A dedicated page of useful materials you can give your EmblemHealth patients to help manage their care and keep their costs down.
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Provider Toolkit
2020
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2020 Benefits Plans No Referrals
2020 Lab List
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2020_Medicare_Advantage_Guide
2019
2019 EmblemHealth Benefit Plans with No Referrals Required
2019 Network and Benefit Plan Updates
ConnectiCare Website Information
ConnectiCare Members May Use Providers in the EmblemHealth Prime Network
Helping Outreach to Individuals Eligible for Health and Recovery Plans and Behavioral Health (BH) Home and Community Based Services
Annual Plan News & Regulatory Reminders
ConnectiCare Website Information
2018 Plan News & Regulatory Reminders
Welcome to EmblemHealth
Here is some information to help you get to know us and help you best serve our members, your patients.
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2020 Summary of Companies, Networks & Benefit Plans
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2020 Benefit Plans that Do Not Require a Referral
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EmblemHealth Quick Reference Card - Using our Secure Provider Portal
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Transition to New Medicare Numbers and Cards Fact Sheet
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Notice of Privacy Practices
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Welcome to the Select Care Network, a Quick Reference Guide
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Welcome to Enhanced Care Prime Network for HARP and Essential Plan
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In Our Prime, A Comparison of the Prime Network and Select Care Network
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Guide for Managing Bridge Network Members
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How To Keep Your Directory Data Current
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2020 Medicare Advantage Guide
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EmblemHealth Contact Information
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CDC’s Recommended Immunization Schedules
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HEDIS/QARR Medical Record Review and Clinical Data Collection
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Medical Record Audits
Claims
Visit Claims Corner for the latest information on our claims policies.
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Health Home Billing Guide - Under Revision
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EPO/PPO Corrected Professional Paper Claim Form
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National Provider Identifier (NPI) Reporting Sheet
Care Management
Visit Clinical Corner for practice guidance resources.
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Advise Your Patients to Visit Our Network Urgent Care Centers for Non-emergent Medical Care
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EmblemHealth Injectable Drug Utilization Management Program
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Medical Policies
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Domestic Abuse Guidelines
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Domestic Violence Confidentiality Protocols
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New York City Domestic Violence Resources
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The Office for the Prevention of Domestic Violence
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Medicare Health Outcomes Survey (HOS): An Overview for Providers
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Medicare Health Outcomes Survey (HOS): Provider Tips
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Confidentiality Policy Poster
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Children and Family Treatment Support Services
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Outreach to Individuals Eligible for HARP and Behavioral Health Home and Community Based Services
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Behavioral Health Screening Tools
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Visit Clinical Corner for formulary updates.
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2019 Medicare Part D Opioid Policies: Prescriber Tip Sheet
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2019 Medicare Part D Opioid Policies: Prescriber Webinar
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EmblemHealth Spine Surgery and Pain Management Therapies Program Guide
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Pain Management Prior Authorization Request Form
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Spinal Surgery Prior Authorization Request Form
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eviCore healthcare
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Quick Guide to EmblemHealth’s Radiation Therapy, Cardiology Imaging and Radiology Programs
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EmblemHealth Radiation Therapy Program Clinical Pathways and Code List
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EmblemHealth Benefit Extensions Treatment Plan
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EmblemHealth Extension Request for a Current Authorization
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Americans With Disabilities Act (ADA) Accessibility Attestation Form
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Provider Credentialing Tool: CAQH Universal Credentialing Datasource
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Provisional Credentialing Attestation Form
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Managed Care Law of 2009
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Medicare Advantage Addendum
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New York State Standard Clauses - April 2017
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Register for Access to Our Secure Website
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Get to Know Our Provider Home Page
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Take Advantage of Our Learning Opportunities
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Alcohol Abuse Screening Tool and Clinical Guidelines for Non-Mental Health Providers
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ASOT Agreement
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ASOT Template
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2018 Provider Networks and Member Benefit Plans chapter
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2017 Provider Networks and Member Benefit Plans chapter
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2016 Provider Networks and Member Benefit Plans chapter
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EmblemHealth Spine Surgery and Pain Management Therapies Program Guide
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Pain Management Prior Authorization Request Form
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Spinal Surgery Prior Authorization Request Form
