The Bridge Program

 

Starting July 1, 2021, you will start to see non-ASO, fully insured large groups with plans that have Bridge on their ID Cards in addition to the ASO self-funded Bridge Program members you can see today.

 

The Bridge Program

The Bridge Network

Bridge is an innovative concept which gives our members access to a combination of our existing networks though our affiliated companies and partners.

These are the five (5) networks that members may access:

  • EmblemHealth Insurance Company’s (formerly HIPIC) Prime Network
  • EmblemHealth Plan Inc.’s (formerly GHI) National Network
  • ConnectiCare, Inc.’s (CCI) Choice Network
  • QualCare Network
  • First Health Network

Table of Companies, Lines of Business, Networks & Benefits Plans

See all plans offering Bridge in this comprehensive Summary of our offerings


If you participate in any of these networks, you are an in-network provider for Bridge Program members. The Frequently Asked Questions section below details how to determine if you may see a member with Bridge access and how you will be paid.

Sample ID Cards

See the Member ID Card chapter of the EmblemHealth Provider Manual for samples of all Member ID Cards. If the card says “Bridge” as shown below, the member has access to all five networks shown above.

Sample ID Card for Fully Insured Members

Sample ID Card for ASO Self-Funded Members



How to use the Member's ID Card

Use the Member's ID card to see which administrative processes to follow and which rules apply

 

Important Links Key

 

 

 

 

 

Frequently Asked Questions

It means:

  • Increasing the number of our members who may come to you for care.
  • Ensuring your staff knows how to identify these new members who can see you.
  • Following the underwriting company’s administrative guidelines.
  • Sending members to their designated utilization management programs.

You are considered in-network for a member seeking care if you are part of any of the networks listed below and the word “Bridge” appears on the member’s ID card.

Look to the branding and instructions on the member’s ID Card. ID card will have “Bridge” in the network field and ConnectiCare, QualCare, and First Health logos.

If you participate with both EmblemHealth Insurance Company (formerly HIP Insurance Company of New York (HIPIC)) and EmblemHealth Plan Inc. (formerly Group Health Incorporated (GHI)) OR participate with both EmblemHealth Insurance Company and ConnectiCare (CCI), you will be paid according to your EmblemHealth Insurance Company contract terms. If you participate with both Health Insurance Plan of Greater New York (HIP) and EmblemHealth Plan Inc., EmblemHealth Plan Inc. rates will apply. If you participate only with EmblemHealth Plan Inc. or only with CCI, you will be paid the respective contracted EmblemHealth Plan Inc. or CCI rate.

If you have a question or concern about which contract rate applies, see the chart below or contact us at 866-447-9717, Monday through Friday, from 8 a.m. to 6 p.m., and a Customer Service agent will assist you.

Contracts & Rates

Participation

Paid under this contract

EmblemHealth Insurance Company and ConnectiCare

EmblemHealth Insurance Company

EmblemHealth Insurance Company and EmblemHealth Plan Inc.

EmblemHealth Insurance Company

HIP and EmblemHealth Plan Inc.

EmblemHealth Plan Inc.

EmblemHealth Plan Inc. only

EmblemHealth Plan Inc.

ConnectiCare only

ConnectiCare

You follow the same billing protocols as you would for any other member fulling under a given underwriting company and their applicable vendor partnerships. See our Claims Contacts

Referrals are not required. Follow the Utilization Management rules for the underwriting company found on the back of the Member’s ID Card.

See Who to Contact for Preauthorization.

Fully insured members follow all the standard administrative guidelines as every other member with the same benefit plan underwritten by the same company. This includes using the same preauthorization lists, preauthorization contacts, and special vendor managed utilization management programs.

The Bridge ASO program was initially launched with the goal of having all Bridge ASO members follow EmblemHealth Insurance Company’s standard utilization management rules. However, based on client request, we have given ASO clients the option to customize their utilization management rules. They may adopt an existing standard set of rules, or they may choose to develop their own.