Medicare Advantage Providers
Empire offers a variety of Medicare plans to support member needs. We also support our providers with access to information about our plans and member benefits, news and updates, training materials and guides and other helpful resources.
Plans & Benefits
To search for evidence of coverage (EOC), summary of benefits (SOB) and Formulary documents for our Individual Medicare Advantage products please visit our Medicare Advantage Plans page. If the product you are searching for is not listed, please call the number on the back of the member’s ID card.
GRS Hearing Aid Coverage Update
Effective January 01, 2022
Many Group Retiree Solutions (GRS) plans now include the requirement that all hearing aids be supplied by Hearing Care Solutions (HCS).
If you are not an HCS provider and are going to fit a patient for a hearing aid, first verify the member’s out-of-network benefits and then follow the protocol outlined in the following document:
Provider Guides & Forms
Make use of these helpful resources to assist you when working with our Medicare Advantage products and patient claims.
Important information about credentialing, reimbursement, appeals, and more
Examples of member identification cards to familiarize yourself with the format
A library of forms related to Medicare Advantage and doing business with Empire
As a clinician, you play a powerful role in ensuring your patients are adherent to their medication regimens. Motivating your patients to adhere to their medication can contribute to improved outcomes and increased STARS performance. We created these videos to offer you best practices for helping your patients remain adherent to their medication therapies and educate them on the role that statins play.
Individual Plans & Employer Group Plans
Empire reimbursement policies outline the basis for reimbursement for services covered by a member’s benefit plan and serve as a guide to assist you in accurate claims submission.
Medicare Advantage PPO members of non-Anthem Blue Plans should utilize our Medicare Advantage reimbursement policies. There are five reimbursement policies that only apply to MA PPO members of non-Anthem Blue Plans. These policies have been listed as MA PPO.
For the most direct point of contact, use the number provided on the back of the member’s ID card. If those numbers are not available to you, use the phone numbers listed below for assistance with your questions.