CommercialAdministrativeMedium impact
Emergency Care Services 10.01.12
Excellus BlueCross BlueShield·NY · Emergency Medicine·Miscellaneous
Effective date
Mar 19, 2026
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield updated their Emergency Care Services policy (10.01.12) effective March 19, 2026, establishing clear definitions for emergency conditions and services. The policy confirms that emergency services require no prior authorization, are covered regardless of network status, and members cannot be balance-billed for emergency care.
Action Required
By March 19, 2026: Billing team must ensure emergency services are billed without prior authorization requirements for Excellus BlueCross BlueShield members. Verify billing system settings allow emergency claims to process without prior auth holds. Update staff training to confirm emergency services use in-network cost-sharing rates regardless of provider network status.