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Compliance, Regulatory & Policies - Patient Resource - 2020
New York State Department of Health – Vaccine Safety and the Importance of Immunization
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Immunization
NY DOH
  
Compliance, Regulatory & Policies - Practice Guidelines and Tips - 2020
New York State Department of Health Information for Health Care Providers on Lead Poisoning Prevention and Management
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doh
  
Compliance, Regulatory & Policies - Practice Guidelines and Tips - 2021
New York State Department of Health Guidance for Point-of-Care Blood Lead Testing and Reporting
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doh
  
Provider Alerts - Telehealth - Policy, Billing, or Coverage Update - 2021
Privileging of Providers to Offer Telehealth Services

Healthfirst has established a policy and application process to enable our network of contracted providers to offer telehealth services to our members to improve access to care and outcomes of care. The policy and application process detailed herein is applicable to all providers and vendors who wish to render telehealth services.

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Administration
  
Telehealth - Policy, Billing, or Coverage Update - 2021
Healthfirst Telehealth Designation Application

Telehealth Assessment Tool. Please reach out to your Healthfirst Network Account Manager for more information

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Administration
  
Plans & Benefits - Policy, Billing, or Coverage Update - 2021
Medical Necessity Form (MNF) Form FAQs

Effective May 1, 2021, providers must fill out a Medical Necessity Form (MNF) to schedule Advanced Life Support (ALS) or Basic Life Support (BLS) non-emergent transportation for Healthfirst members to any provider approved by the Centers for Medicare & Medicaid Services (CMS). Here are some frequently asked questions.

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Medicare
  
Provider Alerts - Claims & Billing - Coronavirus (COVID-19) - Policy, Billing, or Coverage Update - 2021
COVID-19 Testing — Billing Guidance

Healthfirst will cover medically appropriate COVID-19 testing at no cost share during the public health emergency when such testing is ordered by a physician or licensed healthcare professional for the purpose of diagnosis or treatment of COVID-19.

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COVID-19
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2020
Healthfirst Reimbursement Policy Updates - Effective February 1, 2021

Effective February 1, 20201, several changes will be made to our reimbursement policy to maintain compliance with industry-accepted coding and reimbursement practices as well as state and national regulatory requirements.

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Reimbursement
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2021
Healthfirst Reimbursement Policy Updates Frequency of Trigger Point Injections

Healthfirst aims to ensure that our reimbursement policy standards are compliant with state and national industry standards. As a reminder, Healthfirst does not reimburse more than three (3) trigger point injections in a 90-day period.

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Reimbursement
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2020
Healthfirst Reimbursement Policy Updates - Effective December 1, 2020

Effective December 1, 2020, several changes will be made to our reimbursement policy to maintain compliance with industry-accepted coding and reimbursement practices as well as state and national regulatory requirements.

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Reimbursement
  
Coding - Coronavirus (COVID-19) - Practice Guidelines and Tips - 2021
Coding Novel Coronavirus: Type COVID-19

This document provides guidance on proper coding practices for a confirmed diagnosis of the 2019 novel coronavirus disease (COVID-19). Please note that Healthfirst guidelines related to waiving the cost share for evaluating a member for suspected COVID-19 are not reflected within this coding guidance. Please refer to the Coronavirus (COVID-19) section at hfproviders.org to find information on claims/encounters that will result in the waiver of cost sharing for members.

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COVID-19
  
Provider Alerts - Claims & Billing - Policy, Billing, or Coverage Update - 2021
Healthfirst Reimbursement Policy Updates Effective April 1, 2020

Healthfirst Reimbursement Policy Updates

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Reimbursement
  
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