EmblemHealth Accreditations

EmblemHealth, Inc. through its companies GHI and HIP, is committed to providing members with access to high-quality care. EmblemHealth products are underwritten by Group Health Incorporated, HIP Health Plan of New York and HIP Insurance Company of New York. Both GHI and HIP are accredited by the industry's leading accrediting body, NCQA.

“NCQA is an independent, not-for-profit organization dedicated to assessing and reporting on the quality of managed care plans, managed behavioral healthcare organizations, preferred provider organizations, new health plans, physician organizations, credentials verification organizations, disease management programs and other health-related programs.” 

As a member and/or employer group, you want a health plan with quality and service you can count on.

“NCQA Health Plan Accreditation is a voluntary review process, a nationally recognized evaluation that purchasers, regulators and consumers can use to assess health plans. NCQA Health Plan Accreditation evaluates how well a health plan manages all parts of its delivery system, physicians, hospitals and other providers and administrative services – in order to continuously improve the quality of care and services provided to its members.” 

Learn More about the NCQA

 

Accreditation Information

GHI

EmblemHealth’s GHI’s product currently holds an “Accredited” NCQA accreditation status for the Commercial PPO plan.

HIP

EmblemHealth’s HIP product currently holds an “Accredited” NCQA accreditation status for the Commercial HMO/POS plan, the Exchange, and the Medicare HMO plan.

“Achieving an accreditation status of Commendable from NCQA is a sign that a health plan is serious about quality,” says Margaret E. O’Kane, president of NCQA. “It is awarded to plans whose service and clinical quality meet or exceed NCQA’s rigorous requirements for consumer protection and quality improvement.”

Information on EmblemHealth’s QI program description, including goals and achievements, is available at the Quality Improvement Program page.

Information posted on the EmblemHealth website will help you understand the benefits and services covered in your benefit plan; plan restrictions; how to obtain health care services and medications; how to file a claim for payment (if needed); how submit a complaint; how to appeal an adverse decision; and how EmblemHealth evaluates new technology, your rights and responsibilities, access to physicians, pharmacies, behavioral health practitioners, hospitals, and more. Please see EmblemHealth's Member pages for more information.

The EmblemHealth family of companies includes Group Health Incorporated, HIP Health Plan of New York, HIP Insurance Company of New York, ConnectiCare and EmblemHealth Services Company LLC, and provides access to health plan benefits and services through one or more of these companies.