We look forward to working with you to provide quality services to our members. Log in to your account and send us a message. Medical Policy and Prior Authorization for Blue Plans. NYC Health + Hospitals/Elmhurst. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. If your state isn't listed, check out bcbs.com to find coverage in your area. Dental benefits are provided through LIBERTY Dental. Give your health the best shot this flu season.Find a plan pharmacynear you. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. This enables Empire to meet the needs of members with mental health and substance use disorders as well as those with intellectual and developmental disabilities. You can also visit bcbs.com to find resources for other states. Your dashboard may experience future loading problems if not resolved. This provider is an insurance plan that provides a Medicaid Managed Long Term Care (MLTC) product called a Medicare Advantage plan (MAP). Provider manuals and quick reference guides Contact Request Form; Enroll; Renew; Care. These providers must have a valid Medicaid ID. Our Interactive Care Reviewer (ICR) tool via Availity is the preferred method for submitting prior authorization requests, offering a streamlined and efficient experience for providers requesting inpatient and outpatient medical or behavioral health services for our members. Empire wants you to have the best care possible. If you think you are in danger of harming yourself or others, call 911 or go the nearest emergency room. Our Member Advisory Council meets at least four times a year, so you can: To learn more, ask your care manager about upcoming events. When you join our plan, you keep all your current Medicaid benefits. Phone: 1-800-450-8753; Hours: Monday to Friday 8:30 a.m. to 5:30 p.m. Fax: 1-800-964-3627; Empire Pharmacy Department Contact Us | NY Provider - Empire Blue Cross Click on a category in the menu below to learn more about it. HEDIS (The Healthcare Effectiveness Data & Information Set), Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Medicaid-Approved Preferred Drug List (PDL), Prior Authorization Lookup Tool Online for Empire. The benefit package includes , Health (7 days ago) WebMedicare Customer Services tel. The enrollee receives both Medicaid and Medicare services from one plan. Get translation and interpretation services free of charge. The ICR allows detailed text, photo images and attachments to be submitted along with your request. 1-800-300-8181 (TTY 711) Are expected to need at least one (1) of the following community based long-term care services for more than 120 continuous days from the effective date of enrollment: Consumer Directed Personal Assistance Services, Hear whats happening in the MLTC Community. Prior Authorization Requirements | NY Provider - Empire Blue It excludes specialized mental health services. If you need help finding mental health and substance use services, call Member Services at 1-800-300-8181 (TTY 711) Monday through Friday from 8 a.m. to 8 p.m. Eastern time/Saturday from 9 a.m. to 5 p.m. Eastern time. We'll help you with your health care needs every step of the way. empire-blue-cross-blue-shield-healthplus-900184, Tel: Your care manager is here to answer your questions and work with your providers to make sure that you have the right care at the right time. Stay informed activate your online account. Find Providers by Procedure Find Providers by Condition. 1-800-300-8181 (TTY 711) Search . These services are voluntary and provided through your Medicaid benefit at no cost to you. For any information you may reach us 24/7. 9/1/22 Medicaid Enrollment Requirement Notice Register today: Exploring the intersection of race and . Empire will proud to serve Medicaid members in New York. You can access the ICR from the Availity home page: Providers and staff can also contact Empire for help with prior authorization via the following methods: The It looks like you're outside the United States. Please visit You do not need to see your primary care provider (PCP) before getting behavioral health services. Empire is now sending some bulletins, policy change notifications, prior authorization update information, educational opportunities and more to providers via email. Empire provider manuals provide key administrative information, details regarding programs that include the utilization management program and case management programs, quality standards for provider participation, guidelines for claims and appeals, and more. HEDIS (The Healthcare Effectiveness Data & Information Set), Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Centers of Medical Excellence Transplant Operations Manual, New York Medicaid provider quick reference card, Behavioral Health Quick Reference Benefit Grid, Medical Policies & Clinical UM Guidelines: Full List, August 2022 Clinical Utilization Management Guidelines, February 2022 Clinical Utilization Management (UM) Guidelines, November 2021 Clinical Utilization Management (UM) Guidelines, August 2021 Clinical Utilization Management (UM) Guidelines, May 2021 Clinical Utilization Management (UM) Guidelines, February 2021 Clinical Utilization Management (UM) Guidelines, November 2020 Clinical Utilization Management (UM) Guidelines, May 2020 clinical utilization management (UM) guidelines, February 2020 clinical utilization management (um) guidelines, Electronic Clinical Data Systems coding booklet, HEDIS ECDS Prenatal and Postpartum Care Coding Bulletin 2023, HEDIS Well Child and Immunizations Coding Bulletin 2023, HEDIS telehealth eligible measures coding bulletin. We currently don't offer resources in your area, but you can select an option below to see information for that state. [Business]: , 9 Pine St, 14th Fl, , , NEW YORK, NY, 10005-. 