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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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Search our online provider directory when you need a doctor, hospital or other health care provider.

Claim adjustments for members reaching out-of-pocket maximums – February 2015
Preventive care services covered with no member cost-share - Updated 2/12/15)
Updated contact information for ERA and EFT registration – February 2015
Update regarding the mailing of paper remittance vouchers for providers enrolled in Electronic Remittance Advice (ERA) – Updated October 2015
Preventive care services covered with no member cost-share – Updated September 2014
Empire will discontinue the mailing of paper remittance vouchers for ERA registered providers beginning September 15, 2014
New online processes for ERA only registration and provider management of paper remittance vouchers – May 15, 2014
Reminder - Preventive Care services covered with no member cost-share – January 2014
Upcoming changes to ERA and EFT processes – Updated January 2014
Coverage for Members in Clinical Trials – November 2013
Upcoming changes to ERA and EFT processes – November 2013
Pre-existing waiting periods to be removed beginning January 1, 2014
A Closer Look at Health Insurance Exchanges - January 2013
Colonoscopy Billing Reminder- Preventive vs. Diagnostic - December 2012
U.S. Supreme Court upholds health care reform law – June 2012
Health Care Reform Expands Preventive Care Coverage for Women - March 2012
What We’ve Implemented and Future Changes- November 2011.
Drug Coverage and Preventive Care – June 2011
Coding Preventive Evaluation and Management Services – May 2011
Preventive Care Benefits Due to Health Care Reform – Updated May 2011
Update Regarding Essential Health Benefits – February 2011
No Annual Dollar Limits – Some Waivers Granted by HHS – February 2011
New Modifier Impacts Coding of Colonoscopy Claims – February 2011
New CPT Modifier 33 for Preventive Services under PPACA – February 2011
Preparing for 2011 – December 2010
Health Care Spending Accounts Require Prescriptions for OTC Medications under Patient Protection and Affordable Care Act – November 2010
Health Care Reform Impacts Member Policies Differently – September, 2010
Key Provisions Impact Member Benefits – August 2010
Medicare Part D Prescription Rebate – August 2010
Surprising Facts about Health Care Spending and Health Insurer Profits – June, 2010
Website Launched to Help Answer Your Health Care Reform Questions – June, 2010
Breast Cancer Patient Protection Act Provision Implemented – June 2010
Early Implementation of Dependent Coverage Extension – May 2010
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