CommercialReimbursementHigh impact
Reimbursement Policies
EmblemHealth·Provider News
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare have updated multiple reimbursement policies affecting bundled services, surgical procedures, telehealth, preventive care, laboratory services, and coding edits. Billing teams should review the revision histories for each policy to understand specific effective dates and changes that may impact claim processing and reimbursement.
Action Required
Immediately: Billing team must review the revision histories for all updated policies at the source URL to identify specific effective dates and changes. Update billing software rules, prior authorization requirements, and encounter forms based on changes found in each policy. Focus on bundled services, surgical procedures with modifiers 80/81/82/AS, telehealth services, preventive care, and laboratory/venipuncture policies. Verify current coding edits are aligned with updated EmblemHealth and ConnectiCare requirements to prevent claim denials.