Did you know there are faster ways to get your patient and clinical information?
As COVID-19 increases demands on your practice and our customer service call center, we want to share with you some faster ways to send us referrals, emergency admission notifications, and preauthorization requests. You can also check the status of authorizations and patients who have been admitted to the hospital without making a phone call.
We strongly encourage you to use our secure provider portal by signing in at this link. This is currently the most efficient way to work with us. If you do not yet have your own account on our secure provider portal, this guide will show you how to register. **Note: This does not apply to GHI PPO members. Please see the fax information below for communicating with us about these members.
The provider portal is also the best place to check on the status of an authorization. Regardless of how you requested the authorization—by phone, fax, or portal—status messages are available on the portal. Furthermore, you can check on the status of patients admitted to the hospital.
Your portal account includes a report for hospital admissions that includes the patient’s name, facility name, and whether EmblemHealth has an authorization pending, approved, denied, partially approved, or if the patient was discharged. Through the portal, providers may also enter required notices of admission, saving even more time. This guide can help you find the reports after you have signed in to your account on the provider portal.
The provider portal offers additional services that you may find valuable, including:
- How to create a Referral
- How to create a Preauthorization for a Site of Service code with Clinical criteria
- How to create a Preauthorization – Outpatient case
- How to create a Preauthorization – Inpatient case
- How to search for Member Benefit/Eligibility and Existing Referral/Preauthorization on the web
What if you don’t have internet access?
If you do not have internet access but still want a faster way to work with us, you may fax requests for the following services to the number shown:
- GHI Predetermination: 212-510-5200
- Benefit Extensions for PT/OT/Allergy/Speech/Vision: 212-967-2995
- Home Infusion: 212-510-5978
- GHI (Commercial/Medicare Advantage) Home Care: 877-374-3809
- GHI DME (Commercial/Medicare Advantage): 866-426-1509
Fax numbers for all other requests (Inpatient, Outpatient, Office, and Post-Acute Care):
GHI ER Admission and Prior Authorization Requests: 212-563-8391
HIP ER Admission and Prior Authorization Requests: 866-215-2928
To submit clinical records by fax:
HIP Clinical Records: 877-818-0810
GHI Clinical Records: 212-510-5200