- US Legal Forms
- Form Library
- More Forms
- More Multi-State Forms
- NY Empire Blue Cross Blue Shield Precertification Request 2019
Get NY Empire Blue Cross Blue Shield Precertification Request 2019-2024
Lus (Empire) at 1-800-964-3627. Use the following specific contact numbers if your request pertains to: Outpatient services (physical health): o Phone: 1-212-563-5570, ext. 106-200-1261, option 1 o Fax: 1-855-201-8530 Durable medical equipment/orthotics/prosthetics: o Fax: 1-855-201-8527 Home care: o Fax: 1-855-201-8528 Long-term services and supports personal care services/Consumer Directed Personal Assistance Program: o Phone: 1-212-563-5570, ext. 106-200-1261, prompt 2 o Fax:.
How It Works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.
Licensee FAQ
-
Two companies from those early days of health insurance, Group Health Incorporated (GHI) and Health Insurance Plan of Greater New York (HIP), would later merge and become EmblemHealth. And after 80 years, our mission is still the same: to create healthier futures for our customers and communities.
-
Use the Prior Authorization tool within Availity or. Call Provider Services at 1-800-450-8753 (TTY 711)
-
GHI-Empire CBP option consists of two components: GHI, an EmblemHealth company, offering benefits for medical/physician services, and • Empire BlueCross BlueShield offering benefits for services provided at hospital and out- patient facilities.
-
Empire BlueCross BlueShield HealthPlus (Empire) is a wholly owned subsidiary of Anthem, Inc. (Anthem). As a leader in managed healthcare services for the public sector, Empire Corporation's subsidiary health plans provide healthcare coverage exclusively to low-income families, seniors and people with disabilities.
-
Empire BlueCross (Empire) is the trade name of Empire HealthChoice Assurance, Inc. and Empire BlueCross HMO is the trade name of Empire HealthChoice HMO, Inc. independent licensees of the Blue Cross Blue Shield Association, serving residents and businesses in the 28 eastern and southeastern counties of New York State.
-
We're here for you! Call Member Services at 1-800-300-8181 (TTY 711).
-
.empireblue.com/nymedicaiddoc To prevent delays in processing your prior authorization request, fill out this form in its entirety with all applicable information and fax to Empire BlueCross BlueShield HealthPlus (Empire) at 1-800-964-3627.
Llc Related content
-
Questions about prior authorization? Here's what...
p What does prior authorization mean? Some types of care require your provider to get an...
Learn more -
EMPIRE EPO
$15 co-pay. Precertification is required by Empire's Behavioral Healthcare Management...
Learn more -
Empire Plan Report
This Empire Plan Report summarizes the changes to your benefits and coverage under the New...
Learn more -
New York State Employees: Empire BlueCross...
Physician/surgeon fee. $0/admission. Not Covered. Precertification required. 3 of 10...
Learn more -
2022 Non-Medicare Eligible Retiree Benefits Guide
01-Nov-2021 — The information in this Enrollment Guide is presented for illustrative...
Learn more -
Amerigroup Provider sites
New York – Empire BlueCross HealthPlus · New York – Highmark Blue Cross Blue Shield...
Learn more -
PA Participating Agencies
01-Jan-2022 — This includes obtaining precertification for certain services when The...
Learn more -
Formulary Exception/Prior Authorization Request...
Expedited/Urgent Review Requested: By checking this box and signing below, I certify that...
Learn more -
Anthem Provider sites - Anthem Blue Cross Blue...
At Availity, you can: Request authorizations. Submit claims. Confirm eligibility. Log in...
Learn more -
EmblemHealth | Providers
10-Oct-2019 — This is why many of our plans, including the EmblemHealth EPO Value plan...
Learn more -
NEW YORK STATE MEDICAID PROGRAM INFORMATION ...
01-Sept-2006 — ➢ Inquiry Procedures. The Fiscal Agent handles written and telephone...
Learn more -
January 1, 2019 Empire Plan Certificate
Jan 1, 2019 — The hospital will contact Empire BlueCross BlueShield for payment. ... An...
Learn more -
Empire Plan Report - NY.gov
NY Active Empire Plan Report – October 2019. It is the policy of the New York State...
Learn more -
NYC Medicare Advantage Plus Enrollment Guide
Jan 1, 2022 — In-network providers who accept NYC Medicare. Advantage Plus are required...
Learn more -
ghi-comprehensive benefits plan/empire bluecross...
Pre-certification required contact NYC. Healthline at 1-800-521-9574. *Must be dispensed...
Learn more -
NYSHIP - 2020 at a Glance
... require precertification to confirm medical necessity before starting treatment (see...