1-800-342-9871. Empire Managed Long-Term Care (MLTC) is designed for adults living with long-term health conditions or disabilities.. You can get a flu shot at local pharmacies like Rite Aid and CVS. We offer deep discounts and one of the largest dental networks in the nation, along with ways to customize our plans for total flexibility. MLTC: 855-661-0002 (TTY 711) The CDPAS provides in-home services for people who: Being a self-directing member means you or a person you choose are responsible for making decisions about and managing your CDPAS services. Already a member? You can also search by physician, practice, or hospital name . Our team is available 24 hours a day and can: Sydney Health is now your mobile app. * CarelonRx, Inc. is an independent company providing pharmacy benefit management services on behalf of the health plan. Its easy to make one just register at the login screen. Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). The resources for our providers may differ between states. Medicaid-Approved Preferred Drug List (PDL)includes information such as mandatory generic requirements, prior authorization (PA), quantity limits, age limits or step therapy. NYC Health + Hospitals/Harlem. We currently don't offer resources in your area, but you can select an option below to see information for that state. Prior Authorization. Call our toll-free 24/7 NurseLine Empire Blue Cross Blue Shield HealthPlus, NEW YORK, NY 1-800-342-9871. Medical policies address the medical necessity of new services or procedures and new applications of existing services or procedures. Healthplus medicaid prior authorization number, Health (1 days ago) WebPhone: 1-800-450-8753 Prior authorization fax (medical): Fax: 1-800-964-3627 Behavioral health inpatient precertification fax: Fax: 1-877-434-7578 Behavioral health outpatient precertification fax: Fax: 1-866-877-5229 Retail pharmacy fax: Fax: 1-844-490-4877 , Category: Medical, Pharmacy Detail Health, Health (7 days ago) WebMLTC plans provide services and support to people that have a long term health problem or disability for more than 120 days. FAQ: Update to AIM phone number - Empire Blue Please update your browser if the service fails to run our website. Get help with mental health or substance use issues any time day or night.. North American Partners In Anesthesia in Oceanside, NY - WebMD Below is a partial list of Empire MLTC services. According to the New York Department of Healths 2015 Managed Long-Term Care Consumer Guide for NYC. Get the mobile app. Search . Visit a doctor 24/7 through live video using LiveHealth Online. Our network comprises , Health (4 days ago) WebTo contact Health-Plus Insurance Agency, Inc. directly, please fill out the following form as completely as possible. Empire Blue Cross Blue Shield (BCBS) Health Plus - Hospitals We look forward to working with you to provide quality services to our members. It excludes specialized mental health services. Empire BlueCross BlueShield HealthPlus (Empire) is committed to supporting you in providing quality care and services to the members in our network. We routinely update Medical Policies and Clinical UM Guidelines as part of the review process. Were available Monday through Friday from 8 a.m. to 8 p.m. and on Saturday from 9 a.m. to 5 p.m. Eastern time. HEDIS (The Healthcare Effectiveness Data & Information Set), Early and Periodic Screening, Diagnostic and Treatment (EPSDT). Video chat with a doctor 24/7 from your smartphone, tablet or computer at no cost to you. Have a question? The resources for our providers may differ between states. 2021 copyright of Anthem Insurance Companies, Inc. Contact Us | Empire Information for New York Change State Contact Us Please select from the following categories to find information specific to your question: Need to update your practice or provider information? Medicaid, CHPlus, Essential Plan and HARP: 1-800-300-8181 (TTY 711) Were always looking for ways to improve your plan. Sutter Health Plus Member Services is available weekdays, 8:00 am 7:00 pm at (855) 315-5800 or TTY: (855) 830-3500. Healthplus Hp Providers - health-mental.org The benefit package includes primary, acute and long term care services. Medicaid, CHPlus, Essential Plan and HARP: 1-800-300-8181 (TTY 711) Didnt find what youre looking for? The resources for our providers may differ between states. Get Medical Policies, Clinical Utilization Management (UM) Guidelines, Provider Manuals and Pre-Certification/Pre-Authorization Requirements any time you need them. Search for up-to-date drug information, including hundreds of brand-name and generic medications. 