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Provider Alerts - Claims & Billing - Coronavirus (COVID-19) - Telehealth - Policy, Billing, or Coverage Update - 2022
Coronavirus: Telehealth Policies FAQ

Did you know that providers need to be approved by Healthfirst to continue qualifying for reimbursement of telehealth services? Access our FAQs to learn more.

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COVID-19
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2021
Drug Testing Policy

Healthfirst aims to ensure that our policy standards are up to date and are compliant with state and national industry standards. Effective February 1, 2021, Healthfirst has limited the reimbursement of drug testing as outlined in this document.

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Reimbursement
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2024
Reimbursement Policy: PO-RE-041 Serum Tumor Markers for Malignancies

Tumor biomarkers are proteins detected in the blood, urine, or other body fluids that are either produced by the tumor itself or in response to its presence.

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Reimbursement Policy
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2020
Newborn Hearing Screening; Lost to Documented Follow-Up Considerations for the Medical Home
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Children & Family
  
Coding - Practice Guidelines and Tips - 2020
HCC Coding, Risk Adjustment, and Physician Income
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General ICD-10/ICD-11 Information
  
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
  
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