CommercialReimbursementHigh impact
Reimbursement Policies
EmblemHealth·Provider News
We identified it
Jun 20, 2026
Summary
Multiple reimbursement policies have been updated for both EmblemHealth and ConnectiCare, affecting a wide range of services including lab testing, surgical procedures, preventive care, and coding requirements. This is a comprehensive policy refresh covering both commercial and Medicare plans with various laboratory benefit management (LBM) policies included.
Action Required
Immediately: Billing team must visit the EmblemHealth and ConnectiCare websites to review the revision histories for each updated policy to determine specific effective dates and applicable changes. Cross-reference member plans to ensure correct policy application. Update billing procedures, prior authorization requirements, and coding practices based on the specific changes found in each policy's revision history.