EmblemHealth will manage post-acute care (PAC) services for our members, replacing eviCore, for any services starting on or after Dec. 1, 2022. These services include home health care, skilled nursing facilities, acute rehabilitation, and long-term acute care hospital admissions. Providers will contact EmblemHealth to help arrange for PAC services and support. Note: eviCore will continue to handle durable medical equipment for EmblemHealth members and manage ongoing care requests for PAC services that began prior to Dec. 1, 2022.
We’re hosting a series of informational webinars to help explain how EmblemHealth’s management of all PAC services and the Transitions of Care (TOC) program affect the members in your care. We invite you to join the session that’s best suited for your facility/provider type – no registration required. All sessions will be held via Microsoft Teams between Nov. 8 and Nov. 17, 2022. See session dates and times.
Attention home health care providers: Our provider portal has a Home Health Status report to give you a combined view of the preauthorization requests for all members under your care. See the quick guide and video in the Preauthorization section of our Portal Training page for instructions on how to create the Home Health Status report.
A new Home Health Care Services Reimbursement Policy is being introduced in support of the PAC insourcing noted above.
Additional support: We offer a Transitions of Care (TOC) program to help members with complex care issues better manage their health after a hospital admission. Our team will work with the member to make sure they are educated about their condition, have needed resources, and get the right care to feel better. Program information is available to our members on the Live Well section of our member website.
