Claims Contacts

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

Company/Program Type of Claim EDI or Payor ID Clearing House Paper Claim Submission Address Contact for Inquiries
HIP/HIPIC/Bridge Professional claims HIP/HIPIC/Bridge: 55247

HIP plan’s branded GHI HMO: 25531
Vendor or direct 
submission
EmblemHealth
PO Box 2845
New York, NY 10116-2845
emblemhealth.com/providers or
866-447-9717
HIP/HIPIC/Bridge Facility claims HIP/HIPIC/Bridge: 55247

HIP plan’s branded GHI HMO: 25531
Vendor or direct 
submission
EmblemHealth
PO Box 2803
New York, NY 10116-2803
 emblemhealth.com/providers or
866-447-9717
GHI 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
GHI 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 
GHI Facility claims 13551 Vendor or direct 
submission
EmblemHealth
PO Box 2833
New York, NY 10116-2833
emblemhealth.com/providers or
212-501-4444
GHI Dental claims Not applicable Vendor or direct 
submission
EmblemHealth 
PO Box 2838
New York, NY 10116-2838
emblemhealth.com/providers or
212-615-4EMC
Vytra All claims 22264 Vendor or direct 
submission
Vytra Health Plans
Attn: Claims Department
PO Box 9091
Melville, NY 11747-9091
emblemhealth.com/providers or
888-288-9872
CCI CCI VIP Medicare Advantage claims 78375 Vendor ConnectiCare
PO Box 4000
Farmington, CT 06034-4000
877-224-8230
Montefiore CMO 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] HIP claims for members managed by HCP 11328 Vendor HealthCare Partners
Attn: Claims Department
501 Franklin Avenue
Suite 300
Garden City, NY 11530-5807
516-746-2200 or
888-746-2200
HCP Cohort 2 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 For Medical Claims – Medicaid/CHP/HARP and Essential Plan 81336 Vendor SOMOS IPA, LLC., P.O. 211473, Eagan, MN 55121 844-990-0255
Palladian 
Muscular 
Skeletal Health

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

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 Options Emblem 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 for members with a K-ID. Prior to transition to our new claims systems, continue to submit claims to EmblemHealth.
FHC &Affiliates Vendor EmblemHealth
PO Box 1850
Hicksville, NY 11802-1850
Beacon Health Options or
800-235-3149
Empire City of New York GHI PPO Claims for facility and other services managed by Empire       800-433-9592
EyeMed 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
Milwauke, WI 53201
Fax: 262-834-3589
provider.dentaquest.com
Other Claims Contacts
PNC HIP & GHI Medical and Hospital claims   PNC Remittance Advantage   877-597-5489, option 1
ECHO Health, Inc. (ECHO) ASO Bridge Members   ECHO   888-492-0032