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Medical Protocol Updates Available Online – June 2022

Date:
June 28, 2022

LEGACY SYSTEMS

We recently reviewed 66 medical protocols.

These will be posted online on or before July 1, 2022, and will have an effective date of August 1, 2022, unless otherwise noted. 

  • Please refer to the cover letter for brief summaries of new or changed protocols
  • Please note that some of the protocol updates may not pertain to all members 
  • If you need help finding specific protocol updates, please contact Provider Service at 1-800-444-4552 or (518) 220-5620

HIGHMARK SYSTEMS

Highmark’s monthly Medical Policy Update Newsletter will be available online on or before June 27. These changes may impact your patients who have moved onto Highmark’s system. Policy updates described in the newsletter will be effective September 26, 2022 and can be reviewed by clicking on the link below.

All medical policies for Highmark system patients can be reviewed by clicking on the link below.

Recent Articles

  • Right Start Prenatal Program Transition for 2023
    Beginning January 1, 2023, Right Start prenatal and home visiting programs for high-risk pregnancies will no longer be continuing for your Highmark Blue Shield of Northeastern New York patients. Your Highmark BSNENY patients that are enrolled in Right Start and still need support into 2023 will be transitioned into our High-Risk Maternity Specialty Case Management program.
  • Improving Patient Satisfaction with CAHPS and HOS Surveys
    The Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Medicare Health Outcomes Survey (HOS) are patient surveys that affect CMS star ratings – for you and for us. Improving patient experience leads to better health outcomes for your patients and helps support gap closure programs. In this article, you can find tips to help your office improve patient satisfaction, as well as additional information about these surveys.
  • Reminder: Working with BetterDoctor
    Highmark Blue Shield of Northeastern New York partnered with BetterDoctor in 2020 to help keep our network provider information current. As part of our network, you can expect to receive emails from BetterDoctor and should not hesitate to respond to their outreach.
  • Congratulations to New York State HPV Vaccination Honor Roll Award Winners
    We want to congratulate several provider offices for achieving superior youth human papillomavirus (HPV) vaccination completion rates in their practice. Despite strong education efforts, youth HPV vaccination rates continue to remain low. According to the NYS HPV Coalition, at least 30% of adolescents in New York State are not fully vaccinated against HPV. Here, you can view the winners and find additional information about HPV vaccination.
  • Diabetes Prevention Program for Medicare Advantage Patients - 2022
    As a reminder, the Medicare Diabetes Prevention Program (M-DPP) is a no-cost program to help your Highmark Blue Shield of Northeastern New York Medicare Advantage patients with prediabetes manage their condition. This evidence-based, CDC-recognized program helps educate and offer support for older adults diagnosed with prediabetes or who are at high risk for developing Type 2 diabetes. In this article, you can learn more about the program and refer your eligible patients.

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Additional Resources

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