CommercialPrior AuthHigh impact
Preauthorization Updates
EmblemHealth·Prior Authorization
We identified it
Jun 20, 2026
Summary
EmblemHealth has updated multiple preauthorization lists affecting GHI PPO City of New York, ConnectiCare Commercial and Medicare plans, and pharmacy medical preauthorization requirements. Billing teams must review the updated lists to identify new prior authorization requirements that could impact claim processing.
Action Required
Immediately: Billing team must access the EmblemHealth provider portal to review updated preauthorization lists for GHI PPO City of New York, ConnectiCare Commercial, and ConnectiCare Medicare plans. Update billing system rules to reflect new prior authorization requirements. Review pharmacy medical preauthorization changes and update medication approval workflows. Failure to obtain required prior authorizations will result in claim denials.