Healthfirst encourages your practice to actively identify patients who may need their annual preventive screenings addressed. For best practices and tips see the Healthfirst Provider Guidebook for Quality Measures.

• Breast cancer is the most common form of cancer in women, and regular mammograms are the best way to catch any cancerous activity. The evidence-based recommendation is for targeted members to be screened every two years, starting at age 45.*
• Cervical cancer screenings offer the best chance of finding cervical cancer early, when treatment may be more effective. The evidence-based recommendation is for targeted members to test every three to five years, starting at age 25.* Patients vaccinated against HPV should still follow these guidelines for their age groups.
• Chlamydia is the most commonly reported bacterial sexually transmitted disease in the United States. The evidence-based recommendation is for targeted members, ages 16-24* who are sexually active, to be screened annually.

• Set up reminder alerts to ensure patients have completed or are scheduled to complete their necessary preventive health screenings.
• During a patient’s visit with you, educate members on the importance of regular preventive health screenings.
• See specific best practices and tips in the Healthfirst Provider Guidebook for Quality Measures (pages 10, 17, and 20).

Please advise your patients that they may be eligible to receive Wellness Rewards for completing certain preventive health screening visits. Reward eligibility and reimbursement amounts may vary depending on the member’s Healthfirst plan participation and screening modality.

• Healthfirst Provider Guidebook for Quality Measures
• HEDIS Codebook®
• Optimizing Telehealth to Achieve HEDIS Measures
• Clinical Support Vendors and Behavioral Health Resources
• To assist providers and coding staff with the documentation and ICD-10-CM selection on services submitted to Healthfirst, see this tip sheet and this 5-minute instructional video

Patients can contact their plan’s Member Services team for help scheduling or getting to their appointments, or for more information about Wellness Rewards. Member Services contact information can also be found on the back of the member’s ID card; see sample ID cards here.

For more information about recommended health screenings for your patients, please contact your assigned Clinical Quality Manager or Network Account Manager. You can also call Provider Services at 1-888-801-1660, Monday to Friday, 8:30am–5:30pm.

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*For information regarding a member’s eligibility for breast cancer, cervical cancer, or chlamydia screening options, please reference their plan’s summary of benefits and coverage.