Learn how the Bridge Program applies to NYCE PPO, Large Group, and ASO plan members in 2026.
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March 16, 2026
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The CAHPS survey measures patients’ perception of their providers and their health insurance plan. We all play an important role in impacting your patients’ experiences.
The quality of care you provide has a direct impact on their response to the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.
High CAHPS survey scores reflect positive relationships between our members and their providers and the ability to access timely well coordinated care. Here are some tips to help you provide the best care for your patients:
Engage in two-way communication. Communicate in plain language. Explain the care provided and treatment plan in a way that is easy to understand. Listen carefully. Make sure patients also understand the care they receive from other providers.
Evaluate the need for increased appointment availability. Consider offering same-day appointments, evening and weekend appointments, an after-hours nurse line, and virtual visits.
Equip patients with tools. Give members material about their health conditions. Implement reminder systems and offer options to get their health records.
Consider timeliness. Limit telephone hold times to under 15 minutes and keep patients informed if you are running behind schedule. Try to schedule well visits/routine physicals within four weeks and nonurgent sick visits within 48 to 72 hours of request.
Learn more about CAHPS and how to improve your scores.
On Jan. 1, 2026, EmblemHealth launched the Advocate+™ Pharmacy Match program in collaboration with our new pharmacy benefit manager Prime Therapeutics™ and Free Market Health (FMH). FMH is an independent health care technology company that uses dynamic market pricing data to determine the most cost-effective pharmacy option for applicable members.
The program matches eligible commercial members* to the best specialty pharmacy for them. Some members, including our Medicare members, will continue to receive standard specialty medications from Accredo.
Getting Started
The following is a summary of the process to submit e-prescriptions for members in the Advocate+ program:
- Prescribers should select FMH Pharmacy and use the following details when submitting e-prescriptions for specialty medications:
FMH Pharmacy
NPI: 1366292880
Fax: 833-998-4435
Phone: 412-755-3241
Email: contact@fmhpharmacy.com
Address: 40 24th St., Suite 150, Pittsburgh, PA 15222
- Continue using the standard CoverMyMeds prior approval process, if applicable.
- If a requested specialty medication is approved, FMH will assign and transfer the prescription to a pharmacy(ies)** that their proprietary system has identified.
- FMH will fax the prescriber the assigned pharmacy(ies).
- The assigned specialty pharmacy(ies) will contact the member to begin onboarding and coordinate delivery.
See the Pharmacy and Specialty Pharmacy chapter of the Provider Manual for more information or call FMH provider support at 877-787-0520. You may also email prescribers@freemarkethealth.com if you have questions.
*The new program applies to all fully insured EmblemHealth plans (i.e., Child Health Plus, Essential Plan, individual and family, NYSHIP, large group and small group) and all EmblemHealth and AdvantageCare Physicians employees. Accredo will remain the specialty pharmacy provider for the following: New York City Employees PPO plan (NYCE PPO), Local 246, NYPD Line of Duty Injury, Uniformed Sanitationmen's Association, and HIP HMO Preferred.
**Note: Members using multiple specialty medications may be matched with more than one specialty pharmacy provider. Once a match is made, refills are handled with that matched specialty pharmacy for one year.
EmblemHealth is partnering with Mae Health, a digital health platform that helps doulas focus on what matters most — supporting women during pregnancy, at delivery, and after the baby arrives. Mae matches EmblemHealth’s Medicaid and HARP members with an in-person doula and helps members track their pregnancies to foster better health outcomes.
How will Mae support members?
Eligible members can sign up with Mae to get culturally-specific pregnancy care from an experienced doula who will support members from their first trimester through twelve months postpartum.
The doula will provide members with:
- Weekly tracking of the pregnant member’s and baby's progress.
- Videos, articles, and educational events to support the member’s mind and body.
- Questions to ask their doctor and ways to "Ask Us Anything."
Mae helps the doula with managing seamless billing, claims, credentialing, and reimbursement at no cost to the doula. Mae is uniquely invested in the doula-member relationship, ensuring continuity of care, and a sustainable future for doulas.
How will Mae support doulas?
Mae will support doulas by providing:
- Marketing support and access to additional client referrals.
- Client management and relationship support.
- Seamless billing and health plan reimbursement.
- One-to-one support to become a Medicaid provider.
- 100% pass-through of state reimbursement payment.
- Mentorship, community, and support.
If your practice knows of doulas who could benefit from this support, they can reach out to Mae at meetmae.com/doulas.
OrthoNet LLC, which is part of Optum Health, reviews preauthorization requests for EmblemHealth's Spine Surgery and Pain Management Therapies Program for select spine surgery and interventional pain management therapy. Starting May 1, 2026, the OrthoNet portal will be discontinued. EmblemHealth providers will need to submit preauthorizations via Optum’s Spine, Pain, and Joint portal.
To use the Optum portal, providers need a One Healthcare ID (OHID) account as previously announced. If you already have an OHID account, you’ll be able to sign in to the portal using your current credentials. If you do not have credentials, please register for an account here. For questions about your Optum provider ID and password, please contact Optum Health Services at 844-504-8091 from 9 a.m. to 6 p.m., Monday through Friday.
Other important notes
Physical letters will no longer be mailed starting May 1, 2026. However, you can access letters using the Optum portal. Please also note that the address on provider letters will be changed to:
Optum, P.O. Box 5600, Kingston, NY 12402-5600.
You will receive another notification 30 days prior to the portal change. This will include more information about portal changes, sign-in instructions, and portal usage guides.
For all other questions, please contact your network account manager or sign in to emblemhealth.com/providerportal and use our live agent chat or Message Center. A provider Customer Service representative will be happy to help.
We appreciate your continued partnership in caring for our members.
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