The following reimbursement policies have been updated. If the policy name does not have a company name shown, the policy applies to both EmblemHealth and ConnectiCare. Refer to the website applicable to the member’s plan (EmblemHealth | ConnectiCare) and see the revision histories for effective dates and applicable changes. Lab Benefit Management policies have “(LBM)” after the policy name.
- Ambulatory Surgical Groupers Reimbursement Policy.
- Biomarkers for Myocardial Infarction and Chronic Heart Failure (LBM).
- Bundled Services (Commercial and Medicare) Reimbursement Policy.
- Cardiovascular Disease Risk Assessment (LBM).
- Coding Edits Policy.
- Coding Edits Reimbursement Policy.
- Computer Assisted Surgical Navigation.
- ConnectiCare Preventive Care Services (Commercial and Medicare).
- Coronavirus Testing in the Outpatient Setting (LBM).
- EmblemHealth Preventive Care Services (Commercial).
- EmblemHealth Preventive Care Services (Medicare).
- Folate Testing (LBM).
- General Inflammation Testing (LBM).
- Hepatitis Testing (LBM).
- Identification of Microorganisms Using Nucleic Acid Probes (LBM).
- Laboratory/Venipuncture Reimbursement Policy.
- Modifier Reference Reimbursement Policy.
- Pancreatic Enzyme Testing for Acute Pancreatitis (LBM).
- Pathogen Panel Testing (LBM).
- Preventive Care Services (Commercial) Reimbursement Policy.
- Preventive Care Services (Medicare) Reimbursement Policy.
- Robotic Surgery.
- Serum Testing for Evidence of Mild Traumatic Brain Injury (LBM).
- Serum Tumor Markers for Malignancies (LBM).
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