The Office of the New York State Comptroller (OSC) has issued an audit report on improper payments by the New York State Dental Insurance Program.  OSC found the New York State Dental Insurance Program failed to properly coordinate benefits with other insurance plans.  You can access and read the OSC audit report below.

New York State Dental Insurance Program – EmblemHealth Plan, Inc. – Overpayments for Services Requiring Coordination of Benefits (2022-S-27) 

The Department of Civil Service contracts with EmblemHealth Plan, Inc. (Emblem) to process and pay claims for services on behalf of the New York State Dental Insurance Program.  To prevent duplicate payment of services, health insurance companies use a process called coordination of benefits for paying health care claims when an individual is covered by more than one insurance plan.  Auditors identified $492,061 in overpayments for services processed with coordination of benefits for the audit period, January 2018 through October 2022, because Emblem failed to correctly coordinate benefits with each member’s other subscriber plan.