2021 copyright of Anthem Insurance Companies, Inc. Keep patients healthy and safe by becoming familiar with the tools and strategies useful in protecting yourself and our members against contagious illnesses. Medicaid, CHPlus, Essential Plan and HARP: 1-800-300-8181 (TTY 711) Search for different types of providers, like: *Empire HealthPlus is currently awaiting approval from the Department of Health for Medicaid products in Sullivan, Columbia, Greene, Delaware, Albany, Schenectady, Saratoga, Rensselaer, Clinton, Washington, Montgomery, Fulton, Warren, Essex and Schoharie counties. Customer , Health (7 days ago) Web1-844-305-6963 Medicare Supplement and Medicare Advantage Plans: 1-855-731-1090 (TTY/TDD: 711) please call us 8:00am - 8:00pm 7 days a week except Thanksgiving and , Health (5 days ago) WebCall our toll-free 24/7 NurseLine 1-800-300-8181 (TTY 711) MLTC members, call 1-855-661-0002 Get answers to your medical questions any time, day or night. Behavioral Health Support 1-800-300-8181 (TTY 711) , Health (1 days ago) WebBCBS Customer Service Call the toll-free number on the back of your member ID card for BCBS customer service. Our resources vary by state. Visit docinfo.org to search for providers and find out where they went to medical school. Use the location bar above to find providers of these services in your area.See the FAQs to learn how to save and organize your results. 1-800-300-8181 (TTY 711) We can help you live your best life. EDI for Providers | Anthem.com Once youve found one you want, write down or copy their name so you can enter it into the Change your PCP tool. We currently don't offer resources in your area, but you can select an option below to see information for that state. These learning opportunities will assist you in administering your patients health plan and provide you with the knowledge to best assist our members. 2021 copyright of Anthem Insurance Companies, Inc. Here, you will find Empire provider manuals, guidelines for clinical Utilization Management (UM) and medical policies. Individuals & Family Plans (under age 65): 1-844-305-6963 Medicare Supplement and Medicare Advantage Plans: 1-855-731-1090 (TTY/TDD: 711) please call us 8:00am - 8:00pm 7 days a week except Thanksgiving and Christmas Employers Plans: Contact your broker or consultant to learn more about Empire plans. You can reach us in several ways. Welcome to Empire BlueCross BlueShield HealthPlus Managed Long Term Care Plan. Empire BlueCross BlueShield HealthPlus is the trade name of HealthPlus HP, LLC, an independent licensee of the Blue Cross and Blue Shield Association. It looks like you're in . Corporate , Health (2 days ago) WebEnter your ZIP code to learn about the CarePlus Medicare Advantage plans in your area, or call us at 1-855-605-6171; TTY: 711. Have a question? Provider manuals, policies & guidelines - Empire Blue MLTC | Medicaid Empire We currently don't offer resources in your area, but you can select an option below to see information for that state. Its an easy way to get care for you or your family anytime of the day or night without leaving home. We look forward to working with you to provide quality services to our members. As of January 1, 2020, you can receive Essential Plan coverage from Empire BlueCross BlueShield HealthPlus in these eight counties: Live in one of these locations? Behavioral Health Support 1-800-300-8181 (TTY 711) Get help with mental health or substance use issues. Complete benefit information can be found in your member handbook. To find an eye doctor, call Superior Vision at 1-800-879-6901, or visit their website. Services provided by HealthPlus HP, LLC, a licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. COVID-19 At Home Testing and Vaccine Counseling. Find one who meets your needs using the search tool below. * Availity, LLC is an independent company providing administrative support services on behalf of Empire BlueCross BlueShield HealthPlus. HOW WE SUPPORT Business care for top care providers. Alta Bates Summit Medical Center Anesthesiology in Berkeley, CA - WebMD MLTC: 855-661-0002 (TTY 711) Your browser is not supported. Empire is available by phone or the Interactive Care Reviewer (ICR) via Availity 24 hours a day, 7 days a week to accept prior authorization (PA) requests. Our 24/7 NurseLine gives you fast, free medical advice, anytime day or night, in more than 170 languages. You do not need to see your primary care provider (PCP) before getting behavioral health services. Access resources to help health care professionals do what they do bestcare for our members. Contact Us: Customer Support by Phone & Email | Empire Blue Our resources vary by state. We currently don't offer resources in your area, but you can select an option below to see information for that state. Find drug lists, pharmacy program information, and provider resources including the prior authorization process. Healthplex , Health (2 days ago) WebConnect by Phone Were happy to answer any questions you may have. Get help with mental health or substance use issues. Home | Medicaid Empire Call our toll-free 24/7 NurseLine 1-800-300-8181 (TTY 711) | MLTC members, call 1-855-661-0002 Get answers to your medical questions any time, day or night. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. To reach your care manager, call Member . Sydney Health is now your mobile app. Empire BlueCross BlueShield HealthPlus is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners. I am* Select If you need immediate medical assistance, please dial 911 or go to the emergency room at , Health (4 days ago) WebUnitedHealthcare Customer Service advocates are available to assist you with password resets, enhancement requests and technical issues with the website. Learn more about behavioral health resources. Check out Empire's Individual and Family plans. Pharmacy services billed with the following revenue codes always require prior authorization: Behavioral health services billed with the following revenue codes ALWAYS require prior authorization: Services billed with the following revenue codes alwaysrequire prior authorization: We look forward to working with you to provide