Get your plan, your way with EmblemHealth. Let us help you find or build a plan to meet both your budget and the needs of your institution's faculty and staff.
We'll work closely with you to tailor a coverage solution that fits within your budget and shows your faculty and staff that you care — like we do — about all the things that go into a great health plan.
Your Plan, Your Way — The EmblemHealth Shared Administrative Advantage Program
At EmblemHealth, we understand that as health care costs continue to rise, it's more challenging than ever for your faculty and staff, hard-working New Yorkers, to get the most out of their health care dollar.
By combining EmblemHealth's extensive provider network with your health care plan, the Shared Administrative Advantage (SAA) program is a health care option designed to help you get your staff members the quality care they deserve — at an affordable price.
You're in the driver's seat
You can customize your own health plan to the needs of your faculty and staff, who will benefit from:
- Provider discounts
- An extensive provider network — nationwide
- Premier hospitals in New York State
- A seamlessly administered plan
- Quality care
We know that each higher education institution is unique, so we don't limit the SAA program to colleges or universities of a particular size. Whether you're a small or large institution, the overall cost of your care can go down when you use the SAA network of practitioners.
Because we have extensive and long-standing partnerships with health care professionals and facilities in New York State, we can pass on great discounts to your faculty and staff. Let us prove
it to you.
When we meet, we'll present two extensive analyses of your groups's health care expenditures:
- Complimentary claim repricing based on an analysis of your claims history. We'll show you in precise dollar amounts what your real health coverage costs are and how much your group could save with the SAA program.
- A head-to-head comparison of every provider and facility in your current network to demonstrate the EmblemHealth network advantage.
Schedule a meeting at your convenience. E-mail us at email@example.com or call 877-411-3625.
Great Provider Network
The EmblemHealth Shared Administrative Advantage program offers access to hospitals throughout New York State, including some of the nation's most recognized cancer centers, such as Memorial Sloan-Kettering Cancer Center and Roswell Park Cancer Institute.
Your faculty and staff will also have discounted access to some of the largest medical groups in the New York area, such as Allied Pediatrics of New York, Crystal Run Healthcare, ProHealth Care Associates LLP, Mount Kisco Medical Group, PC and WESTMED Medical Group, just to name a few.
By using our provider network, you get peace of mind that your group is saving on costs while your staff members are receiving quality care.
Our partnership with our providers extends beyond claims payments. We provide end-to-end support.
We use effective and proven management tools to help practitioners guide their patients' through the health care process. We encourage the use of clinical practice guidelines and we regularly review current medical literature to assess the safety and efficacy of new and existing technologies.
Plus, nurse care managers provide review and case management when members are hospitalized or receive skilled nursing facility care, rehabilitation, home care or hospice services. They can assist the coordination of care by multiple providers across different health care systems, so the member can concentrate on getting better.
Your Role and Our Role
The EmblemHealth SAA program keeps your group in control of faculty and staff benefits and allows you to take advantage of our operational expertise.
We will seamlessly integrate the SAA program into your existing medical plan. Our professional and highly experienced account managers will provide ongoing support how and when you need it.
Here's how your group and EmblemHealth work together for a well-run health plan that focuses on your staff members and keeps your costs down.
|Your Employer Group Will Provide:
||EmblemHealth Will Provide:
|Enrollment and eligibility maintenance
|ID card issuance
|Explanation of benefits issuance
|Benefit file maintenance
||Explanation of payments
||Explanation of payments
||Medical record reviews
||Provider directory and lookup
How SAA Works
With over 75 years of experience providing quality health care coverage in New York State, we have established solid relationships with doctors and hospitals in our region and are well-positioned to manage our providers' expectations.
EmblemHealth will continue to adjudicate claims for network practitioners and facilities the way they are accustomed to. With consistent claims pricing and seamless claims payments, network doctors can focus on providing care and not be concerned with how and when their claims will be paid.
This translates into provider satisfaction and deep discounts to your faculty and staff.
The Program, Step-by-Step
- The plan member easily finds a network provider through our provider lookup tool, available through your group's Web site.
- The member receives care from a network provider.
- The member is only responsible for the applicable copay, deductible, coinsurance and noncovered service charges.
- The network provider sends the claim to EmblemHealth.
- EmblemHealth applies network benefits and claim adjudication edits at our discounted rate.
- EmblemHealth transfers the claim file to your group for confirmation.
- EmblemHealth pays the network provider.
- Your group adjudicates and pays the out-of-network provider.