Policies and procedures for the coordinated care of our members.
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Policies & Procedures
| Date (YYYY/MM/DD) | Title |
|---|---|
| 2021/07/12 | Enhanced Claims Editing Processes |
| 2021/06/20 | Claims Submission -Timely Filing |
| 2021/01/05 | Home Delivered Meals For Medicaid and HARP –Billing Guidance |
| 2/17/2022 | In-Office Testing List to Cover All EmblemHealth Members |
| 2020/12/17 | Look Back Periods to Reconcile Overpayments |
| 2020/11/18 | Maternity Claims Adjusted Procedures |
| 2020/06/12 | Audits Involving Medicare Demand Billing and Overpayments Involving Dual Eligible Recipients |
| 2020/04/11 | Restricted Breast Cancer Surgery Facilities for Medicaid/HARP Recipients |
| 2020/01/02 | Billing for Non-Covered Services |
| 2020/01/02 | Do Not Balance Bill Dual-Eligible Members |
| 2020/01/02 | Home Health Billing Guide |
| 2020/01/02 | Surprise Bills and Emergency Services Uniform Notice for Out of Network Providers |
| 2020/01/02 | Keep Billing Information Current |
| 2015/06/15 | Annual Fee Schedule Updates from CMS |
| 2013/07/25 | Out of Network Provider Appeal Process for Denied Claims |
| 2022/04/25 | Hospital Readmissions Policy - Updated |
