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What's New

Posted Sep 25, 2023
FAQ - OrthoNet Descope

Effective Jan. 1, 2024, Healthfirst will resume responsibility for management of some prior authorization (PA) requests previously managed by OrthoNet.

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Posted Sep 15, 2023
Inflation Reduction Act Impacts Cost Sharing for Medicare Part B Drugs

Details of cost sharing changes for Medicare Part B drugs due to the Inflation Reduction Act

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Posted Sep 12, 2023
Provider Alert - Credentialing

We are pleased to announce that Healthfirst has recently partnered with Andros, an industry-leading, NCQA-Certified, CVO (Credentials Verification Organization).

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Posted Sep 01, 2023
Healthfirst Provider Toolkit: Patient Recertification

This recertification toolkit includes educational resources for your practice and easy-to-use guides to help you inform your patients on how to maintain their access to healthcare.

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Posted Aug 24, 2023
Provider-Identified Overpayments

Information for providers who determine that Healthfirst has overpaid a claim.

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Posted Aug 16, 2023
Improving Specificity in ICD-10-CM Diagnosis Coding

Invalid ICD-10-CM diagnosis codes are expiring.

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Posted Jul 14, 2023
Healthfirst Cares Powered by Welldoc App Member Referral Form

Refer any Healthfirst member who may benefit from the app’s diabetes tools and program resources.

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Posted Jun 23, 2023
NYRx Transition Fill Period Ending

Important Information for Medicaid Providers

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Posted Jun 22, 2023
Change in Level of Service Determinations and Prior Authorizations for ACT

Effective June 20, 2023, Healthfirst, in accordance with the State of New York, will no longer require Level of Service Determinations (LOSD) or prior authorization for Assertive Community Treatment (ACT).

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Posted Jun 08, 2023
Acceptable Procedure Code/Modifier Combinations

Important information about deactivation of all references to invalid procedure code/modifier combinations that are in our claims system.

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Posted Jun 06, 2023
Children's Home and Community-Based Care (HCBS) FAQ

This FAQ provides important workflow reminders, answers to questions you may have about HCBS, and other helpful resources.

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Posted May 24, 2023
Coronavirus Telehealth Services

This document outlines the Healthfirst Telemedicine Reimbursement Policy.

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