Join Our Networks

EmblemHealth and our companies GHI and HIP have a single overriding mission: To provide affordable, quality health care to all of our members. We are proud of a tradition of providing helpful information and prompt, responsive service to our members, of giving your patients many plan options, and of our partnerships with health care professionals.

If you would like to join the thousands of physicians and clinicians who are partnering with GHI and EmblemHealth, please follow the instructions below.

Before You Apply

Credentialing GHI/EmblemHealth Applicants
Credentialing is a process which reviews and verifies a practitioner's training and qualifications prior to that practitioner being approved for participation with a health plan. Specific criteria are applied in determining participation in our networks. Every three years, practitioners are required to be re-credentialed in accordance with NCQA guidelines. The recredentialing process ensures that the provider's credentials are up-to-date and accurate.

EmblemHealth requires all applicants for GHI HMO or GHI PPO to complete the Council for Quality Health Care's credentialing application form. If you do not have a CAQH number, please contact our Provider Relations department first. A provider representative will collect the preliminary information needed to add you to our CAQH roster of providers. CAQH will then let you know when to go to their Web site to complete the rest of your credentialing information online.

Attention: Participating Practitioner Agreements and Applications
The application and contract material in this section applies to individual clinicians only. This application and contract will not be accepted for facility or other provider types.

Joining GHI PPO

To join the GHI PPO or EmblemHealth EPO/PPO National Network, please make sure you have reviewed the “Credentialing GHI/EmblemHealth Applicants” section before downloading and completing the applicable forms:

• PPO Agreement (PDF — 15 pages)
• Provisional Credentialing Attestation Form (PDF — 2 pages)
• American Disabilities Act (ADA) Checklist (PDF — 3 pages)
• Form W-9

GHI HMO Network Optimized

The GHI HMO network is optimized and we are not enrolling new providers for participation in our GHI HMO network. Pending approval from the NYS Departments of Health and Financial Services (DOH and DOFS, respectively), EmblemHealth anticipates merging its company GHI HMO Select, Inc. (GHI HMO) into HIP Health Plan of New York (HIP).

Providers joining an existing GHI HMO group will be granted participation only under that group's Tax ID number. Providers who are part of an existing practice through an individual agreement and pursue solo practice will maintain their participation status, and their contract will not terminate.

Please submit any questions you may have to our message center on our web site at www.emblemhealth.com.

Sending Your Application

For New York City, including Nassau and Suffolk counties, as well as New Jersey, Connecticut and Florida applicants, please send your completed application and agreements to:

GHI
PO Box 2802
New York, NY 10117-0919

For all other counties in New York State, as well as all other out-of-state applicants, please send your completed application and agreements to:

GHI
Attn: Provider Relations
80 Wolf Road
Albany, NY 12205-2608

Please note: All applications must be sent along with the corresponding signed agreement for the networks you are electing to join.

HIP HMO Network Optimized
The HIP HMO network is optimized at the present time and we are not enrolling new providers for participation in our HIP HMO network. Providers will be recruited only if there is a need for a particular specialty within a specific geographic area.

Providers joining an existing group will be granted participation only under that group's Tax ID number. Providers who are part of an existing practice through an individual agreement and pursue solo practice will maintain their participation status, and their contract will not terminate.

Please submit any questions you may have to our message center on our web site at www.emblemhealth.com.