For eligible Healthfirst Medicare, Essential Plan, and Qualified Health Plan (QHP) members.
View postCoding is essential for healthcare professionals: physicians, coders, and billers
View postThe New York State Department of Health (NYSDOH) is transitioning to the online Medicaid Provider Services Portal (PSP).
View postLearn more about key updates providers should know.
View postThe Healthfirst Clinical Documentation and Coding team offers resources to support accurate and complete documentation and coding for patients with hepatitis.
View postHealthfirst is aligning with NYS Medicaid Billing Guidelines to ensure consistency in claims processing and reimbursement.
View postHere’s what you need to know about the annual Consumer Assessment of Healthcare Providers & Systems (CAHPS) survey.
View postWhere to submit your requests
View postA provider questionnaire will now accompany initial prior authorization requests for Adult Physical Therapy across all Healthfirst plans to support efficient reviews and appropriate care decisions.
View postEffective August 1, 2026, Healthfirst will implement Cotiviti’s Claim Pattern Review Program to conduct ongoing reviews of specific professional claims.
View postCodes newly released by the Centers for Medicare and Medicaid Services (CMS) on April 1, 2026, will include prior authorization requirements starting June 1, 2026.
View postEffective July 1, 2026, Healthfirst will require prior authorization requirements for several CPT codes.
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