Search

Resource Type
Clear All
Filter
Year
Sort By
Showing 37-48 of 728
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026
Reimbursement Policy: PO-RE-016 β-Hemolytic Streptococcus Testing

Streptococcus are Gram-positive, catalase-negative bacteria that are further divided into α-hemolytic, such as S. pneumoniae and S. mutans; β-hemolytic, such as S. pyogenes (Group A), S. agalactiae (Group B), and S. dysgalactiae subsp equisimilis (Groups C and G); and γ-hemolytic, such as viridans group streptococci.

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026
Reimbursement Policy: PO-RE-015 Testing for Vector Borne Infections

Arthropod vectors, including mosquitoes, ticks, fleas, and mites, that feed on vertebrate hosts can spread bacteria, protozoa, and viruses during feeding to their susceptible host, resulting in a variety of infections and diseases.

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026
Reimbursement Policy: PO-RE-014 Diagnostic Testing of Common Sexually Transmitted Infections

Sexually transmitted infections (STIs), often referred to as sexually transmitted diseases or STDs, include a variety of pathogenic bacteria, virus, and other microorganisms that are spread through sexual contact and can cause a multitude of complications if left untreated.

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026
Reimbursement Policy: PO-RE-013 Urine Culture for Bacteria

Bacteriuria is the presence of bacteria in the urine. Urinary tract infections (UTIs) can occur in the urinary system and can be either symptomatic or asymptomatic

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026
Reimbursement Policy: PO-RE-012 Pathogen Panel Testing

Infectious diseases can be caused by a wide range of pathogens. Conventional diagnostic methods like culture, microscopy with or without stains and immunofluorescence, and immunoassay often lack sensitivity and specificity and have long turnaround times.

Open document
Reimbursement Policy
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2026
Reimbursement Policy: PO-RE-009 Diagnostic Testing of Influenza

Influenza is an acute respiratory illness caused by influenza A or B viruses resulting in upper and lower respiratory tract infection, fever, malaise, headache, and weakness.

Open document
Reimbursement Policy
  
Pharmacy Resources & Formularies - Provider Resources - 2026
Prior Authorization Pharmacy Medical Benefit Grid

It is the policy of Healthfirst to require prior authorization for medical claims for all medications listed within this document. To learn more, including ways to submit prior authorization, access this resource.

Open external link
Authorization
  
Documentation & Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Aneurysm

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 an Aneurysm.

Open document
Clinical Documentation Improvement
  
Documentation & Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Annual Wellness Visits, Initial Preventive Physical Examinations, and Problem Oriented Visit

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 distinguishing between Annual Wellness Visits (AWV), Initial Preventive Physical Examinations (IPPE), and Problem Oriented Visit.

Open document
Clinical Documentation Improvement
  
Documentation & Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Cerebral Palsy

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 Cerebral Palsy.

Open document
Clinical Documentation Improvement
  
Documentation & Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Chronic Post Rheumatic Arthropathy [Jaccoud]

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 Chronic Post Rheumatic Arthropathy [Jaccoud].

Open document
Clinical Documentation Improvement
  
Documentation & Coding - Practice Guidelines and Tips - 2025
Documentation and Coding: Diabetes with Eye Complications

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 Diabetes with Eye Complications.

Open document
Clinical Documentation Improvement