Providers are encouraged to review these updated policies to ensure compliance with current billing and reimbursement requirements.
View postThese FAQs serve as a resource to help practices identify and address member concerns and dissatisfaction. Along with enhancing the quality of care and service delivery to foster a positive member experience and reduce the occurrence of complaints and grievances.
View postThe Healthfirst Clinical Documentation and Coding team offers resources to support accurate, complete documentation and coding for patients with Lung Cancer.
View postStarting August 1, 2026, Healthfirst will implement Cotiviti’s Claim Pattern Review (CPR) Program to conduct ongoing reviews of specific professional claims.
View postEffective April 6, 2026, Healthfirst may designate a portion of authorized Personal Care Services (PCS) or Consumer Directed Personal Assistance Services (CDPAS) hours as shared services when two or more members live in the same household.
View postThis FAQ helps providers understand Access to Care and Appointment Availability (ACAA) standards and prepare for compliance audits.
View postLearn more about key updates providers should know.
View postThe updated ABA policy outlines applicable requirements, including coverage criteria, authorization requirements, documentation expectations, and other relevant guidance for ABA services.
View postTo ensure Healthfirst members receive quality, consistent, and timely care, a provider questionnaire has been introduced to accompany the initial prior authorization request for Adult Physical Therapy.
View postTake a mid-year moment to refresh your documentation and coding knowledge.
View postPlease review these lab policies to understand how they may impact claims submission and payment.
View postCodes newly released by the American Medical Association will include prior authorization requirements starting July 1, 2026.
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