Your practice information appears in our network dentist directories (including our online Find a Doctor tool) and is used in claims processing. Keeping your information current helps ensure that patients can locate your practice and that we can process your claims accurately. Please report updates to your practice information, as instructed below, whenever one of the following occurs:
- The address of your practice changes.
- The telephone number of your practice changes.
- You wish to add or delete a dentist from your practice. If you are adding a provider to your practice, please confirm with EmblemHealth that the provider has been added as a participating provider. If you submit claims for a provider as the treating dentist who has not been added, claims will be processed as out-of-network until the provider is officially participating.
- Your Internal Revenue Service (IRS) taxpayer identification number (TIN) changes. In this case, you will need to complete an IRS Form W-9 and return it to our Dental Professional Relations department.
- You are reporting your National Practice Identifier (NPI) number to EmblemHealth. We need your name exactly as it appears on your license to practice dentistry, and the TIN recognized by the IRS. If you do business as a corporation or partnership, we require the TIN, along with the exact name it is registered with as recognized by the IRS. This must be reflected on Line 1 of the Form W-9.
We must use your unique individual 10-digit NPI number to process standard health care electronic transactions, as required by federal law. This information is required and is necessary to ensure the accurate and timely processing of your claims.
How to report updates to your practice information
For your protection, all changes to your file must be submitted in writing. You may submit changes either by:
- E-mail: dentalproviders@emblemhealth.com
- Mail:
Dental Network Development
PO Box 2818
NY, NY 10116 - Fax: 1-212-615-4953 (downstate) or 1-518-446-0185 (upstate)
Note: Accuracy is essential. If any information provided is inaccurate, we may be required to withhold 31 percent from all payments to your account and forward this amount to the IRS. In addition, your practice would be subject to a penalty by the IRS for failure to provide your correct name/TIN combination. To avoid unnecessary withholding, please be sure to contact us when your records require updates.
