We offer a wide variety of networks and benefit plans for our members to choose from. We heard your frustration in determining whether you are in-network for a specific member – especially when the member has access to multiple networks through the Bridge Program or has reciprocal network access between EmblemHealth and ConnectiCare.
To help you, your Appointment Schedulers, and Insurance Verifiers determine if the selected provider is in-network for a specific member, we added an easy, time-saving lookup tool on the provider portal’s Member Details page. Now you will see a new Check Provider Network Status button in the main section at the top of the page. After clicking the button, the member’s information will carry forward to a new screen where you can search for the provider the member wants to see. The search results will display the provider’s network status for that member in the right-most column in the results table.
As with all member details shared on the portal, being in the member’s network is not a guarantee of payment. Payment is subject to the member’s participation, covered benefits, Managing Entity assignment, referrals, preauthorizations, etc., on the date(s) of service, as applicable.
Member ID Card Section Moved Up
We moved the member ID card section to the top to make it easier for you to find. Expand the section to see an image of the card.
Get Your Information Faster
Stop wasting your time, and slowing care for your patients, by eliminating faxing for requests. It’s faster, ensures accurate processing, and you can upload supporting documents for your preauthorization requests, concurrent reviews, and discharge plans even after your original request is submitted.
See how easy it is to go back into an existing preauthorization request and add documents by viewing our guides and videos for EmblemHealth and ConnectiCare.
Portal Survey Available for a Limited Time
Take our Provider Portal survey—located at the top of our portal home pages—to let us know what features you use most and how we can make those transactions even better for you. We value your opinion and want to put our efforts into building a portal that is valuable to your practice and helps you deliver care to our members. The enhancements shown above are a direct result of our provider-partners’ previous feedback.