quality services to our members. Your dashboard may experience future loading problems if not resolved. Thats why you can always call our 24/7 NurseLine and speak directly to a nurse. It looks like you're in . Clinical UM guidelines focus on detailed selection criteria, goal length of stay, and location for generally accepted technologies or services. To request or check the status of a PA request or decision, log in to Availity. We work collaboratively with hospitals, group practices and independent behavioral healthcare providers, community and government agencies, human service districts, and other resources. MLTC plans provide services and support to people that have a long term health problem or disability for more than 120 days. If your state isn't listed, check out bcbs.com to find coverage in your area. Medical Policies & Clinical UM Guidelines: Full List on the Empire website to view or search for specific medical policies and Clinical UM Guidelines. We currently don't offer resources in your area, but you can select an option below to see information for that state. We've provided the following resources to help you understand Empire's prior authorization process and obtain authorization for your patients when it's . MLTC members, call 1-800-950-7679 (TTY 711). Your care manager can assist you with getting these services. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. If your prescriber or pharmacy is not enrolled with Medicaid Fee for Service, the prescriptions and supplies that they prescribe or fill will not be covered. Get help with mental health or substance use issues any time day or night.. It looks like you're outside the United States. Find a Doctor | Medicaid Empire Health (6 days ago) WebContact Information. Healthplus Customer Service - health-mental.org . The Availity Portal* offers healthcare professionals free access to real-time information and instant responses in a consistent format regardless of the payer. For some covered services, you may need a physicians order and/or prior approval from Empire before you receive them. At Empire, you will have a dedicated team of nurses and social workers who will ensure that your care and services help you live as independently as possible.. To reach your care manager, call Member Services at 1-855-661-0002 (TTY 711). Call Monday through Friday from 8 a.m. to 8 p.m. Eastern time/Saturday from 9 a.m. to 5 p.m. Eastern time. Services provided by HealthPlus HP, LLC, a licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. Support Sections Forms Member Needs Glossary Services provided by HealthPlus HP, LLC, a licensee of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. The resources for our providers may differ between states. Contact Us | Medicaid Empire InteractiveCare Reviewer is a utilization management tool that lets you submit prior authorization requests and other clinical information quickly and easily. Get the mobile app. Vaccination is important in fighting against infectious diseases. Your browser is not supported. * Availity, LLC is an independent company providing administrative support services on behalf of Empire BlueCross BlueShield HealthPlus. Interested in joining our provider network? All you need is your smartphone, tablet or computer.Sign up or log in to get started. List Your Practice; Find Doctors and Dentists Near You . Empire BlueCross BlueShield HealthPlus (Empire) is committed to supporting you in providing quality care and services to the members in our network. We work Monday- Friday (8:00 AM EST - 4:00 PM EST) 207 Park Lawn , Health (7 days ago) WebGet convenient online service through the ProviderPortal, or call AIM Specialty Health for support at 800-554-0580. Provider News is your source for important news and announcements, including policy updates, prior authorization changes, new product and program offerings, and more. Prior authorization contact information for Empire. We work with hundreds of doctors and facilities to make getting care easy. Thats why we encourage all our moms-to-be to take part in our New Baby, New LifeSM program, which is a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns. Providers can also use this tool to make inquiries on previously submitted PA requests, regardless of how they were sent (phone, fax, ICR or another online tool). The enrollee receives both Medicaid and Medicare services from one plan. Please follow the instructions in the letter to find a new provider or pharmacy before September 1, 2022. Log in to your account and send us a message. New York State, Telephone: Get translation and interpretation services free of charge. You can use the Find a Doctor toolhere to find a provider or pharmacy enrolled in Medicaid Fee for Service. Medicare Advantage and Duals Provider Site. Enroll with Empire today, or call 1-844-430-1699 (TTY 711) to find out if you qualify! Use this search to find a PCP by location or specialty. Choose your location to get started. Your "one-stop shop" comprehensive information center for online behavioral health resources. Medicare Advantage and Duals Provider Site. Get answers to your medical questions any time, day or night. The Category Search is arranged by topic. Essential Plan 4; Empire Health and Recovery Plan (HARP); Gatekeeper (Formerly - Pathway Enhanced); Medicaid Advantage Plan (MAP); Pathway Priority; Your insurance is accepted at the following hospitals: NYC Health + Hospitals/Bellevue. We look forward to working with you to provide quality services to our members.