EmblemHealth conducts an annual Provider Satisfaction Survey, which is now underway. If you received this survey, please take a few minutes to complete it either on paper or online. We appreciate your prompt response.
Upcoming Medical Record
Audits for 2013
EmblemHealth conducts medical record audits to ensure we comply with Centers for Medicare & Medicaid Services and New York State Department of Health regulatory requirements, as well as National Committee for Quality Assurance standards of patient care. Here are some audits you can expect in 2013:
HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).
Transportation Benefit Updates
On January 1, 2013, the transportation benefit changed for both Medicaid Managed Care and Family Health Plus (FHPlus)* members enrolled in
New York City:
Medicaid: Emergency and nonemergency medical transportation are covered by regular Medicaid.
FHPlus: Only nonemergency medical transportation is covered by regular Medicaid.
HIP no longer covers emergency and nonemergency transportation for our NYC Medicaid enrollees, nor nonemergency transportation for NYC FHPlus members. This means HIP-participating practitioners no longer need to reimburse NYC-enrolled Medicaid and FHPlus members for the cost of transportation to and from medical appointments. More
*Includes UFT FHPlus.
New Diagnostic Imaging Self-Referral Policy
In July 2013, EmblemHealth will institute an Outpatient Diagnostic Imaging Self-Referral Payment Policy (SRPP) to replace HIP's Radiology and Cardiology Imaging Privileging programs. The policy defines the minimum accreditation and certification requirements by specialty for diagnostic imaging conducted in an office setting. Prior approval rules will continue to apply where applicable. More
Please join us for a no-cost Webinar on the second Wednesday of each month, from 10 am to 11 am and 2 pm to 3 pm, to help you manage your business with us. All you need is Internet access, a phone and an hour.
Web topics include:
Navigating our Web site
Using medical and payment policy tools
Identifying EmblemHealth member ID cards and member benefits
Group Health Incorporated (GHI), GHI HMO Select, Inc. (GHI HMO), 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.