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:
Below are supplemental forms you may also need:
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.
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.
Credential Your Providers Quickly and Accurately
Joining GHI PPO
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:
55 Water Street
New York, NY 10041
Attn: Physician Contracting, 7th floor
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:
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.
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.
Any questions? Sign in to our secure website and proceed to the Message Center. When writing your message, select “General Information” as the category in the drop-down menu on the “Ask a Question” page.