HF Logo HF Logo Provider Portal Login
Provider Home

Search

Resource Type
Clear All
Filter
Year
Sort By
Showing 361-372 of 774
Provider Alerts - General Update - 2024
Healthfirst Availity Clearinghouse Update

Review our Frequently Asked Questions (FAQ) resource dedicated to the Availity Clearinghouse release on March 1st, 2024. We recognize that navigating through new processes and procedures can pose challenges, which is why we've curated this comprehensive list of frequently asked questions to provide you with assistance.

Open document
Availity
  
Provider Alerts - Policy, Billing, or Coverage Update - 2024
Expanded Spinal Muscular Atrophy (SMA) Carrier Screening

New York State (NYS) Medicaid has provided coverage for Spinal Muscular Atrophy (SMA) carrier screening since 2014. However, effective October 1, 2023, the coverage criteria for SMA carrier screening has been expanded to all NYS Medicaid members who are planning to become, or already are pregnant.

Open document
Preventive Measures
  
Provider Alerts - Policy, Billing, or Coverage Update - 2024
Healthfirst CompleteCare and Senior Health Partners Changes to Non-Emergency Transportation Benefits

Healthfirst CompleteCare (HMO D-SNP) and Senior Health Partners (SHP) Changes to Non-Emergency Transportation Benefits, Effective March 1, 2024. Services now available through NYS Medical Answering Services (MAS).

Open document
Healthfirst Plans
  
Compliance, Regulatory & Policies - Provider Resources - 2024
The End of the Public Health Emergency, Part 4

The federal Public Health Emergency (PHE) related to the COVID‑19 pandemic ended on May 11, 2023. In this resource, you will find the latest PHE policy and procedure updates that may affect Healthfirst participating providers.

Open document
Administration
  
Provider Alerts - Claims & Billing - Practice Guidelines and Tips - 2024
New Prior Authorization Guidelines for Select Services effective July 1, 2024

Effective July 1, 2024, Healthfirst will change its authorization guidelines for select services on the CMS code list. As of that date, the services requiring prior authorization will include laboratory services (managed through eviCore). See the Provider Alert for a list of codes that will now require prior authorization.

Open document
Authorization
  
Documentation & Coding - Practice Guidelines and Tips - 2024
Documentation and Coding: Compression of Brain, 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 Compression of Brain (non-Traumatic).

Open document
Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2024
New Effective Date for Acupuncture, Occupational Therapy, Physical Therapy, and Speech Therapy Standard Fee Schedule Rates

The effective date for these changes has been delayed from April 1, 2024, to June 1, 2024.

Open document
Reimbursement
  
Provider Alerts - Provider Resources - 2024
Announcing Essential Plan 200–250

Healthfirst is excited to announce our newest benefit plan, Essential Plan 200–250, launching on April 1, 2024. This new plan is part of New York State’s continued efforts to improve health insurance affordability and accessibility. Healthfirst is proud to be the only 5-star-rated Essential Plan in New York State.

Open document
Healthfirst Plans
  
Documentation & Coding - Practice Guidelines and Tips - 2024
Documentation and Coding: Aspiration Pneumonia, 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 types of Aspiration Pneumonia.

Open document
Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2024
Reimbursement Policy: PO-RE-096 New Physician Dispenser

Effective September 1, 2022, Medicaid pharmacy claims submitted from a physician dispenser will be rejected by Healthfirst’s pharmacy benefit manager, CVS Caremark.

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2024
Reimbursement Policy: PO-RE-097 Nurse Practitioners and Physician Assistants

Effective April 1, 2019, Healthfirst will implement changes to its reimbursement policy for nurse practitioners (NPs) and physician assistants (PAs) to better align with existing Centers for Medicare & Medicaid Services (CMS) reimbursement policies regarding these types of physician extenders.

Open document
Reimbursement Policy
  
Documentation & Coding - Practice Guidelines and Tips - 2024
Documentation and Coding: Hepatic Encephalopathy, 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 Hepatic Encephalopathy.

Open document
Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
You are now navigating away from the Healthfirst website.

Links to non-Healthfirst websites are provided for your convenience only. Healthfirst is not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.