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We will be performing routine system maintenance on Sunday May 31th from 1 till 8 am. The Pay My Bill feature will not be available during this time.
Our goal is to make it easier for you to do what you do best - take care of patients.
Take a Tour of our secure provider Web site.
Our Provider Manual has what you need to know about our plans, policies and procedures.
Quick and easy access to EmblemHealth’s administrative guidelines.
Online and onsite opportunities to learn about EmblemHealth's administrative guidelines, new programs and web tools.
Providing fast, accurate claim payments is how we take better care of our health care professionals.
Getting alerts, news, forums, webinars, clinical info and other resources is now easier than ever.
Working with us means you can work with patients from GHI, HIP and EmblemHealth Plans.
Quick and easy access to EmblemHealth's administrative guidelines
Clinical review criteria to determine medical necessity
Evidence-based recommendations to determine benefit plan coverage
The latest news about our benefit plans, vendor programs and administrative guidelines
Programs, discounts and tools to help your patients stay healthy, get well and live better
Select a chapter or chapter and section, then click “Go.”
EmblemHealth Provider Manual
This manual applies to all EmblemHealth, GHI, HIP and Vytra plans, and it replaces all provider manuals published before November 2009. It includes detailed information about your administrative responsibilities, contractual and regulatory obligations, and best practices for interacting with our plans and helping our members navigate our delivery systems.
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Your member ID # is on the front of your ID card.
In most cases, if you are the policy holder, you can also use your Social Security Number to register.