EmblemHealth Builds Digital Provider Portal to Streamline and Improve Quality of Care

Contact:

EmblemHealth Public Relations Office | Email: press@emblemhealth.com

Kwame Patterson | Email: kpatterson@emblemhealth.com

NEW YORK, NY— To create a more user-friendly, technologically advanced health plan, EmblemHealth, one of the nation’s largest nonprofit health insurers, developed a state-of-the-art online provider resource hub. The new digital provider portal makes working with EmblemHealth more accessible, easy, and efficient for physician teams, which can lead to quicker delivery of care and better health outcomes for millions of health plan members. 

“EmblemHealth built a best-in-class automated resource that changes how our network of clinicians does business with us,” said Thomas MacMillan, SVP & Chief Information Officer, EmblemHealth. “We created a more modern way for everyone to work from one source, strengthening connectivity and efficacy in health care delivery. Everything we do is ultimately about the member and their care. A major part of that is making our providers’ lives easier.”

There are more than 100,000 physicians with over 854,000 providers and 5,200 hospitals in the health plan’s national network. Starting immediately, all EmblemHealth in-network doctors, provider care teams and hospitals can register for access to the portal, where they can upload documents supporting their preauthorization requests, concurrent reviews, and discharge plans right at their fingertips and in real time. The new secured online portal, engendered from listening to and learning from clinical administrators, allows physicians and their care teams to connect with EmblemHealth 24/7. It also standardizes how information appears across different stages of patient care transactions.

The platform gives doctors the power to search for claims and check details of each claim, request approval for services, and attach clinical paperwork digitally—actions typically conducted by facsimile or by telephone for decades. Now providers have a much simpler, more expedited, and modernized online process. Additionally, the digital portal enables primary care offices to access panel reports that deliver a complete list of patients assigned to their charts and newly assigned patients. Providers can also review their utilization management letters through individualized portal accounts, which reduces paperwork, wait times, and disruptions often associated with the common use of mailed-in letters.

EmblemHealth’s portal makes member care plans available online for providers caring for members with complex medical needs as well. Similarly, patient eligibility checks can be conducted through the online platform, making it quicker for members to check in at their doctor’s office.

Overall, the newly improved provider portal is a seamless end-to-end journey for EmblemHealth’s network of providers, producing better, more comprehensive health care services for members and patients.