There are exceptions to the partnerships listed below. Please contact your Administrator regarding participation with EmblemHealth if you are part of:
- HealthCare Partners
- A federally qualified health center
- A diagnostic and treatment center
Based on your specialty, click on the link below to get information about the credentialing process you will need to follow. If your specialty is not listed, check the practice affiliation tab to see if you fall under a delegated credentialing arrangement.
(Applied Behavior Analysis, Psychiatry, Psychology, Counseling, Psychiatric Nurse)
EmblemHealth has partnered with Carelon Behavioral Health (formerly Beacon Health Options) to manage behavioral health and substance use services for our members. Through this partnership, Carelon Behavioral Health is responsible for provider credentialing and recredentialing. For more information, contact the Carelon Behavioral Health National Provider Service Line at 800-397-1630 from 8 a.m. to 8 p.m.
For more information about our partnership with Carelon Behavioral Health, please see the Behavioral Health Services chapter of our Provider Manual.
EmblemHealth has partnered with Healthplex to manage the dental benefits for New York State and federal government-sponsored plans. Through this partnership, providers contract directly with Healthplex. Go to Healthplex for more details or call their Provider Services Hotline at 888-468-2183.
For those who wish to participate in our PPO dental networks and benefit plans, please see our Join Our Dental Networks page.
Vision Service Providers
EyeMed is responsible for the provider network covering routine vision and hardware services, including contracting and credentialing, claims processing and payment, routine vision grievances, and claims appeals.* Please note: Medical vision services are still contracted directly with EmblemHealth or other applicable delegate.
If you are interested in joining EyeMed, complete an online interest form or call EyeMed’s provider service department at 800-521-3605.
*Exception: Medicare grievances and claims appeals will continue to be managed by EmblemHealth.
JP 64723 02/2024