Audience: All providers
Our claims processing system will be continuously updated to reflect CPT® codes that are not covered benefits for Medicaid Managed Care (MMC) and Health and Recovery Plan (HARP) members per the Medicaid eligibility verification system, eMedNY.org. This applies to our members with HMOBlue Option, Blue Choice Option, Blue Option Plus, Premier Option, or Premier Option Plus coverage.
We encourage you to review the eMedNY website for benefit coverage of specific codes prior to submitting a preauthorization request for MMC or HARP members. Be sure to also log into our website to obtain patient eligibility and benefits prior to rendering services. As a reminder, members with MMC and HARP coverage cannot be billed for non-covered services.
Please share this information with anyone within your office or facility who should be aware of it.
Thank you for the quality of care and service that you provide to our valued members.Email this article