Healthfirst for providers
Get all the tools you need to manage your practice and deliver excellent service to Healthfirst patients
Get all the tools you need to manage your practice and deliver excellent service to Healthfirst patients
What's New
Provider Resources
Coronavirus (COVID-19)
Visit this section and stay current on the latest guidance in billing, telehealth and more as it relates to COVID-19.
Visit this section and stay current on the latest guidance in billing, telehealth and more as it relates to COVID-19.
Behavioral Health
44 items
Modified Jul 1, 2020
Modified Jul 1, 2020
Behavioral Health
Use these resources to find out more about billing, authorization guidelines, and Home and Community Based Services (HCBS) training available to you and your practice.
Use these resources to find out more about billing, authorization guidelines, and Home and Community Based Services (HCBS) training available to you and your practice.
Coding
43 items
Modified Jul 1, 2020
Modified Jul 1, 2020
Coding
Review documentation and coding tips, ICD-10 and ICD-11 resources, and other documentation and coding information.
Review documentation and coding tips, ICD-10 and ICD-11 resources, and other documentation and coding information.
Claims & Billing
49 items
Modified Jul 1, 2020
Modified Jul 1, 2020
Claims & Billing
Learn more below about how to enroll for claims processing, submit claims electronically, and more. Whether you’re a provider or in-office staff, you’ll also find everything you need on billing and reimbursement right here.
Learn more below about how to enroll for claims processing, submit claims electronically, and more. Whether you’re a provider or in-office staff, you’ll also find everything you need on billing and reimbursement right here.
Compliance and Regulatory
25 items
Modified Jul 1, 2020
Modified Jul 1, 2020
Compliance and Regulatory
Healthfirst promotes a culture of compliance and is committed to maintaining an ethical work environment for all of our employees, members, providers, and vendors.
Healthfirst promotes a culture of compliance and is committed to maintaining an ethical work environment for all of our employees, members, providers, and vendors.
Patient Care Resources
209 items
Modified Jul 1, 2020
Modified Jul 1, 2020
Patient Care Resources
Feel free to share resources from this section with your patients to help them manage their chronic conditions and improve their health.
Feel free to share resources from this section with your patients to help them manage their chronic conditions and improve their health.
Pharmacy Resources & Formularies
17 items
Modified Jul 1, 2020
Modified Jul 1, 2020
Pharmacy Resources & Formularies
Find the most updated formulary and medical and pharmacy benefit information here. Tips and resources for pharmacies are also available.
Find the most updated formulary and medical and pharmacy benefit information here. Tips and resources for pharmacies are also available.
Plans & Benefits
7 items
Modified Jul 1, 2020
Modified Jul 1, 2020
Plans & Benefits
Access this section for information on Healthfirst plans and benefits.
Access this section for information on Healthfirst plans and benefits.
Quality Program Resources
135 items
Modified Jul 2, 2020
Modified Jul 2, 2020
Quality Program Resources
Information and resources to help you with your participation in the Healthfirst Quality Incentive Program (HQIP) and federal and state quality incentive programs such as CAHPS, HEDIS, and QARR, are available here.
Information and resources to help you with your participation in the Healthfirst Quality Incentive Program (HQIP) and federal and state quality incentive programs such as CAHPS, HEDIS, and QARR, are available here.
Telehealth
7 items
Modified Jul 1, 2020
Modified Jul 1, 2020
Telehealth
The transition to telehealth can be challenging. Visit this section for billing, coding, best practices, and other great resources on telehealth.
The transition to telehealth can be challenging. Visit this section for billing, coding, best practices, and other great resources on telehealth.
Join Our Network
Healthfirst has over one million members and growing. Join thousands of doctors in providing the best possible care to the patients who need you.
Healthfirst has over one million members and growing. Join thousands of doctors in providing the best possible care to the patients who need you.
Find a Doctor, Hospital or Pharmacy
We work hard to make it easy for you to get the care you need, when you need it. Search in-network providers, hospitals, pharmacies, and more with this convenient tool.
We work hard to make it easy for you to get the care you need, when you need it. Search in-network providers, hospitals, pharmacies, and more with this convenient tool.
Refer Long-Term Care
Provide and coordinates services that are typically covered by Medicaid and Medicare, including the health, social, emotional, nutritional, and rehabilitation services.
Provide and coordinates services that are typically covered by Medicaid and Medicare, including the health, social, emotional, nutritional, and rehabilitation services.
Provider Manuals
These helpful provider manuals will give you and your staff easy access to the information you need to run your practice and provide quality care to Healthfirst members.
These helpful provider manuals will give you and your staff easy access to the information you need to run your practice and provide quality care to Healthfirst members.