AUGUST 2013

 

EmblemHealth Receives Approval for Merger

On June 26, 2013, EmblemHealth merged GHI HMO Select, Inc. into HIP Health Plan of New York. GHI HMO providers received notices of the merger. For now, the merger does not affect how providers conduct business with us. Please continue to follow all current GHI HMO processes.

Claims Corner

Starting July 23, 2013: Manual and Electric Breast Pump Availability
Members with coverage* may purchase manual and electric breast pumps (HSPCS codes: E0602 and E0603) directly from an EmblemHealth durable medical equipment vendor with a prescription. No prior approval is needed.

Members should request a prescription from their provider in the last trimester of their pregnancy, but can obtain a prescription at any time pre- or post-delivery. This benefit covers one breast pump in a 12-month period.

*Not a benefit for Family Health Plus and certain commercial plan members.
See patient's eligibility and benefits on our secure Web site at www.emblemhealth.com.

Download Our Confidentiality Protocols for Endangered/Domestic Violence Victims

New York State Insurance Law 2612 governs the confidentiality protocols for domestic violence victims and endangered individuals. EmblemHealth will accommodate a reasonable request for a covered individual to receive claims-related communications from us by an alternate means or at an alternate location, if the member delivers to us a valid order of protection against the policyholder or other person or indicates they are a victim of domestic violence or endangered by the disclosure of certain information to the policyholder. More

Clinical Corner

Formulary Updates

Review the most recent changes to our Commercial Premier/Child Health Plus, Commercial Select and Medicaid/Family Health Plus formularies. Also review our Medicare HMO/PPO and Medicare Prescription Drug Plan (PDP) formularies.

Health Alerts

See the latest clinical health and medication alerts.

EmblemHealth Neighborhood Care — Community Events

Cambria Heights Calendar of Events August 2013
ALL EVENTS ARE FREE AND OPEN TO THE PUBLIC

Saturdays
   11 am - 12:30 pm: Healthy Living With Diabetes
   5:30 - 6:30 pm: Summer Fitness Workout

Mondays and Wednesdays
   10:30 - 11:30 am: Low Impact Zumba

August 28 and August 30
   2 - 5 pm: Free Dental Screening* — For children and young adults
  ages 2-21** — No appointment needed — Free giveaways

*This screening is not a substitute for dental care provided by a dentist.
**Those under age 18 require a parent/guardian present to sign a consent form.

For a full calendar of events:

 

 

Upcoming Provider Forums at EmblemHealth Neighborhood Care

Register for a Provider Forum at one of our Neighborhood Care sites to learn how to partner with us in caring for your patients.

  • EmblemHealth Neighborhood Care — Cambria Heights
    206-20 Linden Boulevard
    Cambria Heights, NY 11411
    Phone: 1-866-539-0999
    September 20, 2013   9-11 am
    November 6, 2013       9-11 am
  • EmblemHealth Neighborhood Care — Harlem
    215 West 125th Street
    New York, NY 10027
    Phone: 1-866-539-0999
    September 27, 2013   

    10 am -noon

Tours will be given so you can see all that EmblemHealth Neighborhood Care has to offer you and your patients. Contact Larissa Swanberg-Obadia at LSwanbergObadia@EmblemHealth.com for more information.

Monthly Webinars for Practitioners and Office Staff

Topics include:

  • Navigating our secure Web site
  • Using medical and payment policy tools
  • Identifying EmblemHealth member ID cards and member benefits

Who should attend: Practitioners and their staff members who want to learn about new EmblemHealth products and Web site updates.

When: Second Wednesday of each month; 10-11 am and 2-3 pm

To register: Complete and submit an online registration form.

 

 

Review your information now to ensure you are correctly listed in our EmblemHealth directories. If any of your information has changed or is inaccurate, just follow our simple instructions to update your profile online. Can't update your information online? Fax your changes to our Provider Modifications team at 1-877-889-9061.

 
 

©2013 EmblemHealth. All Rights Reserved. Privacy Policy.

Group Health Incorporated (GHI), HIP Health Plan of New York (HIP), HIP Insurance Company of New York and EmblemHealth Services Company, LLC are EmblemHealth companies. EmblemHealth Services Company, LLC provides administrative services to the EmblemHealth companies.

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