Aug 2018 Reminders

Our policy on never events

08/01/2018
EmblemHealth will deny or adjust Medicare or Medicaid claims for never events. These are surgical or other invasive procedures performed in error by a practitioner or group of practitioners. All services related to the never event will also be denied if they were provided during the same hospitalization in which the error occurred. It is not considered a related service if a correct procedure is performed after the never event. More information is available through the Centers for Medicare & Medicaid Services and in our Provider Manual.
Provider Update
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