Empire BlueCross BlueShield Managed Long-Term Care Provider Orientation
This file is a comprehensive orientation guide for providers joining the Empire BlueCross BlueShield Managed Long-Term Care (MLTC) network. It covers important topics such as the provider website, authorization process, claims submission, appeals and grievances, compliance program, fraud prevention, HIPAA, and cultural competency. Providers will find all the necessary information to ensure a successful partnership with Empire.
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How do I fill this out?
To fill out this orientation guide, start by reviewing each section to understand the information required. Take your time to read through the details and notes provided. Make sure to complete all necessary fields and follow the instructions given.
How to fill out the Empire BlueCross BlueShield Managed Long-Term Care Provider Orientation?
1
Review each section of the guide.
2
Take notes on the required information.
3
Complete all necessary fields.
4
Follow the instructions carefully.
5
Ensure all information is accurate before submission.
Who needs the Empire BlueCross BlueShield Managed Long-Term Care Provider Orientation?
1
Healthcare providers who are new to the Empire BlueCross BlueShield MLTC network need this guide to understand the policies and procedures.
2
Providers who need to learn about the claims submission and authorization process.
3
Healthcare professionals who want to familiarize themselves with Empire's compliance program.
4
Providers looking to understand how to report fraud, waste, and abuse.
5
Healthcare providers who need to ensure they are HIPAA compliant and culturally competent.
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What are the instructions for submitting this form?
Submit the completed orientation form to Empire BlueCross BlueShield through the designated submission process. You can submit the form via email, fax, or through their online submission portal. Ensure that all fields are completed accurately and retain a copy for your records.
What are the important dates for this form in 2024 and 2025?
It is important to stay updated with Empire's orientation schedules. Make sure to check for any updates regarding session dates in 2024 and 2025.
What is the purpose of this form?
The purpose of this orientation form is to provide comprehensive guidance to healthcare providers joining the Empire BlueCross BlueShield Managed Long-Term Care (MLTC) network. It ensures providers are well-informed about the policies, procedures, and compliance requirements essential for delivering quality care. By following this guide, providers can foster a successful partnership with Empire and ensure the best possible outcomes for members.
Tell me about this form and its components and fields line-by-line.
- 1. Provider Website: Information on accessing and utilizing the provider website.
- 2. Authorization Process: Details on the authorization process for services.
- 3. Claims Submission: Guidelines for submitting claims accurately.
- 4. Appeals and Grievances: Instructions on handling appeals and grievances.
- 5. Empire Compliance Program: Overview of the compliance program and requirements.
- 6. Fraud, Waste, and Abuse: Information on reporting suspected fraud, waste, or abuse.
- 7. HIPAA: Guidelines to ensure HIPAA compliance.
- 8. Cultural and Linguistic Competency: Information on cultural competency in healthcare delivery.
What happens if I fail to submit this form?
Failing to submit this form may result in delays in your orientation process or potential non-compliance with Empire's requirements.
- Compliance Issues: Non-compliance with orientation guidelines.
- Delayed Authorization: Delays in service authorization and claims processing.
- Missed Deadlines: Potentially missing important deadlines for provider credentialing.
How do I know when to use this form?
- 1. Joining Empire MLTC Network: For healthcare providers new to the Empire MLTC network.
- 2. Policy and Procedure Training: To become familiar with Empire's policies and procedures.
- 3. Compliance Training: To ensure compliance with Empire's guidelines and regulations.
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