What's New

Reminder: Prior Authorization for Genetic and Molecular Laboratory Services

eviCore providing authorization services for Genetic and Molecular laboratory services.

Reminder regarding members who seek mental health or substance abuse services

Child HCBS Authorizations and Reminder of State Billing and Claiming Requirements

This notice is to remind Children’s Home and Community-Based Services (HCBS) providers of HCBS billing and claiming requirements, per the April 4, 2022, NYSDOH memo.

Community Oriented Recovery and Empowerment (CORE) Services

Four Behavioral Health Home and Community Based Services transitioning to a new service array called CORE Services

Telehealth Resources Available

For best practices, coding and billing tip sheets, and more

Delayed: Applied Behavioral Analysis Benefit Carve Out

Learn more about the delay and what that means for you

Billing Guidance for Dual-Eligible Special Needs Plan (D-SNP) Members Under Healthfirst’s Plans

Stay current on billing practices

Children and Family Treatment and Support Services (CFTSS)

Learn more about CFTSS

Bringing Patients Back to Get the Care They Need

Access these helpful tips and resources

Initial Health Assessments for Kids in Foster Care

Learn more about this transition, which takes place on July 1, 2021

Medical Record Requests for the HHS Risk Adjustment Data Validation Program (HHS-RADV)

Learn more about the coding and documentation audit which began in May 2021