New York
Provider Communications

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Title Publication Category Date

Reminder of New Referral Process

May Empire Provider News Products & Programs May 1, 2019

Pharmacy information available on empireblue.com

May Empire Provider News Pharmacy May 1, 2019

Tips for billing CPT modifier 33

October 2018 Empire Provider Newsletter New York Empire BlueCross BlueShield extra long article title Provider Communications Test Long Title N/A Oct 22, 2018

Empire expands specialty pharmacy level of care (clinical site of care) drug list

SD Test Publilcation 102218 Administrative Oct 22, 2018

Access patient-specific drug benefit information through EMR

SD Test Publilcation 102218 Administrative Oct 22, 2018

Integrated Medical and Behavioral Healthcare Services

SD Test Publilcation 102218 Reimbursement Policies Oct 22, 2018

APPROVED - TEST_Keep up with Medicare news

NY Publication TEST _ Article Issues N/A Jun 7, 2018

NY - Amendment to Physician Agreement

NY April Newsletter _ Test Shae Administrative May 14, 2018

Amendment to Physician Agreement

April 2018 Empire Newsletter Administrative Apr 9, 2018

Empire expands hospice benefits

Beginning June 1, 2018, Empire is further extending hospice benefits to allow disease modifying treatments to continue alongside hospice services.
April 2018 Empire Newsletter Products & Programs Apr 9, 2018

Medical Policy Updates

April 2018 Empire Newsletter Medical Policy & Clinical Guidelines Apr 9, 2018

Elotuzumab to require prior authorization

April 2018 Empire Newsletter Medicaid Apr 9, 2018

New Alpha/Numeric Member Identification Prefixes effective April 15, 2018

The Blue Cross and Blue Shield Association (BCBSA) assigns member ID prefixes for all Blue Cross and Blue Shield-branded Plans – Empire Plans as well as non-Empire Plans. Effective April 15, 2018 the BCBSA will begin assigning prefixes that contain a combination of letters and numbers, or alpha-numeric prefixes.  
April 2018 Empire Newsletter Administrative Apr 9, 2018

Update Regarding Clinical Data Sharing Requirements

Providers and Empire have a shared goal to improve the quality of health care for Empire members. To support this goal, it is critical that both providers and Empire have access to up-to-date clinical and administrative data.
February 2018 Empire Newsletter Administrative Mar 27, 2018

Important information about filing Home Infusion Therapy claims

To assist in the accurate and timely processing of Home Infusion Therapy (HIT) claims, it is important for HIT Providers to file professional HIT claims to the correct Blue Plan. The following information applies to professional HIT claims for all Bluebranded health plans.
February 2018 Empire Newsletter Administrative Mar 27, 2018

Important Outreach to Opioid Use Disorder Providers about Medication Assisted Therapy

Opioid addiction rates and deaths from overdose continue in the United States at alarming rates. To help address this crisis, Empire urgently requests that you contact us if you are authorized to administer Medication Assisted Therapy (MAT).
February 2018 Empire Newsletter Administrative Mar 27, 2018

A new look is coming to our Network Update newsletter

February 2018 Empire Newsletter Administrative Mar 27, 2018

Empire’s Electronic Tools and Resources Migrating to the Availity Portal

Beginning March 16, 2018 the Empire BlueCross BlueShield’s (“Empire”) secure provider facility and professional portals are transitioning a majority of online tools and resources to the Availity Portal (www.availity.com). At that time, Availity will be your exclusive secure web portal to access these important Empire electronic tools and resources.
February 2018 Empire Newsletter Administrative Mar 27, 2018

Empire expands specialty pharmacy prior authorization list

Shazia Test 3/15 - April Newsletter Products & Programs Mar 20, 2018

Update to AIM Radiation Oncology Clinical Appropriateness Guidelines

Shazia Test 3/15 - April Newsletter Products & Programs Mar 15, 2018

Site of Service Update

Shazia Test 3/15 - April Newsletter Administrative Mar 15, 2018

New Alpha/Numeric Member Identification Prefixes effective April 15, 2018

Shazia Test 3/15 - April Newsletter Administrative Mar 15, 2018

HEDIS 2018® Weight Assessment and Counseling for Nutrition and Physical Activity

Shazia Test 3/15 - April Newsletter Administrative Mar 15, 2018

Test Attachment SD

Shazia Test - April Newsletter Administrative Feb 27, 2018

Blue Priority Reminder

Shazia Test - April Newsletter Administrative Feb 26, 2018

Integrated Care Model for plans purchased on the Health Insurance Marketplace benefits patients and physicians

