This is part of an ongoing effort to improve the accuracy and consistency of Electronic Remittance Advice (ERA) delivery.
View postHealthfirst is aligning with NYS Medicaid Billing Guidelines to ensure consistency in claims processing and reimbursement.
View postThese devices must be obtained through an in-network Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) provider, rather than a pharmacy.
View post(Post updated 8/11/26) Providers are encouraged to review these 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.
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