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CommercialReimbursementMedium impact

Reminder: New Reimbursement Policies Starting June 15

EmblemHealth·Provider News
Effective date
Jun 15, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

EmblemHealth and ConnectiCare are implementing two new reimbursement policies effective June 15, 2024: compression garments following CMS guidelines when prescribed by physicians and provided by DME suppliers, and a Lab Benefit Management policy for homocysteine metabolism testing. Both policies establish new coverage and reimbursement criteria for these specific services.

Action Required

Action needed
By June 15, 2024: Billing team must review and implement new reimbursement guidelines for compression garments and homocysteine metabolism testing for EmblemHealth and ConnectiCare patients. Ensure compression garment claims follow CMS guidelines with proper physician prescriptions and DME supplier documentation. Update billing procedures to align with new Lab Benefit Management policy for homocysteine testing.

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