CommercialAdministrativeMedium impact
See EmblemHealth’s Utilization Management (UM) Determination Letters in the Provider Portal
EmblemHealth·Provider News
Effective date
Jun 24, 2022
We identified it
Jun 20, 2026
Summary
EmblemHealth providers can now view Utilization Management determination letters directly in their provider portal for commercial, Medicaid, HARP, and Essential Plan members. Users with preauthorization access can search by Reference ID and find formal determination letters in the UM Letters section.
Action Required
Immediately: Staff with preauthorization access should familiarize themselves with the new UM Letters section in the EmblemHealth provider portal. Train team members to use the Reference ID search function to locate determination letters for commercial, Medicaid, HARP, and Essential Plan cases. Update workflow procedures to check portal for determination letters instead of waiting for separate correspondence.