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Removal of Primary Care Provider Referrals for Specialty Care

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Removal of Primary Care Provider Referrals for Specialty Care

Starting Jan. 1, 2023, EmblemHealth will no longer require primary care provider (PCP) referrals for Enhanced Care (Medicaid), Enhanced Care Plus (HARP), and Child Health Plus (CHPlus) members.

The EmblemHealth CHPlus member ID cards will be updated to reflect this change. The “Referral Required” on the upper right-hand corner below the plan name will be removed. To view a sample of the updated card, refer to the Member Identification Cards chapter of the EmblemHealth Provider Manual. Member ID cards will be reissued to CHPlus members. There is no change to the Enhanced Care (Medicaid) and Enhanced Care Plus (HARP) member ID cards.

 

 

 

JP# 56547 12/2022

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Chapter 8: Access to Care and Delivery System Reminder: No Referrals for EmblemHealth’s NYS Sponsored Plans in 2023 Reminder: No Referrals for EmblemHealth’s State Sponsored Programs and Essential Plans
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Any information provided on this Website is for informational purposes only. It is not medical advice and should not be substituted for regular consultation with your health care provider. If you have any concerns about your health, please contact your health care provider's office.

Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage.