Emblem Health Claims Corner Coding

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Coding EmblemHealth

(9 days ago) WEB106 rows · HIPPS and Rate Codes for SNF and HHA Claims Required/ Keeping Accurate Documentation and Coding - Critical to Patient Care: 2020/06/12: Hospital Discharge Services: 2018/12/06: ICD-10-CM Excludes 1 Notes Policy: …

https://www.emblemhealth.com/providers/claims-corner/coding

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Payment Policy: Coding Edit Rules - espanol.emblemhealth.com

(6 days ago) WEBCoding Edit Rules (Commercial, Medicare & Medicaid) Proprietary information of EmblemHealth. 2024 EmblemHealth & Affiliates Page 1 of 109 Review Date: …

https://espanol.emblemhealth.com/content/dam/emblemhealth/pdfs/provider/EH-Coding-Edit-Rules.pdf

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Reimbursement Policies EmblemHealth

(3 days ago) WEBStarting April 1, 2024, the ASC Grouper 2024 reimbursement policy for EmblemHealth and ConnectiCare has been updated to include new codes. For provider contracts that follow …

https://www.emblemhealth.com/providers/news/reimbursement-policies-202405

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Fax Lines Disconnected EmblemHealth

(3 days ago) WEBIf you are a non-participating provider who has never submitted a claim to us, you will not be able to use our provider portal without our assistance. Instead, you …

https://www.emblemhealth.com/providers/news/fax-lines-disconnected-202405

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General Surgery Coding Alert - AAPC

(2 days ago) WEBAs of 2016, EmblemHealth has instructed all claim editing systems and vendors to turn off all gender-based rules, as well as all facility claims reported with …

https://www.aapc.com/codes/coding-newsletters/my-general-surgery-coding-alert/healthcon-2024-avoid-denials-related-to-gender-and-sexual-orientation-177956-article

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NEW YORK STATE MEDICAID OBSTETRICAL DELIVERIES PRIOR …

(8 days ago) WEBMedicaid FFS and Managed Care Practitioner Claim Coding Guidelines: All obstetrical deliveries, whether prior to, at, or after 39 weeks gestation, require the use of a modifier …

https://www.emedny.org/ProviderManuals/communications/OBSTETRICAL_DELIVERIES_PRIOR_TO_39_WEEKS_GESTATION.pdf

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Reminder: New Reimbursement Policies Starting June 15

(2 days ago) WEBStarting June 15, 2024, we are introducing two new reimbursement policies for EmblemHealth and ConnectiCare.

https://www.emblemhealth.com/providers/news/new-reimbursement-policies-june-202405

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Quick Reference Guide for Horizon Behavioral HealthSM …

(1 days ago) WEBClaims Inquiries: 1-800-626-2212 1-800-991-5579 (for NJ State Health Benefits Program only) Address for claims submitted via paper: Horizon BCBSNJ Horizon Behavioral …

https://s21151.pcdn.co/wp-content/uploads/HBH_QRG_HBCBSNJ.pdf

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Preauthorization Updates EmblemHealth

(5 days ago) WEBEmblemHealth Preauthorization List: See Notable Changes for updates. Switch to: members brokers Claims Corner. Claims Resources; Coding …

https://www.emblemhealth.com/providers/news/preauthorization-updates-202405

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Reduce Costs When Prescribing NSAIDs EmblemHealth

(5 days ago) WEBClaims Corner. Claims Resources Fee Schedule Updates Hospital Readmission Policy Electronic Claims Policy In-Office Testing List Submissions Claims …

https://www.emblemhealth.com/providers/news/reduce-costs-prescribing-nsaids

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Quick Reference Guide for Horizon Behavioral Health Providers

(7 days ago) WEBclaim submission, please call TriZetto at 1-800-556-2231. Submit all electronic claims to the Horizon NJ Health EDI Payer Number 22326. You may also choose to contract with …

https://s21151.pcdn.co/wp-content/uploads/HorizonNJHealth-QuickReferenceGuide-NewBenefits10.1.pdf

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Infusion Care - Site of Service Policy Update EmblemHealth

(Just Now) WEBStarting July 15, 2024, the Infusion Site of Service policy for our commercial members for both EmblemHealth and ConnectiCare is being updated to remove age …

https://www.emblemhealth.com/providers/news/infusion-care-site-of-service-202405

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