News & Announcements

SOMOS management of delegated functions postponed

The collaborative partnership between Empire BlueCross BlueShield HealthPlus (Empire) and SOMOS IPA, LLC (SOMOS) and its affiliates previously set for March 1, 2020, has been postponed until further notice.

• SOMOS management of delegated functions postponed

SOMOS to manage delegated functions effective March 1, 2020

We are pleased to announce that Empire BlueCross BlueShield HealthPlus (Empire) has expanded its collaborative partnership with SOMOS IPA, LLC and its affiliates (SOMOS). This new agreement aligns incentives between the plan and SOMOS to deliver the highest possible quality care to our Medicaid Managed Care (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHPlus) and Essential Plan members in New York.

• SOMOS to manage delegated functions effective March 1, 2020

Availity Provider FAQ and Availity Notification

Starting March 9, 2020, Empire will launch the use of Availity’s Medical Attachment functionality for electronic communications. This new functionality allows providers to upload medical records and itemized bill information electronically instead of through traditional paper communications. This functionality can improve communications for medical record requests and receipt and will not impact the audit program.

• Availity - Provider FAQ
• Availity Notification

Montefiore ACO IPA and Montefiore Care Management

Effective December 31, 2019, the provider collaboration partnership with Montefiore ACO IPA and Montefiore Care Management (CMO) will dissolve.

• Montefiore ACO IPA and Montefiore Care Management

Acute care general hospital inpatient medical or surgical room and board

The purpose of this communication is to provide guidance on the reimbursement of Exempt Unit services.

• Acute care general hospital inpatient medical or surgical room and board

Empire NY Priority HEDIS Measures recording link

• Empire NY Priority HEDIS Measures recording link