EmblemHealth
Important Update for EmblemHealth Providers: The transition to the new Optum Spine, Pain, and Joint Provider Portal has been postponed. Providers should continue using the current OrthoNet Provider Portal for all submissions until further notice. There will be no automatic redirection on May 1, 2026. A new transition date will be communicated once confirmed.
EmblemHealth has delegated utilization management for select spine surgery and interventional pain management therapy procedures to OrthoNet. The Program requires that the treating clinician obtain prior approval for spine surgery and interventional pain management procedures defined by a list of CPT/ICD codes. For a full list of spine surgery and interventional pain management therapy codes that require prior approval please visit emblemhealth.com. As with all utilization management programs, this Program will determine if the proposed service meets the definition of medical necessity under the member's benefit plan.