12/16/2015

Healthfirst Policies Update

We have been provided some updates from Healthfirst regarding system and policy news

Injection codes: The claim system was updated December 2 and pre-authorization for injection codes has been removed. All denied claims are being reprocessed, although we don’t have a firm date yet. There is no need to resubmit claims.

CMS Guidelines:  We have been having ongoing dialogue regarding Healthfirst Medicare products being non-complaint with CMS guidelines. They are undertaking a complete review of their plans to make sure they mirror Medicare LCD policies. The target date for completion is on or about January 31, 2016.

Podiatric Toolkit:  They have offered (and we accepted) to put together a podiatric educational toolkit on their routine foot care policies. The toolkit will be posted online and hard copies will be sent to all enrolled providers. The target date for completion is on or about January 31, 2016.