CommercialPrior AuthHigh impact
Preauthorization Updates
EmblemHealth·NY·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 home infusion therapy drug requirements. Billing teams must review the updated preauthorization requirements for these specific plan types to ensure proper prior authorization is obtained before services are rendered.
Action Required
Immediately: Billing team must access the updated preauthorization lists at emblemhealth.com for GHI PPO City of New York, ConnectiCare Commercial, ConnectiCare Medicare, EmblemHealth/ConnectiCare Home Infusion Therapy Drugs, and Pharmacy Medical lists. Update billing software and prior authorization workflows to reflect new requirements. Train front desk staff on new preauthorization requirements to prevent claim denials.