Date Issued: 1/1/2009
(For all benefit plans)
For HIP and CompreHealth Benefit Plans
If you have submitted a claim for a HIP or CompreHealth HMO/EPO plan member that was denied because critical information was invalid or omitted and you would like to make changes to the claim for an additional review, please resubmit the claim with corrections on the form (professional CMS-1500 or facility UB04) as you would an original claims request. If we have any questions regarding your claim request, we will contact you at the phone number you provide on the form.
For GHI, GHI HMO and EmblemHealth EPO/PPO Plans
If you have submitted a claim for a GHI, GHI HMO or EmblemHealth EPO/PPO plan member that was denied and you would like to make changes to the claim for an additional review, please send the additional or corrected claim information by logging on to www.emblemhealth.com and click on "Claims" in the left navigation bar. At the bottom of the claim, you'll see a link that reads "Contact EmblemHealth About this Claim." You'll find that all the claim information is already filled in for you. All you need to do is include the additional information. Or, click on "Message Center" on the left navigation bar, and you'll be prompted to fill in the message center form, which will automatically be submitted to our Customer Service department.