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We’ve expanded our Prime Network to serve more members
On July 1, 2018, we began offering the Prime Network to small group members using QualCare in New Jersey and ConnectiCare in Connecticut. Expanding our Prime Network into these two states means our small group members will enjoy:
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Greater convenience with over 133,000 providers and 250 hospitals across New York, New Jersey, and Connecticut.
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Access without any additional cost. Rates stay the same for the rest of 2018.
All existing and new small group members for 2018 will have access to the expanded network. |
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Prior approval rules for durable medical equipment have changed
There are 270 durable medical equipment codes for which the prior approval requirement was dismissed, dating back to January 1, 2018. We have already corrected claims that were denied for no prior approval. Review the list to make sure you know which claims no longer need prior approval. Please note certain
Continuous Positive Airway Pressure (CPAP) supplies will require prior approval effective December 1, 2018. |
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St. Barnabas and Union Community Health Center Members Included in Special Utilization Management Programs
St. Barnabas and Union Community Health Center primary care physicians are part of EmblemHealth’s special utilization management programs. Learn how the prior approval process for these members has changed. |
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Encourage your Medicaid patients to complete their CAHPS® survey
It’s that time. The annual Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey will be mailed from October through December 2018. Please encourage your Medicaid patients to fill out and return the survey. This survey asks them about their experience with you, their health plan, and the care they receive. The results tell us how well we’re meeting their needs. |
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