EmblemHealth partners with Palladian Musculoskeletal Health (Palladian), a specialty network and utilization management organization, to manage chiropractic services for our Commercial (including Child Health Plus and Essential Plan) and Medicare members according to their benefit plans.
Hospital Outpatient Facility
Palladian conducts preauthorization review for chiropractic services delivered at a hospital outpatient facility. However, claims processing and appeals for denial determinations of these services are handled directly by EmblemHealth.
Palladian also conducts preauthorization review for non-hospital settings, processing professional claims and appeals for denial determinations made on professional claims (excluding members with Medicare plans).
Preauthorizations do not guarantee claims payment. Services must be covered by the member’s health plan and the member must be eligible at the time services are rendered. Claims submitted may be subject to benefit denial.Prior to rendering services, all providers must verify member eligibility and benefits by signing in to emblemhealth.com/providers and using the Eligibility drop-down under the Member Management tab.