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Documentation & 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
  
Documentation & 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
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Waiting Room Material in Spanish

A helpful flyer that explains recertification to your Healthfirst patients. Print copies and leave them in the waiting room to help your Healthfirst patients navigate the renewal process.

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Recertification
  
Provider Alerts - Provider Resources - 2023
Healthfirst Provider Toolkit: Patient Recertification - Waiting Room Material in English

A helpful flyer that explains recertification to your Healthfirst patients. Print copies and leave them in the waiting room to help your Healthfirst patients navigate the renewal process.

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Recertification
  
Provider Alerts - Provider Resources - 2023
Recertification 101 for Healthfirst Providers (slides)

Learn how your practice can identify Healthfirst members eligible for recertification.

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Recertification
  
Provider Alerts - Practice Guidelines and Tips - 2023
Provider Credentialing

This Provider Alert announces Healthfirst's new partnership with Andros, an industry leading, NCQA-Certified, CVO (Credentials Verification Organization), effective October 1, 2023.

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Credentialing
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2023
Provider Alert - Cost Sharing for Medicare Part B Drugs

Details regarding cost sharing policy changes due to the Inflation Reduction Act.

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Cost Sharing
  
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