Learn more -
2019 Employee Benefits Guide
Oct 18, 2018 — Information and enrollment forms for employees covered by our Express...
Learn more -
FORM 10-K
Securities registered pursuant to Section 12(g) of the Act: NONE. Indicate by check mark...
Learn more -
February 2, 2022
Feb 2, 2022 — provide to employees, to replace the Empire Blue Cross/Blue Shield ... (5)...
Learn more -
Home Health Services
Feb 15, 2005 — ... Form Completion. Instructions. Effective on and after April 1, 2014...
Learn more -
Services Requiring Pre-Certification for City of...
require precertification. This can be done by calling the NYC Healthline at 1-800 ... Blue...
Learn more -
ghi-comprehensive benefits plan/empire bluecross...
Payment for services will be made directly to the provider - you will not have to file a...
Learn more -
Empire Plan Report
... empireblue.com/nys/resources-forms. PRESS. OR SAY. 3. Mental Health and ... Some...
Learn more -
New York State Employees: Empire BlueCross...
Facility fee (e.g., hospital room). $0/admission. Not Covered. Precertification required...
Learn more -
2022 Non-Medicare Eligible Retiree Benefits Guide
Nov 1, 2021 — Our coverage with Empire Blue Cross Blue Shield includes a free nurse...
Learn more -
PA Participating Agencies
Jan 1, 2022 — If you have questions regarding specific benefits or claims, contact the...
Learn more -
Formulary Exception/Prior Authorization Request...
PLEASE PROVIDE ALL RELEVANT CLINICAL DOCUMENTATION TO SUPPORT USE OF THIS MEDICATION...
Learn more -
Amerigroup Provider sites
New York – Empire BlueCross HealthPlus · New York – Highmark Blue Cross Blue Shield...
Learn more -
Anthem Provider sites - Anthem Blue Cross Blue...
As one of the nation's leading health plans, Anthem serves millions of members in...
Learn more -
HEALTH INSURANCE CHOICES FOR 2019
Program to request a copy of the SBC for The Empire. Plan. If you need an SBC ... Empire...
Learn more -
ON THE - Road
Empire BlueCross BlueShield may require medical records to process your claim. Ask the...
Learn more -
January 1, 2019
01-Jan-2019 — This guide briefly describes the principal New York State Health...
Learn more -
Empire Plan Report
This Empire Plan Report summarizes the changes to your benefits and coverage under the New...
Learn more -
Welcome to EBD
Administered by Empire BlueCross BlueShield, New York State Service Center, P.O. Box 1407...
Learn more -
AT A GLANCE | JANUARY 2020
01-Jan-2020 — This guide briefly describes Empire Plan benefits. It is not a complete...
Learn more -
Please provide your medical and pharmacy benefits...
Most require prior authorization/pre-certification and or registration with infertility...
Learn more -
NYSHIP SEHP Report
01-Jan-2022 — This Report summarizes the changes to your benefits and coverage under the...
Learn more -
Health Plan
01-Jan-2022 — If the hospital participates with another Blue Cross and Blue Shield plan...
Learn more -
Empire Plan Report
This Empire Plan Report summarizes the changes to your benefits and coverage under the New...
Learn more -
NYS Medicaid Managed Care Pharmacy Benefit...
For information about NYRx, the Medicaid Pharmacy Program visit the NYRx site. For...
Learn more -
PEF Public Employees Federation
Jan 1, 2023 — submit a DAW Exception Request form (available at www ... Claims...
Learn more -
Insurance Information for Hospital for Special...
HSS accepts most major insurance plans for hospital services - see list below. Insurance...
Learn more -
Health Insurance Choices 2022 - Business Services...
It's Time to Make Your Health Plan Choices for 2022. This booklet explains the options...
Learn more -
Direct POS
Under the Direct POS, the network of health care providers is made available to you...
Learn more -
Planning for Retirement
The Empire Plan is designed for New York State employees and retirees. The ... BlueCross...
Learn more -
New York City Summary Program Description (SPD)
For NYCAPS Central agencies, employees should use Employee Self Service (ESS) to enroll in...
Learn more -
January 1, 2019
Jan 1, 2019 — (administered by Empire BlueCross BlueShield):. • Before a scheduled...
Learn more -
Empire Plan Report - NY.gov
The Empire Plan Certificate Amendments reflecting the changes outlined in this Report will...
Learn more -
January 1, 2019
Jan 1, 2019 — This guide briefly describes the principal New York State Health...
Learn more -
HEALTH INSURANCE CHOICES FOR 2019
Program to request a copy of the SBC for The Empire. Plan. If you need an SBC for a NYSHIP...
Learn more -
ON THE - Road
Empire BlueCross BlueShield may require medical records to process your claim. Ask the...
