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Information for New York







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.

City of New York Group Retirees

The NYC Medicare Advantage Plus plan, an alliance between Empire BlueCross BlueShield and EmblemHealth, will no longer be implemented on April 1, 2022. Please check back often for more detailed information as it becomes available.

NYC Medicare Advantage Plus Implementation Update

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:

Download the new protocol for hearing aids

Medicare Advantage Updates

Stay current on the latest news and changes with these important Medicare Advantage updates. For information directly regarding coronavirus, visit our COVID-19 news page.


Provider Guides & Forms

Make use of these helpful resources to assist you when working with our Medicare Advantage products and patient claims.

HMO & PPO Provider Guidebook

Important information about credentialing, reimbursement, appeals, and more

Member ID Card Samples

Examples of member identification cards to familiarize yourself with the format

Provider Forms

A library of forms related to Medicare Advantage and doing business with Empire

Featured Videos

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.

Training

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.

View Medicare Advantage policies

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.

View Medicare Advantage policies

Contact Us

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.

HMO Products

1-866-395-5175

LPPO Products

1-800-499-9554