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Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements
View requirements for Local Plan and BlueCard Out-of-Area members.

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Empire Provider and Facility Online Services - Changes Effective March 14, 2014  
Effective March 14, 2014, Physician and Facility Online Services will no longer provide eligibility, benefits and claim status information. After that date this information will be available only at www.availity.com. To register or access Availity go to www.availity.com. 
Medical Policies
Medical policies that offer guidance and support for benefit determinations. 
Self-Service and Support  
Cancer Care Quality Program
Advance Patient Notice for Use of an Out-of-Network Breast Reconstruction Surgeon

Out-of-Network Exception Requests for Breast Reconstruction Following a Mastectomy

WINFertility to provide prior authorization for infertility services
Participating Providers/Facilities - Get connected with Electronic Funds Transfer
Availity's Web Portal now available for Empire providers
Services Administered by AIM Specialty Health (AIM)
Split Group Policy
Advance Patient Notice for Use of a Non-Participating Provider Policy
Download Commonly Used Forms and Quick Guides
Dental Provider Resources
Electronic Data Interchange (EDI)
Enhanced Personal Health Care Program
Our Plans and Benefits  
Chiropractic Services
Behavioral Health Management
Pharmacy Management
Information about Health Insurance Exchanges
Sign up for Network Rapid Updates
Empire Newsletters
Health Care Reform Updates and Notifications
ICD-10 Updates
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