Immunodeficiency Virus (HIV)

Human immunodeficiency virus (HIV) is an RNA retrovirus that infects human immune cells, specifically CD4 cells, causing progressive deterioration of the immune system ultimately leading to acquired immune deficiency syndrome (AIDS) characterized by susceptibility to opportunistic infections and HIV-related cancers (CDC, 2014). HIV-1 is the dominant subtype of HIV infection, but another subtype, HIV-2, is a crucial subtype in certain areas of the world, such as Western Africa (Wood, 2023).

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Reimbursement Policy
  
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