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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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Medical Policies
Medical policies that offer guidance and support for benefit determinations. 
Self-Service and Support  
Advance Patient Notice for Use of a Non-Participating Provider Policy
Advance Patient Notice for Use of an Out-of-Network Breast Reconstruction Surgeon

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

Cancer Care Quality Program
Dental Provider Resources
Download Commonly Used Forms and Quick Guides
Electronic Data Interchange (EDI)
Enhanced Personal Health Care Program
NYC Healthline: Pre-certification requests for City of NY members
Participating Providers/Facilities - Get connected with Electronic Funds Transfer
Services Administered by AIM Specialty Health (AIM)
WINFertility to provide prior authorization for infertility services
Information about Health Insurance Exchanges
Sign up for Network Rapid Updates
Empire Newsletters
Health Care Reform Updates and Notifications
ICD-10 Updates
Our Plans and Benefits  
Chiropractic Services
Behavioral Health Management
Pharmacy Management
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Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc., and/or HealthPlus, LLC., licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans, serving residents and businesses in the 28 eastern and southeastern counties of New York State. All external sites will open in a new browser window. Please view our Website Privacy Policy for more information.