EmblemHealth Network Access Program: Consider Leasing

Want to deliver a plan that realizes cost savings and hassle-free benefits administration? Look no further. The EmblemHealth Network Access Program offers all these benefits and more.

You can lease our hospital network, medical network — or both. Your faculty and staff gain access to quality care delivered by EmblemHealth's extensive network of world-class physicians, hospitals and acute care hospitals. With the EmblemHealth Network Access Program you get:

Discounted Access to Our Providers

Our longstanding relationships with participating providers allow us to negotiate sizable payment discounts. Consider:

  • Medical network reimbursement schedule produces discounts of 75 to 80 percent of RBRVS (Resource-Based Relative Value Scale).
  • Hospital network reimbursement schedule, which produces savings of 40 to 60 percent.

Flexibility

Network Access gives you the flexibility to choose how to price claims, which gives you complete control over your benefits administration. Lease our hospital network, medical network or both.

Extensive Networks That Provide Quality Care

Our medical network provides access to a wide range of medical practitioners, including:

  • Primary care physicians and specialists, including pediatricians, OB/GYNs, cardiologists, oncologists and more
  • Mental health inpatient and outpatient services provided through an alliance with ValueOptions®
  • Ancillary providers, including skilled nursing facilities, medical equipment and vision care
  • Clinical laboratories, such as Quest Diagnostics

Our hospital network includes nearly every acute care hospital, including Memorial Sloan-Kettering Cancer Center, Northern Westchester Hospital Center, St. Frances Heart Center and many others.

Security You Can Trust

Network Access uses the HIPAA 837 format and a secure Web pricing portal to ensure that your claims transmittals are secure and confidential.

Claims Pricing Options

You may utilize one or both of the following claims pricing options:

EmblemHealth Pricing Online Pricing by Client
For clients who want to submit claims electronically, EmblemHealth prices systemically and returns them for processing and payment. Authorized benefit administration staff can sign onto a secure web site to price claims at their own convenience via remote Internet access to the EmblemHealth Network Access provider claims re-pricing system.

Value-Added Health and Wellness Programs

EmblemHealth's Healthy Discounts Program offers your group discounts on weight-loss and exercise programs, hearing aids, massage therapy and more, to help your group members get healthy and stay healthy at no additional cost. And healthy members can mean lower claims costs.

For more information about the program, contact an EmblemHealth representative.