Waiver for Qualified EmblemHealth Practitioners
Buprenorphine is an effective medication for the treatment of opioid use disorders which is approved by the FDA. The good news is qualified EmblemHealth practitioners are now eligible to obtain a waiver to offer buprenorphine.
Qualified practitioners encompass nurse practitioners, physician assistants, physicians, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse-midwives.
To learn more about it you can check here.
Source: https://www.emblemhealth.com/
Network Extension by EmblemHealth
EmblemHealth is happy to announce that they are in a partnership (including its affiliate ConnectiCare Insurance Company, Inc.) with QualCare & First Health to provide coverage for certain benefit plans beyond the contracted networks’ geographic coverage. These extended networks are considered in-network for EmblemHealth’s members based on the following geography:
Bridge Program (EmblemHealth and ConnectiCare)
- QualCare covers New Jersey Only;
- First Health Network (for EmblemHealth’s companies) covers all states except Connecticut, Massachusetts’s 4 Counties (Berkshire, Hampden, Hampshire, and Franklin), New Jersey, and New York’s 28 Counties.
ConnectiCare Insurance Company, Inc.’s Flex Network
First Health Network covers all states except Connecticut, Massachusetts’s 4 Counties (Berkshire, Hampden, Hampshire, and Franklin), and New York’s 28 Counties.
Source: https://www.emblemhealth.com/
Preauthorization List Updates by EmblemHealth
EmblemHealth is continuously reviewing its preauthorization code list. As a positive outcome, starting November 15, 2022, CPT Code (10040) Acne surgery and other CPTs’ (15730, 17380, 21086, 21087, and 40500) will be added to the list.
The changes align with and support the existing medical policies regarding cosmetic procedures.
In addition, EmblemHealth has updated the preauthorization lists to reflect the code changes shared in CMS’ quarterly update for July 2022. To easily look up whether a code requires preauthorization, please check the Preauthorization Check Tool in the provider portals.
You may also see the preauthorization lists on Emblem’s website. In the event of a discrepancy, the published list will prevail.
Source: https://www.emblemhealth.com/
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