Changes to Pre-Certification Process for GHI PPO City of New York Employees/Non-Medicare Eligible Retirees with GHI PPO Benefits

Date Issued: 12/15/2015

Effective January 1, 2016, utilization management for the City of New York employees and non-Medicare eligible retirees with GHI PPO benefits will be managed by Empire BCBS for inpatient and outpatient services. EmblemHealth will process pre-certification requests for the following:

  • Home Health Care
  • Home Infusion Therapy (billed by a home infusion specialist)
  • Nutritional Supplements and Enteral Formulas

To request pre-certification from EmblemHealth you may utilize our secure provider website:, or fax your request to 1-212-563-8391, or call the Coordinated Care Intake department at 1-800-223-9870.

To request pre-certification from Empire BCBS, please call 1-800-521-9574.

For a list of all services requiring Pre-Certification from Empire BCBS, please refer to our Provider Manual’s Directory and Care Management chapters.