CommercialReimbursementMedium impact
Reminders: New Reimbursement Policies Going into Effect in August 2022
EmblemHealth·Provider News
Effective date
Aug 1, 2022
We identified it
Jun 20, 2026
Summary
EmblemHealth and ConnectiCare are implementing new reimbursement policies effective August 2022. A new Readmission Policy will determine when hospital readmissions are treated as separate admissions versus continuations of the original stay. Additionally, new Durable Medical Equipment (DME) reimbursement policies will govern DME billing in office settings and rental versus purchase decisions.
Action Required
By August 1, 2022: Billing team must review and implement new DME reimbursement policies for office-based DME billing and rental vs. purchase decisions for EmblemHealth and ConnectiCare claims. By August 30, 2022: Update readmission billing procedures to comply with new policy determining when readmissions are separately payable versus continuations of original stays. Access full policy details from EmblemHealth provider portal.