News 

2019 EmblemHealth Benefit Plans with
No Referrals Required

In 2019, EmblemHealth is offering more plans that do not require referrals. This makes it easier for our providers to connect members with the specialist care they need. All other prior authorizations are still required.

Providers should allow members with these plans to make an appointment without a referral. Please print the list below as a reference tool for your staff who schedules appointments for you. 


None of these plans require referrals - even if the HealthCare Partners or Montefiore logo is on the member ID card. 

Group Health Incorporated (GHI), Health Insurance Plan of Greater New York (HIP), HIP Insurance Company of New York and EmblemHealth Services Company, LLC are EmblemHealth companies.

EmblemHealth Services Company, LLC provides administrative services to the EmblemHealth companies.



 

IMPORTANT NOTICE:FOR MEDICAID MEMBERS - EXPANSION FOR CHILDREN
Children’s Family Treatment and Support Services

It is important to make sure your child’s physical health and behavioral health are taken care of. A primary care physician (PCP) manages your child’s health care and arranges referrals to any specialists he/she might need. Call your child’s PCP when he/she needs medical care such as annual check-ups and vaccines. Your child’s member ID card has the PCP’s name and phone number on it.

Even though your child’s PCP is their main source for health care, your child may need to see a behavioral health professional to help with mental health or substance use. Children under age 21 can get additional Children and Family Treatment and Support Services (CFTSS) or Children’s Home & Community Based Services (HCBS) to improve their health and well-being.

To find a behavioral health provider call 888-447-2526 (TTY: 711) between the hours of 8 am to 5 pm, Monday through Friday. You can also go to
https://www.emblemhealth.com/Find-a-Doctor.

The Healthcare Aware ongoing video series, hosted by George Ingram, HealthCare Partners Regional Vice President, strives to educate consumers on how the health care systems operate. Various guest speakers will join George to share insights on current industry trends and how they will affect consumers.

For additional information, read the full story: Children and Family Treatment and Support Services



Recipients of 2018 HealthCare Partners Quality Physicians of the Year Award Announced

 

HealthCare Partners, IPA (HCP) announced the recipients of its First Annual Quality Physicians of the Year Award. These awards were presented to the IPAs Primary Care Providers (PCP) who led their peers in providing excellence in quality care to the members of their communities. Of the over 2,000 PCPs associated with HCP, these 14 individuals were selected based upon their performance on Medicare Advantage Stars and Medicaid Managed Care QARR measures. The physicians, their spouses and office managers were honored at a black-tie celebration on Friday, October 5 at the New York Athletic Club in New York City. Co-sponsoring the event with HealthCare Partners was plan partner EmblemHealth. EmblemHealth President and CEO Karen Ignagni presented a keynote address focusing on the value that quality care provides for all healthcare stakeholders. The award winners represented counties within the HealthCare Partners service area, including the boroughs of NYC and all of Long Island, and include Family Practice, Internal Medicine and Pediatric physicians.

Click the link to view Physicians of the Year Award winners: 2018 Quality Physicians of the Year winners