MedicaidAdministrativeHigh impact
Managing Entity Change April 1, 2023
EmblemHealth·Provider News
Effective date
Apr 1, 2023
We identified it
Jun 20, 2026
Summary
Effective April 1, 2023, Montefiore CMO will no longer manage several EmblemHealth plan types including Medicaid, HARP, Child Health Plus, and various HMO plans. Members will receive new ID cards and providers must use new processes for claims submission and authorization requests for these plans.
Action Required
Immediately: Billing team must update patient eligibility verification processes to identify members with new EmblemHealth ID cards. Check the back of new member cards or EmblemHealth provider manual Directory chapter for updated claims submission addresses and authorization request procedures. Update billing system with new payer information and submission processes for EmblemHealth Enhanced Care, Enhanced Care Plus, Child Health Plus, HMO Prime, HMO Access I, HMO Plus, and HMO Preferred members. Verify member eligibility before each visit as ID numbers have changed.