CommercialPrior AuthHigh impact
Preauthorization Updates
EmblemHealth·NY, CT·Prior Authorization
We identified it
Jun 20, 2026
Summary
EmblemHealth has updated multiple preauthorization lists across their network, including GHI PPO City of New York, ConnectiCare Commercial and Medicare plans, and Home Infusion Therapy Drug lists. Medical billing teams need to review the updated preauthorization requirements to ensure proper prior authorization is obtained before services are rendered.
Action Required
Immediately: Billing team must access the updated preauthorization lists at https://www.emblemhealth.com/providers/news/preauthorization-updates-202408 and review all changes to GHI PPO City of New York, ConnectiCare Commercial, ConnectiCare Medicare, Home Infusion Therapy Drug, and Pharmacy Medical preauthorization requirements. Update billing system rules and staff workflows to reflect new prior authorization requirements. Train front desk staff on new preauthorization requirements to avoid claim denials.