Tag: #EmblemhealthHIP

Posted in Insurance, Training, Updates

EmblemHealth (NY)-Care Management Program for Kidney Patients, 05/01/21

Posted on by KR2Medical Billing

Starting 05/01/21- EmblemHealth (NY) will offer the EmblemHealth Chronic Kidney Disease (CKD)/End Stage Renal Disease (ESRD) program.

What will this mean for your patients?

  1. EmblemHealth team of care managers, social workers, and pharmacists may be in touch with the physician’s office as they coordinate patient care.
  2. EmblemHealth is going to manage members affected by kidney disease

What will the EmblemHealth CKD/ESRD program do?

  1. The CKD/ESRD program will provide eligible members with holistic, seamless and, clinically robust wrap around support throughout all stages of their health care journey

What is the purpose of EmblemHealth CKD/ESRD Care Management Program?

  1. EmblemHealth’s CKD/ESRD program aims to slow the progression of illness and reduce unnecessary utilization. The program seeks to improve condition management and navigation of the healthcare system through a structured approach to person-centered assessment, care planning, and delivery of interventions.

Who will select the patents?

  1. EmblemHealth will identify members with complex needs and provide them with individualized care management interventions.

How to get in touch with EmblemHealth CKD/ESRD Care Management Program Staff?

  1. For more information or to make a referral, call us as at 800-447-0768, Monday through Friday, 9 a.m. to 5 p.m.
Posted in Training, Updates

EmblemHealth (NY) Medicare-New Networks for 2021

Posted on by KR2Medical Billing

There are 3 new networks that will be available for Medicare members to choose from, for the year 2021.

These plans are for group and individual members.

Below are the description for these notworks:

1. VIP Prime Network– the largest network for group Medicare members. Medicare Plans on this network require the members to select a PCP and request a referral to see a specialist.

3. VIP Bold– the most extensive network for individual Medicare members. Members will need to select a PCP, but this network will not require referrals.

2. VIP Reserve– this network is for EmblemHealth Individual Medicare Members located in Manhattan, Queens, Brooklyn, and the Bronx. Members will need to enroll in one of our new 2021 VIP Reserve Medicare plans. As with VIP Bold, members will need to select a PCP but will not need referrals.