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May 2018 Policy Updates

EmblemHealth·NY·Provider News
Effective date
Jan 1, 2018
We identified it
Jun 20, 2026
Days to comply

Summary

EmblemHealth is transitioning members from Select Care Network and Metro NY Network to the Prime Network starting January 1, 2018, upon policy renewal. This network change affects commercial plan members who enrolled in 2017 benefit plans.

Action Required

Action needed
Immediately: Billing team must verify network participation status with EmblemHealth Prime Network. Update patient eligibility verification processes to confirm which network applies to each member based on their renewal date. Contact EmblemHealth to ensure practice is credentialed with Prime Network to avoid claim denials.