Claims Contacts

Paper claims (CMS 1500 forms) may be sent to the addresses indicated, unless otherwise noted on the member's ID card.

Company Network Type of Claim EDI or Payor ID Clearing House Paper Claim Submission Address Contact for Inquiries
HIP/EmblemHealth Insurance Company (formerly HIPIC) Bridge
Enhanced Care Prime
Prime
VIP Prime
Bold
Reserve
Professional claims HIP/ EmblemHealth Insurance Company: 55247

HIP plans branded GHI HMO: 25531

HIP plans branded Vytra HMO: 22264
Vendor or direct 
submission
EmblemHealth
PO Box 2845
New York, NY 10116-2845
emblemhealth.com/providers or
866-447-9717
HIP/ EmblemHealth Insurance Company (formerly HIPIC) Bridge
Enhanced Care Prime
Prime
VIP Prime
Bold
Reserve
Facility claims HIP/HIPIC/Bridge: 55247

HIP plans branded GHI HMO: 25531
Vendor or direct 
submission
EmblemHealth
PO Box 2803
New York, NY 10116-2803
 emblemhealth.com/providers or
866-447-9717
EmblemHealth Plan, Inc. (formerly GHI) Bridge
CBP
Tristate
National
Network Access
Medicare Choice
Professional claims, member-submitted 13551 Vendor or direct 
submission
EmblemHealth 
PO Box 3000
New York, NY 10116-3000
emblemhealth.com/providers or
212-501-4444
EmblemHealth Plan, Inc. (formerly GHI) Bridge
CBP
Tristate
National
Network Access
Medicare Choice
Professional claims, provider-submitted 13551 Vendor or direct submission EmblemHealth 
PO Box 2832
New York, NY 10116-2832
emblemhealth.com/providers or
212-501-4444
EmblemHealth Plan, Inc. (formerly GHI) Bridge
CBP
Tristate
National
Network Access
Medicare Choice
Facility claims 13551 Vendor or direct 
submission
EmblemHealth
PO Box 2833
New York, NY 10116-2833
emblemhealth.com/providers or
212-501-4444
EmblemHealth Plan, Inc. (formerly GHI) GHI PPO Dental Dental claims Not applicable Vendor or direct 
submission
EmblemHealth 
PO Box 2838
New York, NY 10116-2838
emblemhealth.com/providers or
212-615-4EMC
ConnectiCare Choice
Flex
Passage
CCI VIP Medicare Advantage claims 78375 Vendor ConnectiCare
PO Box 4000
Farmington, CT 06034-4000
877-224-8230

Managing Entity Partners

(Applicable to Health Insurance Plan of Greater New York (HIP) only)
Company Network Type of Claim EDI or Payor ID Clearing House Paper Claim Submission Address Contact for Inquiries
Montefiore CMO

Enhanced Care Prime

Prime

VIP Prime

Bold

Reserve

HIP claims for members managed by Montefiore CMO 13174 Vendor CMO
200 Corporate Drive
Yonkers, NY 10701 877-447-6668
HealthCare Partners (HCP) [except for members in HCP Cohort 2]

Enhanced Care Prime

Prime

VIP Prime

Bold

Reserve

HIP claims for members managed by HCP 11328 Vendor HealthCare PartnersAttn: Claims Department
501 Franklin Avenue
Suite 300
Garden City, NY 11530-5807
516-746-2200 or
888-746-2200
HCP Cohort 2

Enhanced Care Prime

Prime

VIP Prime

Bold

Reserve

HIP claims for members managed by HCP Cohort 2 55247 Vendor or direct submission EmblemHealth
PO Box 2845
New York, NY 10116-2845 emblemhealth.com/providers 
or 866-447-9717
SOMOS Enhanced Care Prime For Medical Claims – Medicaid/CHP/HARP and Essential Plan 81336 Vendor SOMOS IPA, LLC.,
P.O. 211473
Eagan, MN 55121
844-990-0255

Vendor Partners

Company Network Type of Claim EDI or Payor ID Clearing House Paper Claim Submission Address Contact for Inquiries
Palladian Muscular Skeletal Health

Bridge – for plans underwritten or administered by EmblemHealth Insurance Company

Enhanced Care Prime

Prime

VIP Prime

Bold

Reserve For the PT/OT Program:

  •  Professional providers, please submit claims directly to Palladian.
  • Facilities, please submit claims to EmblemHealth as indicated above.
37268 Vendor Palladian Health
PO Box 366
Lancaster, NY 14086
 
PHInfo@evicore.com
eviCore 

Bridge

Enhanced Care Prime

Prime

VIP Prime

Bold

Reserve

Tristate National Network Access

Medicare Choice

For the Outpatient Diagnostic Imaging Privileging for Non-Radiologists, Radiology, Cardiology Imaging, and Radiation Therapy Programs:

  •  eviCore contracted providers, please submit claims directly to eviCore.
  • All others, please submit claims to EmblemHealth as indicated above.
14182 Vendor/Relay Health eviCore
400 Buckwalter Place Blvd.
Bluffton, SC 29910
800-420-3471
Beacon Health Option

Bridge

Enhanced Care Prime

Prime

VIP Prime

Bold

Reserve Emblem 

CBP

Tristate
National Network Access

Medicare Choice CBP

Tristate National Network Access

Medicare Choice

Behavioral Health Services Program
Submit claims to Beacon. Providers who are not in Montefiore’s network, submit claims to Beacon for Montefiore members and all other Beacon-managed members. 

 

EmblemHealth Behavioral Management Program
Submit claims to Beacon.

FHC &Affiliates Vendor Vendor
 
EmblemHealth
PO Box 1850Hicksville, NY 11802-1850
Beacon Health Options
or 800-235-3149
 
Empire CBP City of New York GHI PPO Claims for facility and other services managed by Empire       800-433-9592
EyeMed All For all members with a vision care benefit     EyeMed
4000 Luxottica Place
Mason, Ohio 45040

eyemed.com

Medicare 844-790-3878

Medicaid  877-324-2791

Commercial (HMO, PPO, POS) 877-324-4063

On/Off Individual and Group Exchange and Essential Plans) 877-324-6211

DentaQuest   For the HIP plans supported by DentaQuest where there is a dental benefit claim

Payor ID:
EMBDQ

Payor Name:
DQ/Emblem

 

Emblem Dental (DentaQuest)
P.O. Box 463
Milwaukee, WI 53201

Fax: 262-834-3589

provider.dentaquest.com

Additional Claim Partners

Company Network Type of Claim EDI or Payor ID Clearing House Paper Claim Submission Address Contact for Inquiries
PNC All HIP & GHI Medical and Hospital claims prior to transitions to ECHO Health, Inc.   See EmblemHealth section above. PNC Remittance Advantage N/A 877-597-5489, option 1
ECHO Health, Inc. (ECHO) All All claims after the transitions from PNC.
See EmblemHealth section above. ECHO See EmblemHealth section above. 888-492-0032