Coordination of Care

Navigating a complex health care system can be a challenge, but coordinating services among all providers, primary and specialty practitioners, and care settings is essential for ideal patient care. This is especially true as conditions and care needs change over time.

EmblemHealth encourages its members to choose a primary care physician (PCP) to have a 360-degree view of their health care needs and services. PCPs can help with care coordination, even for members in plans that do not require referrals. See: PCP’s care coordination responsibilities.

Sending care reports back to the PCP is key to care coordination. This is important whether these reports are from a medical or behavioral health specialist, or created after an inpatient discharge, emergency room or urgent care encounter, or from some other treatment/diagnostic setting.

Specialists, as a best practice, should also consider scheduling a call with the PCP or referring practitioner when the member is with you during the consultation.

EmblemHealth is here to help you with care transitions. The Utilization Management department may assist when new members join EmblemHealth or a member’s benefits end. Our Care Management Transition of Care team can assist when a child is ready to transition to an OB/GYN and/or an adult physician, or when an older adult could benefit from a geriatrician instead of an internist. Case management is available to assist with complex conditions including pregnancies.