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Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2023
Healthfirst to Manage Some Outpatient Authorization Requests Formerly Handled by OrthoNet

Effective Jan. 1, 2024, Healthfirst will resume responsibility for management of prior authorization (PA) requests for all Physical, Occupational, and Speech Therapies; Podiatry Services, and Vascular Surgery. This Provider Alert will help you understand how this change might affect you...

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Prior Authorization
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Rheumatoid Arthritis vs. Osteoarthritis

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 common types of rheumatoid arthritis and osteoarthritis.

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Clinical Documentation Improvement
  
Provider Alerts - Policy, Billing, or Coverage Update - 2023
Provider Alert: Prohibiting Copays at OTP Facilities (1205 23)

Effective Jan. 1, 2023, New York law (S.5690/A.372) prohibits commercial health insurance plans from imposing copayments and coinsurance for treatment delivered at an Opioid Treatment Program (OTP). This impacts Qualified Health Plan (QHP), commercial, and Essential Plan products

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QHP
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Panel 1 - The Health Equity Imperative: Exploring Solutions to Address Current Health Crises in Our Community

(Panel 1 booklet) October 5, 2023: This continuing medical education activity aims to promote the advancement of community health and well-being through a focus on health inequities and professional practice gap experiences by community-based primary care providers.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Panel 6 - The Health Equity Imperative: Exploring Solutions to Address Current Health Crises in Our Community

(Panel 6 booklet) October 5, 2023: This continuing medical education activity aims to promote the advancement of community health and well-being through a focus on health inequities and professional practice gap experiences by community-based primary care providers.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Panel 5 - The Health Equity Imperative: Exploring Solutions to Address Current Health Crises in Our Community

(Panel 5 booklet) October 5, 2023: This continuing medical education activity aims to promote the advancement of community health and well-being through a focus on health inequities and professional practice gap experiences by community-based primary care providers.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Panel 3 - The Health Equity Imperative: Exploring Solutions to Address Current Health Crises in Our Community

(Panel 3 booklet) October 5, 2023: This continuing medical education activity aims to promote the advancement of community health and well-being through a focus on health inequities and professional practice gap experiences by community-based primary care providers.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Program Book: The Health Equity Imperative: Exploring Solutions to Address Current Health Crises in Our Community

(Program Book) October 5, 2023: This continuing medical education activity aims to promote the advancement of community health and well-being through a focus on health inequities and professional practice gap experiences by community-based primary care providers.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Panel 4 - The Health Equity Imperative: Exploring Solutions to Address Current Health Crises in Our Community

(Panel 4 booklet) October 5, 2023: This continuing medical education activity aims to promote the advancement of community health and well-being through a focus on health inequities and professional practice gap experiences by community-based primary care providers.

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Provider Events
  
Education Events & Patient Care Resources - Practice Guidelines and Tips - 2023
Panel 2 - The Health Equity Imperative: Exploring Solutions to Address Current Health Crises in Our Community

(Panel 2 booklet) October 5, 2023: This continuing medical education activity aims to promote the advancement of community health and well-being through a focus on health inequities and professional practice gap experiences by community-based primary care providers.

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Provider Events
  
Provider Alerts - Behavioral Health and Foster Care - Practice Guidelines and Tips - 2023
Behavioral Health Utilization Review Implementation

In response to a requirement by the New York State Office of Mental Health (OMH), Healthfirst has implemented a new, trigger-based approach to utilization review (UR) for certain acute mental health services (MH) for all of our health plans, except for Medicare Advantage plans.

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Behavioral Health
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Patient Renewal Email (Chinese)

This email text explains recertification to your Healthfirst patients. You can copy and paste it into your practice’s patient emails.

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Documentation
  
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