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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
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Cardiomyopathy, 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 the main type of cardiomyopathy.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Opioids Abuse/Use, 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 Opioids Abuse/Use.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Cocaine Abuse/Use, 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 Cocaine Abuse/Use.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Cannabis Abuse/Use, 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 Updates, on services submitted to Healthfirst—specifically for cannabis abuse/use.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Purpura and Other Hemorrhagic Conditions, 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 purpura and other hemorrhagic conditions.

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Clinical Documentation Improvement
CMS-HCC_V28 Model Updates
  
Provider Alerts - Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023
Provider-Identified Overpayments

If a provider determines that Healthfirst has overpaid a claim, the provider shall, within 60 days of discovery, send a refund check made out to Healthfirst PHSP, Inc. in the amount of the overpayment. View the provider alert for details.

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Reimbursement
  
Coding - Practice Guidelines and Tips - 2023
Documentation and Coding: Dementia

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 dementia.

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Clinical Documentation Improvement
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Patient Renewal Email

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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Recertification
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Patient Renewal Reminder

This short note explains recertification to your Healthfirst patients. You can copy and paste the text into your practice’s patient communications such as patient billing statements, paperwork, and more.

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Recertification
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Patient Renewal Letter

An easy‑to‑read letter that explains recertification to your Healthfirst patients. You can copy and paste it into your patient mailings.

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Recertification
  
Provider Alerts - Practice Guidelines and Tips - 2023
The Importance of Recertifications to Your Patients

New York State requires annual eligibility reviews and renewals for members enrolled in the following health insurance plans: - Medicaid - Essential Plan - Child Health Plus - Personal Wellness Plan (HARP) - Medicare Advantage plans with Medicaid or Medicare Savings Program - Managed Long-Term Care

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Recertification
  
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