All PlansAdministrativeLow impact
MD Perspectives: Sandra Rivera-Luciano, MD
EmblemHealth·Provider News
We identified it
Jun 20, 2026
Summary
EmblemHealth is promoting their Peer-to-Peer (P2P) process for providers to have direct conversations with health plan physicians about adverse determinations. This is informational content highlighting an existing process rather than announcing new policy changes.
Action Required
No immediate action required. Billing team should be aware that when claims are denied or prior authorizations are rejected, providers can request a Peer-to-Peer conversation with EmblemHealth medical directors to discuss cases. Use provider portals for claim inquiries, not the email address mentioned.