CommercialCoverageHigh impact
Reminder: Program and Policies Starting March 1, 2023
EmblemHealth·Pathology·Provider News
Effective date
Mar 1, 2023
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare are implementing a new Laboratory Benefit Management (LBM) program starting March 1, 2023, which will affect reimbursement for laboratory services, tests, and procedures. Claims may be denied under new criteria, and denied claims will reference specific LBM policies accessible via a provided website link.
Action Required
By March 1, 2023: Billing team must review the new Laboratory Benefit Management policies on EmblemHealth and ConnectiCare websites before submitting lab claims. When lab claims are denied, check the denial message for the website link bit.ly/Our-RP and look up the specific test tagged with '(LBM)' to understand denial reasons. Update staff training on new LBM denial procedures and policy lookup process.