Care Plans* for members who participate in our Case/Care Management programs are now available in the member’s Eligibility Details in the Member Management section of the provider portals.
For members with complex health care needs, coordination of care among their providers is critical. By sharing Care Plans through the portals, we offer greater transparency and more timely updates to all Care Team members. Care Plans document goals, progress, challenges, etc. If you need to update the Care Plan or ask a question about it, you can submit a message directly to the Care Team. Care Plan updates can be expedited based on the level of urgency you select. You will receive responses to questions or concerns by phone or email.
See our Provider Portal Care Plans quick reference guides (EmblemHealth/ConnectiCare) for instructions on using these new online tools.
To refer a member to one of our Care/Case Management programs, please contact us:
- EmblemHealth: See our Care Management Programs page for program descriptions, ways we can support you and your patients, and program-specific contact information. If you need general assistance, you can call 800-447-0768 Monday through Friday from 9 a.m. to 5 p.m.
- ConnectiCare: Call 800-390-3522 Monday, Thursday, and Friday from 8 a.m. to 4 p.m. or Tuesday and Wednesday from 8 a.m. to 7:30 p.m.
*Some Care Plans, or sections of Care Plans, with highly sensitive information will not be available through the portal. Contact the assigned Care/Case Manager or follow the onscreen instructions to inquire about these plans.
Preauthorization Reminders:
Utilization Management (UM) letters for Commercial and Medicaid members are being posted to Preauthorization transactions. The responses you need may be available online before the mailed letter gets to you.
Faxing documents delays the review process. Take advantage of the provider portal’s ability to upload documents in support of your preauthorization requests, concurrent reviews, and discharge plans. Upload while creating the preauthorization request or go back into the request later to add more information.
Provider Portal Survey
We want to know what you think about the provider portal. Please take a few minutes to complete the survey at the top of the Home Page after you sign in to your portal account. This will help us prioritize updates to make the portals more useful and easier for you to use.