Shazia Test - April Newsletter Behavioral Health Feb 26, 2018

Medical Policy Updates

Shazia Test - April Newsletter Medical Policy & Clinical Guidelines Feb 26, 2018

Coding Patient Services Reminders

Shazia Test - April Newsletter Medicare Feb 26, 2018

Behavioral Health Medication Management program

Shazia Test - April Newsletter Behavioral Health Feb 26, 2018

Shae's Test Featured Article - Medicare Advantage

Improve member medication regimen Empire and the Centers for Medicare & Medicaid Services consider medication review and reconciliation a top priority to help ensure members take their medications safely. Our pharmacists use medication review and reconciliation to help members understand what medications they are taking, why they are taking them, how they should be taking their medication and to answer any questions or concerns they have about their medication regimen.
Shae's Test Publication 2018 NY Administrative Feb 22, 2018

Shae's Test Empire’s Electronic Tools and Resources Migrating to the Availity Portal

Beginning March 16, 2018 the Empire BlueCross BlueShield (“Empire”) secure provider facility and professional portals are transitioning a majority of online tools and resources to the Availity Portal (www.availity.com). At that time, Availity will be your exclusive secure web portal to access these important Empire electronic tools and resources.
Shae's Test Publication 2018 NY Administrative Feb 22, 2018

Shae's Test Policy Update - Not registered on the Availity Portal yet?

Visit www.availity.com to register today. If you already use Availity, no additional registration is needed. Empire will appear as one of your options in the payer drop-down lists.
Shae's Test Publication 2018 NY Policy Updates Feb 22, 2018

Shae's Test Med Policy and Clinical Guidelines

Empire expands specialty pharmacy prior authorization list
Shae's Test Publication 2018 NY Medical Policy & Clinical Guidelines Feb 22, 2018

Shae's Test - Reimbursement Policies

Effective for dates of service on and after May 1, 2018, intra-articular injections of hyaluronan for the treatment of pain due to reducing and non-reducing disc displacement disease of temporomandibular joint disorders, are considered investigational and not medically necessary. No prior authorization for these agents will be required, but rather reviewed post-service.
Shae's Test Publication 2018 NY Reimbursement Policies Feb 22, 2018

Shae's Test - Products and Programs - Empire expands specialty pharmacy prior authorization list

Effective for dates of service on and after May 1, 2018, the following specialty pharmacy codes from new or current medical policies or clinical UM guidelines will be included in our existing prior authorization review process.
Shae's Test Publication 2018 NY Products & Programs Feb 22, 2018

Shae's Test - P&P Behavioral Health - Hyaluronan Injections in joints other than the Knee (DRUG.00017)

Medical policy DRUG.00017 addresses the use of injections of hyaluronan in joints other than the knee, including osteoarthritis and temporomandibular joint disease. This therapy may also be referred to as viscosupplementation.
Shae's Test Publication 2018 NY Behavioral Health Feb 22, 2018

Shae's Test - P&P - Pharmacy

Revised Medical Policy Effective 11-09-2017
Shae's Test Publication 2018 NY Pharmacy Feb 22, 2018

Shae's Test - State and Federal - Medical Policy Updates

Archived Medical Policies Effective 12-27-2017 (The following policies have been archived and their content has been transferred to new Clinical UM Guidelines.)
Shae's Test Publication 2018 NY State & Federal Feb 22, 2018

Shae's Test - S&F - Federal Employee Plan (FEP)

Improve member medication regimen
Shae's Test Publication 2018 NY Federal Employee Plan (FEP) Feb 22, 2018

Shae's Test - Medicaid - New pharmacy electronic prior authorization request tool effective January 1, 2018

Empire BlueCross BlueShield HealthPlus (Empire) has partnered with CoverMyMeds to offer an electronic prior authorization (ePA) request tool that simplifies the process for requesting medications and checking the status of your submissions.
Shae's Test Publication 2018 NY Medicaid Feb 22, 2018

Shae's Test - S&F - Medicare - Availability The tool will be available beginning January 1, 2018.

These new features help simplify the prior authorization process. You will be able to:
Shae's Test Publication 2018 NY Medicare Feb 22, 2018

Test article clone

Empire may contact you to discuss members’ medications as part of either the Medication Therapy Management (MTM) or the Medication Reconciliation Post Discharge (MRPD) programs.
Export Test Newsletter Medicare Feb 14, 2018

asdfasdfasdf to require prior authorization clone

Effective May 1, 2018, Empire BlueCross BlueShield HealthPlus requires prior authorization (PA) for elotuzumab for Medicaid Managed Care members.
Export Test Newsletter Medicare Feb 14, 2018

Hyaluronan Injections in joints other than the Knee (DRUG.00017)

Medical policy DRUG.00017 addresses the use of injections of hyaluronan in joints other than the knee, including osteoarthritis and temporomandibular joint disease.
February 2018 Empire Provider Newsletter Products & Programs Feb 13, 2018

