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Patient Care Resources - Practice Guidelines and Tips - 2021
0421 21 Pediatric CME Conference Program Booklet

May 6-7, 2021 Virtual Conference This CME activity is designed to help improve the skill level of primary care providers who care for overweight or obese children in their evaluation, treatment and referral for obesity-related illness. Obesity rates have increased rapidly in the pediatric populations, especially in minorities and children living in poverty. Recent studies suggest that abnormal weight gain and poor eating practices begin in infancy and young childhood and continue through early school years and adolescence, leading to obesity.

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Provider Events
  
Coding - Policy, Billing, or Coverage Update - 2021
Documentation and Coding: Cerebrovascular Disease

Codes in this category describe the type of stroke and the sequelae (late effects) caused by the stroke. Documentation should clearly state whether a neurological deficit is directly related to cerebrovascular disease or a cerebrovascular accident. Ensure that all diagnoses reported are supported by the MEAT (Monitoring, Evaluating, Assessing, Treating) concept.

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Clinical Documentation Improvement
  
Pharmacy Resources & Formularies - Quality and Compliance - 2023
Pharmacy Carve Out Delay Announcement

The Pharmacy carve-out has been delayed by two years, until April 1, 2023. Review this DOH announcement to learn more.

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Medicaid
  
Quality Program Resources - Practice Guidelines and Tips - 2021
Checklist for HARP CAHPS Success

This document outlines ways you can improve your patients’ experience and help with the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey that your Health and Recovery Plan (HARP) patients may receive this year. For your reference, the HARP CAHPS survey questions are also available in this document.

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HARP Health And Recovery Plan
  
Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2023
Reimbursement Policy: PO-RE-002v3 Thyroid Disease Testing

Thyroid hormones are necessary for both prenatal and postnatal development, as well as metabolic activity in adults (Brent, 2020).

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Reimbursement Policy
  
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 - 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
  
Patient Care Resources - Practice Guidelines and Tips - 2021
Building the Future We Wish to See: Partnerships for Optimal Medical Outcomes in 2021 and Beyond

Healthfirst’s semi-annual Provider Symposium features the innovative work of practices, health care organizations and industry leaders who care for and serve our members. Providers, administrators, and leaders from a variety of ambulatory, community based, and independent health and social service settings look forward to attending and learning from colleagues and health leaders.

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Mental Health
  
Coding - Practice Guidelines and Tips - 2021
Documentation and Coding: Chronic Kidney Disease

This tip sheet will offer guidance on how to submit diagnosis codes with greater specificity for coding Chronic Kidney Disease classified based on severity, by stages 1–5 and End Stage Renal Disease.

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Clinical Documentation Improvement
  
Patient Care Resources - Practice Guidelines and Tips - 2021
The Business of Medicine in Primary Care in the Era of COVID-19: Part 1

This Continuing Medical Education activity is designed to update primary care and specialty practices on the evolving strategies for implementing value-based care, new primary care practice models, and evidence-based medicine to meet the needs of communities ravaged by the COVID-19 pandemic. The intent is to inform the attendees on best practices and innovations in addressing racial equity and the needs of special patient populations.

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Provider Events
  
Patient Care Resources - Practice Guidelines and Tips - 2021
2021–2022 Seasonal Influenza Vaccine Codes

Based on the August 2021 guidance from the CDC, the CPT influenza vaccine codes in this document reflect updates to the recommendations on the use of seasonal influenza vaccines in the United States from the Advisory Committee on Immunization Practices (ACIP). Healthfirst’s benefit configurations have been updated to include this full range of vaccines.

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Annual Flu Vaccine
  
Claims & Billing - Form - 2021
Superior Vision - Medical Authorization Request Form

Please submit authorization forms for different dates of service and individual members as separate requests.

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Authorization
  
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