New EmblemHealth Vision Services Program

Starting January 1, 2017, contingent upon approval by the New York State Department of Health, EmblemHealth will introduce the EmblemHealth Vision Services Program (EHVSP), in partnership with EyeMed Vision Care, LLC (EyeMed). EHVSP will replace Davis Vision, CPS, GPS and Eye Advantage and all other eye care agreements for all EmblemHealth members.* See our new Vision Services Program for complete details.

*This program will serve members in plans underwritten by HIP Health Plan of New York (HIP) and HIP Insurance Company of New York (HIPIC) as well as members managed by Group Health Incorporated (GHI).

Help Your Medicaid Patients Keep Their Coverage

Remind patients to renew their Medicaid eligibility. Several months before coverage ends, Medicaid recipients will receive a renewal package from their local Department of Social Services (DSS). Recipients must be proactive in renewing. Please remind them to call their County DSS office if their renewal application does not arrive. (More)

   Striving for Five

Increase Your Patient Communication Effectiveness

  • Make it a partnership; involve patients in decision making
  • Create an atmosphere of equality and mutual respect:
    • Remind patients about their appointment 48 hours in advance.
    • Inform patients about delays and appointment changes immediately.
    • Communicate test results, including follow-up care required, within 24 hours.
    • Call patients and schedule needed tests, screenings or annual well visits before they are due.
  • During flu season, remind patients to get a flu vaccination.

EmblemHealth is No Longer Contracted with Myriad Genetics

All hereditary cancer risk testing (MyRisk, BRCA, and Lynch Syndrome testing) provided by Myriad Genetics is no longer a covered service for our members on an in-network basis. (More)

Enroll by February 1, 2017, to Prescribe Drugs for Medicare Members

Providers who prescribe Part D drugs on or after February 1, 2017, must be enrolled in Medicare in an approved status (or validly opt-out, if appropriate) for their prescriptions to be covered. This new rule is a requirement of the Centers for Medicare & Medicaid Services (CMS).


The flu season has begun. Please remind and encourage your patients to get their flu vaccine. For more information, see our member website dedicated to the flu, pneumonia, and shingles.

Claims Corner

Medical Technologies Database 2016


The Medical Technologies Database 2016 contains a comprehensive list of medical technologies reviewed by the Medical Policy Subcommittee for coverage consideration.



Religion is Key in Cultural Competency

EmblemHealth is pleased to offer The Medical Manual for Religio-Cultural Competency. It provides practical information to help practitioners understand how a patient's medical decisions can be influenced by their religious observances and is the most comprehensive guide to religion and health care available. Sign on to the secure provider site to get a FREE copy of The Medical Manual.



Monthly Instructor-Led Webinars

For in-depth information about our Networks, benefit plans, web-based tools and resources, join us for one of our monthly live Webinars.

Offered the second Wednesday of each month, at 10 am and 2 pm, this informational session shows you how to get the most value from our website.

All instructor-led webinars are hosted by EmblemHealth provider network staff who can answer questions in real time. Space is limited, so register early.

Register today.

Due October 31, 2016

Complete the 2016 EmblemHealth Special Needs Plan (SNP) Model of Care (MOC) Training with the user ID/PIN that was recently sent to you via fax or email. Each year, as mandated by the Centers for Medicare & Medicaid Services (CMS), all providers in the Medicare Choice PPO Network and the VIP Prime Network are required to complete the SNP MOC Training for each of the Dual Eligible SNPs in which they participate.

Breastfeeding Grand Rounds (BFGR)

BFGR is a free, annual webcast sponsored by the University at Albany School of Public Health in partnership with the NYSDOH to provide continuing education for healthcare professionals on current breastfeeding health issues with both clinical and public health significance. This year's webcast, Breastfeeding Grand Rounds: Building a Continuum of Care to Support Exclusive Breastfeeding in New York State is now available on demand.

Know Your Network Participation

Your provider profile lists your network affiliations. To view it, please login to your Provider/Practice Profile on our secure provider portal at emblemhealth.com. If the network information on the member's ID card matches your network affiliations, then you are in-network for that member's benefit plan. See the Provider Networks and Member Benefit Plans chapter of the EmblemHealth Provider Manual for a listing of all networks and plans.

Review Our Access and Availability Standards

Find Out How You and Your Staff Can Improve the Patient Experience

Help Your Patients Stay Fit

EmblemHealth has health and wellness programs, and tools and resources to help members stay fit and enhance their quality of life. EmblemHealth members have access to Healthy Discounts at no additional cost. Participating vendors offer discounts for health club memberships, acupuncture, massage therapy and nutrition counseling, weight loss services, hearing and vision care, vitamins and supplements, and other comprehensive health care services and products.

Do More On the Go!

Our myEmblemHealth mobile app provides useful benefit and plan information for members, right at their fingertips:

•  Search for a doctor or hospital

•  See copay, benefit and claims

•  Access their ID card

•  Pay their bill

•  View their physician (PCP)

Easy access — anytime, anywhere! Encourage your patients to download it today.

Available on all iOS and Android devices.





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