Empire expands specialty pharmacy prior authorization list

Effective for dates of service on and after May 1, 2018, the following specialty pharmacy codes from new or current medical policies or clinical UM guidelines will be included in our existing prior authorization review process.
February 2018 Empire Provider Newsletter Products & Programs Feb 13, 2018

Empire’s Electronic Tools and Resources Migrating to the Availity Portal

Beginning March 16, 2018 the Empire BlueCross BlueShield (“Empire”) secure provider facility and professional portals are transitioning a majority of online tools and resources to the Availity Portal (www.availity.com).
February 2018 Empire Provider Newsletter Administrative Feb 13, 2018

A new look is coming to our Network Update newsletter

A new look is coming to our Network Update newsletter
February 2018 Empire Provider Newsletter Medicaid Feb 13, 2018

Important Outreach to Opioid Use Disorder Providers about Medication Assisted Therapy

Opioid addiction rates and deaths from overdose continue in the United States at alarming rates.
February 2018 Empire Provider Newsletter Pharmacy Feb 13, 2018

Update regarding Shingrix shingles vaccine

Empire updated its Affordable Care Act (ACA) preventive care coverage to include Shingrix, the new zoster (shingles) vaccine.
February 2018 Empire Provider Newsletter Behavioral Health Feb 13, 2018

Enhancements to AIM Diagnostic Imaging Clinical Appropriateness Guidelines

Beginning with dates of service on and after May 1, 2018, the following enhancements will apply to AIM Diagnostic Imaging Clinical Appropriateness Guidelines,
February 2018 Empire Provider Newsletter Products & Programs Feb 13, 2018

Gamunex-C® and Octagam® are Empire’s clinically equivalent immune globulin agents

Effective for dates of service on or after May 1, 2018, Gamunex-C® and Octagam® will be the immune globulin agents of choice over Bivigam®, Carimune NF® Flebogamma®, Gammagard®, Gammagard S/D®, Gammaplex®, and Privigen®.
February 2018 Empire Provider Newsletter Reimbursement Policies Feb 13, 2018

Empire expands partnership with Aspire Health to support palliative care for commercial members

Beginning April 2, 2018, Empire will partner with Aspire Health to supply palliative care support services to our fully insured commercial members with advanced illness.
February 2018 Empire Provider Newsletter Medical Policy & Clinical Guidelines Feb 13, 2018

Pharmacy information available on empireblue.com

The commercial drug list is reviewed and updates are posted to the web site quarterly.
February 2018 Empire Provider Newsletter Policy Updates Feb 13, 2018

Clinical Guideline Updates

Clinical Guideline Updates
February 2018 Empire Provider Newsletter Reimbursement Policies Feb 13, 2018

Facility Drug Testing

Facility Reimbursement Policy
February 2018 Empire Provider Newsletter Medical Policy & Clinical Guidelines Feb 13, 2018

Improve member medication regimen

Empire may contact you to discuss members’ medications as part of either the Medication Therapy Management (MTM) or the Medication Reconciliation Post Discharge (MRPD) programs.
February 2018 Empire Provider Newsletter Policy Updates Feb 13, 2018

Elotuzumab to require prior authorization

Effective May 1, 2018, Empire BlueCross BlueShield HealthPlus requires prior authorization (PA) for elotuzumab for Medicaid Managed Care members.
February 2018 Empire Provider Newsletter Administrative Feb 13, 2018

New pharmacy electronic prior authorization request tool effective January 1, 2018

Empire BlueCross BlueShield HealthPlus (Empire) has partnered with CoverMyMeds to offer an electronic prior authorization (ePA) request tool that simplifies the process for requesting medications and checking the status of your submissions.
February 2018 Network Update Medicaid Feb 9, 2018

Empire’s Electronic Tools and Resources Migrating to the Availity Portal

Beginning March 16, 2018 the Empire BlueCross BlueShield (“Empire”) secure provider facility and professional portals are transitioning a majority of online tools and resources to the Availity Portal (www.availity.com).
Export Test Newsletter Medicaid Feb 7, 2018

Empire expands specialty pharmacy prior authorization list

Effective for dates of service on and after May 1, 2018, the following specialty pharmacy codes from new or current medical policies or clinical UM guidelines will be included in our existing prior authorization review process.
Export Test Newsletter Pharmacy Feb 7, 2018

Hyaluronan Injections in joints other than the Knee (DRUG.00017)

Medical policy DRUG.00017 addresses the use of injections of hyaluronan in joints other than the knee, including osteoarthritis and temporomandibular joint disease.
February 2018 Network Update Federal Employee Plan (FEP) Feb 7, 2018

Medical Policy Updates Test edit by Jen

Medical Policy Updates
February 2018 Network Update Policy Updates Feb 7, 2018
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