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CommercialAdministrativeMedium impact

Reprocessing NYCE PPO Plan PT/OT Claims

EmblemHealth·Physical Therapy, Occupational Therapy·Provider News
Effective date
Mar 16, 2026
We identified it
Jun 20, 2026
Days to comply
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Summary

EmblemHealth resolved a system error that caused NYCE PPO Plan physical and occupational therapy claims from Jan 1 - March 6, 2026 to be denied incorrectly. Affected claims began automatic reprocessing March 16, 2026 with payment expected within 1-2 weeks.

Action Required

Action needed
No action required: EmblemHealth is automatically reprocessing affected PT/OT claims from Jan 1 - March 6, 2026. Billing team should monitor payments over the next 1-2 weeks and follow up on any claims that remain unpaid after that timeframe.

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