Learn more -
Welcome to EBD
If you have questions about your health insurance enrollment record, eligibility or NYSHIP...
Learn more -
AT A GLANCE | JANUARY 2020
Jan 1, 2020 — This guide briefly describes Empire Plan benefits. It is not a complete...
Learn more -
Please provide your medical and pharmacy benefits...
Our billing associates must submit all documentation requested by your insurer, including...
Learn more -
NYSHIP SEHP Report
Jan 1, 2022 — This Report summarizes the changes to your benefits and coverage under the...
Learn more -
Health Plan
Jan 1, 2022 — Upon request, Empire ... You will need to file a claim form for any...
Learn more -
Benefit Enrollment Guide
Please Note: This enrollment guide is a summary of the benefits provided to benefit...
Learn more -
Making the Most of Your 2019 EmblemHealth Benefits
Pre-certification required — contact. NYC Healthline at 800-521-9574. Please refer to...
Learn more -
EmblemHealth | Providers
Oct 10, 2019 — Effective January 1, 2019, Empire Blue Cross Blue Shield's. (BCBS) added...
Learn more -
Making the Most of Your 2019 EmblemHealth Benefits
You can call Empire. BlueCross BlueShield at 800-300-8181 for more information. *Hospital...
Learn more -
Questions about prior authorization? Here's what...
p What does prior authorization mean? Some types of care require your provider to get an...
Learn more -
HEALTH INSURANCE CHOICES FOR 2019
Program to request a copy of the SBC for The Empire. Plan. If you need an SBC ... Empire...
Learn more -
Drugs That Require Prior Authorization for the...
Jan 1, 2019 — January 2019. Drugs That Require Prior Authorization for the Empire Plan...
Learn more -
NYSHIP - 2020 at a Glance
This guide briefly describes Empire Plan benefits. It is not a complete description and is...
Learn more -
2022 Non-Medicare Eligible Retiree Benefits Guide
Nov 1, 2021 — The information in this Enrollment Guide is presented for illustrative...
Learn more -
2019 Employee Benefits Guide
Oct 18, 2018 — Information and enrollment forms for employees covered by our Express...
Learn more -
FORM 10-K
Securities registered pursuant to Section 12(g) of the Act: NONE. Indicate by check mark...
Learn more -
February 2, 2022
Feb 2, 2022 — provide to employees, to replace the Empire Blue Cross/Blue Shield ... (5)...
Learn more -
Coverage - State Health Benefit Plan - Georgia.gov
Jan 1, 2019 — This booklet gives you the details about your Medicare health and...
Learn more -
Empire Plan Report
This Empire Plan Report summarizes the changes to your benefits and coverage under the New...
Learn more -
NYS Medicaid Managed Care Pharmacy Benefit...
For questions regarding your eligibility or to find out which managed care plan you are...
Learn more -
NEW YORK STATE MEDICAID PROGRAM INFORMATION ...
Sep 1, 2006 — The purpose of this Manual is the provision of information and guidance to...
Learn more -
PEF Public Employees Federation
Jan 1, 2023 — This includes obtaining precertification for certain services when The...
Learn more -
Direct POS
Under the Direct POS, the network of health care providers is made available to you...
Learn more -
Insurance Information for Hospital for Special...
If you need help finding an appropriate doctor who takes your insurance, contact our...
Learn more -
Health Insurance Choices 2022 - Business Services...
It's Time to Make Your Health Plan Choices for 2022. This booklet explains the options...
Learn more -
2023 Empire Plan Benefit Summary
$200 penalty for failure to precertify. No coverage for days not considered to be...
Learn more -
GLANCE - New York State Department of Civil...
Jan 1, 2015 — To request a list of Qualified Procedures, or for preauthorization of...
Learn more -
Contract College Health Care | Working at Cornell
General Inquiries ; Empire Plan Claim Problems, Empire Blue Cross Blue Shield(Hospital)In...
Learn more -
Summary of Health Plans
Please call 1- 800-. 767-8672, 8:30 a.m. to 5:00 p.m., Monday through Friday. You may...
Learn more
Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
Keywords relevant to NY Empire Blue Cross Blue Shield Precertification Request
- BlueCross
- Precertification
- nymedicaiddoc
- nonelective
- icd
- NYEPEC
- licensee
- llc
- empireblue
- ext
- cpt
- HP
- prosthetics
- inpatient
- dob
USLegal fulfills industry-leading security and compliance standards.
-
VeriSign secured
#1 Internet-trusted security seal. Ensures that a website is free of malware attacks.
-
Accredited Business
Guarantees that a business meets BBB accreditation standards in the US and Canada.
-
TopTen Reviews
Highest customer reviews on one of the most highly-trusted product review platforms.