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Provider Alerts - Quality Program Resources - General Update - 2022
Celebrating Top Performers from the 2020 Healthfirst Quality Incentive Program (HQIP)

Thank you to all our providers for your hard work in the Healthfirst Quality Incentive Program. We would like to recognize the top performers from the 2020 HQIP for achieving the highest overall quality ratings among their peers.

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HQIP
  
Provider Alerts - Claims & Billing - Coronavirus (COVID-19) - Policy, Billing, or Coverage Update - 2021
Coronavirus: Type (COVID-19) — Cost-Sharing Waiver

Please be advised that the New York State Department of Financial Services, the New York State Department of Health, and the federal government have directed Healthfirst to waive patient copayments, coinsurance, and deductibles for certain testing and treatment due to the coronavirus (COVID-19) emergency.

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

Healthfirst aims to ensure that our reimbursement policy standards are up to date and are compliant with state and national industry standards. Effective September 1, 2021, 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
  
Claims & Billing - Compliance, Regulatory & Policies - Policy, Billing, or Coverage Update - 2021
Reimbursement Policy: Anesthesia Start and Stop Times

Healthfirst requires that providers include the start time, stop time, and duration of anesthesia in the note segment of the 5010 claim form.

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Reimbursement
  
Behavioral Health and Foster Care - Form - 2020
Adult Behavioral Health (BH) and Community Based Services (HCBS): Initial Service Notification Following Level of Service (LOS) Determination
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Personal Wellness Plan
  
Behavioral Health and Foster Care - Practice Guidelines and Tips - 2020
Frequently Asked Questions: Authorizations for Inpatient Treatment of Substance Use Disorders
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Substance Use Disorder
  
Provider Alerts - Policy, Billing, or Coverage Update - 2020
Authorization Requirement Update for Echocardiography Services
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Authorization
  
Behavioral Health and Foster Care - Practice Guidelines and Tips - 2020
NYS Children’s Medicaid – Children and Family Treatment and Support Services
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Children & Family
  
Behavioral Health and Foster Care - Practice Guidelines and Tips - 2020
Children’s Home and Community Based Services (HCBS) Frequently Asked Questions
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HARP Health And Recovery Plan
  
Provider Alerts - Policy, Billing, or Coverage Update - 2020
Recovery Coordination Agency (RCA
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HARP Health And Recovery Plan
  
Provider Alerts - Practice Guidelines and Tips - 2022
Proper Use of Modifier "-25"
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Reimbursement
  
Claims & Billing - Practice Guidelines and Tips - 2022
OrthoNet Codes Requiring Authorization
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Authorization
  
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