As the Coronavirus (COVID-19) situation evolves, EmblemHealth has taken continuous steps to ensure that their members have peace of mind knowing that they will have the support, protection, and access to the care they need.
Operational Updates
Cost-sharing is being waived for testing as well as in-network physician office visits, urgent care visits, and emergency room visits associated with testing. EmblemHealth will also not require prior authorization for COVID-19 testing.
Medication Delivery
For members who are under quarantine or concerned about visiting pharmacies during the outbreak, EmblemHealth covers 90-day supplies of long-term medications (or maintenance drugs) through Express Scripts mail order service, so members can get their medications delivered right to their homes.
Express Scripts also gives members access to pharmacists 24 hours per day, seven days per week, in case members have questions about their medications.
In addition, Express Scripts has partnered with Medly Pharmacy, a full-service pharmacy startup, to provide home delivery of prescriptions via a local courier (in some cases the same business day) for members across all lines of business in New York City, Long Island, and New Jersey. Medly also provides access to pharmacists seven days per week, servicing customers in more than a dozen languages, including Spanish, Mandarin, Cantonese, and Russian. This service is available (beginning March 9, 2020). Both of these options are available to all members for whom Express Scripts provides drug coverage at all times.
24/7 Availability for Member Questions
To reduce urgent care and emergency room visits during the outbreak, as well as provide peace of mind, EmblemHealth is reminding all members that they have access to their 24-hour Medical Hotline as a resource should they have questions or concerns. In addition, through ACPNY, EmblemHealth will be stepping up virtual visit capability online. This additional resource will be provided to all ACPNY patients. For EmblemHealth City of New York HMO members, the company is expanding their Gold Line capabilities to help answer questions related to the Coronavirus, such as how to get additional medication refills, and then triaging members to their preferred provider partners when additional clinical guidance is needed. EmblemHealth is working hand in hand to ensure that all member-facing functions and touch points have the latest information and resources to provide factual information and triage appropriately.
Expanded Lab Testing
EmblemHealth is working closely with their lab partners as they expand their testing capabilities and on strategies to increase testing sites and abilities quickly.
AdvantageCare Physicians
The practice is prepared to receive patients in need of care, following specific screening protocol, using Department of Health guidance on appropriate testing centers to send patients for testing, adding isolation rooms, and working to provide virtual visits to patients. All staff have been trained to screen for COVID-19 risk factors and providers have been educated with a COVID-19 algorithm for identification and testing. All information is included on their education portal which is updated daily, has a dedicated section on COVID-19, and is continually shared with critical clinical partners, including RadNet/Lenox Hill Radiology, Quest Diagnostics, Cityblock and BronxDocs.
Customer Service Education
EmblemHealth has developed a comprehensive list of Frequently Asked Questions to educate customer service staff who are providing service to members on the phone, social media, in-person, and via email. For up-to-date information on the Coronavirus, members are being directed to dedicated pages on EmblemHealth and ACPNY’s websites, as well as to the Centers for Disease Control and Prevention’s website. These FAQs are controlled by one point of contact for the enterprise to ensure accuracy and version control and are updated throughout the day in response to incoming inquires and updated clinical information. Here are the website links:
https://www.emblemhealth.com/content/emblemhealth/home/live-well/covid19.html
https://www.acpny.com/live-well/2019-novel-coronavirus
Communications Updates
EmblemHealth has established a communications command center to keep members continuously informed during the outbreak.
EmblemHealth Members Webpage
EmblemHealth was one of the first health insurers to issue comprehensive information about the Coronavirus with the launch of a resource webpage four weeks before New York’s first case was confirmed. The page has since been expanded into a dedicated microsite with up-to-date information and Frequently Asked Questions. The microsite can be found here:
https://www.emblemhealth.com/content/emblemhealth/home/live-well/covid19.html
Video
EmblemHealth released an enterprise video featuring practical tips and information on the Coronavirus from Richard Dal Col, M.D., Enterprise Chief Medical Officer and Navarra Rodriguez, M.D., President and Chief Medical Officer of AdvantageCare Physicians. Access the video on You Tube with this link:
Email Communications
Information on prescription delivery services, including the introduction of Medly and a reminder about 90-day mail order prescription availability with Express Scripts, is in response to member inquires on how to receive medicines without visiting retail locations. Link to the new Medly pharmacy page here:
https://www.medlypharmacy.com/emblem
And link to the newly updated pharmacy page on the EmblemHealth website here:
https://www.emblemhealth.com/resources/pharmacy/delivery-and-refills
EmblemHealth Providers
EmblemHealth posted an update to their provider page with information reminding providers that members do not need prior authorizations for COVID-19 testing:
If members have any questions, Emblemhealth is happy to work with you as this situation continues to unfold.
