EmblemHealth understands that getting your claims paid quickly and accurately matters to you. That's why we created Claims Corner — a resource where you will find updated information on claims policy, best practices for coding your claims, changes to regulatory-driven payment methodology and other useful claims-related tips.

If you use a billing agent, please notify your representative of any relevant changes.

If you have any claims-related questions, please sign in to our Provider Online Services and use the Message Center.

See our most recent additions below.

Coding

The proper coding of procedure and diagnosis for billing purposes.

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Benefits

Information on changes to plan benefits that may have an impact on your claims.

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Medicaid Redesign Team Updates

Revisions to Medicaid policy and process developed by the New York Medicaid Redesign Team.

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Fee Schedule

Information and plan updates affecting your claims payments.

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Policy

New or updated policy information relating to claims payment.

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Utilization Review

How utilization management may affect claims payment.

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Submissions

Information on how to properly submit claims to us.

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