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CommercialReimbursementHigh impact

Reimbursement Policies

EmblemHealth·Provider News
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

EmblemHealth and ConnectiCare have updated multiple reimbursement policies affecting surgical procedures, preventive care services, laboratory services, and telehealth. The changes apply to both commercial and Medicare plans with varying effective dates that need to be checked in each policy's revision history.

Action Required

Action needed
Immediately: Billing team must access the source URL to review revision histories for each updated policy to determine specific effective dates and changes. Update billing procedures for Multiple & Bilateral Surgical Procedures, Preventive Care Services (both Commercial and Medicare), Laboratory/Venipuncture services, and Telehealth/Virtual Care Services according to each policy's specific requirements. Failure to implement changes by their respective effective dates may result in claim denials or incorrect reimbursement.

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