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 EmblemHealth, please follow the instructions below.

Before You Apply

Credentialing 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.

At a minimum, you will need to complete and submit the following forms for the credentialing and recredentialing processes:

Credentialing and Recredentialing Forms Download (PDF)
Provider Recruitment Checklist Download (PDF)
CAQH Tips Download (PDF)
PPO Agreement Download (PDF)
Provisional Credentialing Attestation Form Download (PDF)
Americans With Disabilities Act (ADA) Attestation Download (PDF)
Form W-9 Download (PDF)

Below are supplemental forms you may also need:

Supplemental Forms for Credentialing and Recredentialing Download (PDF)
Professional Liability History Download (PDF)
Hospital Coverage Arrangements Attestation Download (PDF)
Hospital Privileges and Malpractice Attestation Form Download (PDF)
Credentialing Application Addendum for Registered Physician Assistant Download (PDF)
Credentialing Application Addendum for Nurse Practitioner Download (PDF)
Advanced Nurse Practitioner Requesting Additional Status as Primary Caregiver Download (PDF)

EmblemHealth requires all applicants for all networks to complete the Council for Affordable Quality Health Care (CAQH) Proview credentialing application form. If you do not have a CAQH number, please register with CAQH ProView. If you have any  questions abouthow to obtain a CAQH number, please call  CAQH at 1-888-599-1771.

Credential Your CHC, FQHC and D&TC Providers Quicky and Accurately

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 EmblemHealth HIP and GHI

To join the GHI PPO or EmblemHealth EPO/PPO National Network, please make sure you have reviewed the “Credentialing EmblemHealth Applicants” section above.

Our network in Florida is closed except for primary care physicians, cardiologists, orthopedic surgeons and any provider that is joining a group that is already participating with EmblemHealth. The network outside of New York, New Jersey, Connecticut and Florida is currently closed unless the provider is joining a participating group. To join the GHI PPO or EmblemHealth EPO/PPO National Network, please make sure you have reviewed the “Credentialing EmblemHealth Applicants” section above.

Sending Your Application

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

EmblemHealth
55 Water Street
New York, NY 10041
Attn: Physician Contracting, 7th floor

For all other counties in New York State, as well as New Jersey, Connecticut and Florida and providers in other states joining a participating group, please send your completed application and agreements to:

EmblemHealth
5015 Campuswood Drive
East Syracuse, NY 13057
Attn: Physician Contracting

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

    Practitioner Rights

    Please be aware, during the credentialing process, practitioners maintain the following rights:

    • The right to review information obtained in support of their credentialing applications, excluding references, recommendations or other peer review protected material.
    • The right to correct erroneous information in written form to the credentialing department within 10 days of receipt of EmblemHealth's notification. This may include: actions on licensure, malpractice claims history and board certification status.
    • The right to be informed of the status of his/her credentialing/recredentialing application. Requests may be made to EmblemHealth via written or telephone inquiry. Response will be made within 10 days of receipt, via same communication method as the original inquiry.