Policies and procedures for the coordinated care of our members.

Date Issued (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
2020/12/01 National Drug Code Payment Policy
2020/12/23 In-Office Testing List to Cover All EmblemHealth Members
2020/12/17 Look Back Periods to Reconcile Overpayments
2020/12/04 Barium Enema Screenings
2020/11/18 Maternity Claims Adjusted Procedures
2020/06/25 Biosimilar Preferred Product Update
2020/06/12 Audits Involving Medicare Demand Billing and Overpayments Involving Dual Eligible Recipients
2020/06/12 Referrals for AdvantageCare Physicians Patients
2020/06/12 Performance and Supervision of Electromyographic Testing
2020/06/10 GHI PPO members are being migrated to our new claims platform
2020/04/11 Restricted Breast Cancer Surgery Facilities for Medicaid/HARP Recipients
2020/01/02 Avoiding Duplicate Claims Submissions For EmblemHealth GHI and HIP Benefit Plans
2020/01/02 Billing
2020/01/02 Claim Tips
2020/01/02 Claim Tips for Paper Submissions
2020/01/02 Claims Submission Changes for Radiologists Treating ACPNY Members
2020/01/02 Do Not Balance Bill Dual-Eligible Members
2020/01/02 Home Health Billing Guide
2020/01/02 How to Submit Medicare PPO Claims
2020/01/02 Surprise Bills and Emergency Services Uniform Notice for Out of Network Providers
2020/01/02 Keep Billing Information Current
2019/04/29 Policy
2015/06/15 Annual Fee Schedule Updates from CMS
2013/07/25 Out of Network Provider Appeal Process for Denied Claims