Paper claims (CMS 1500 and UB-04 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 Millennium Select Care | Professional claims | HIP/ EmblemHealth Insurance Company: 55247 |
HIP plans branded GHI HMO: 25531
(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 |
|---|---|---|---|---|---|---|
| HealthCare Partners (HCP) | Enhanced Care Prime Prime VIP Prime Bold Reserve | 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 |
| 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 |
| Company | Network | Type of Claim | EDI or Payor ID | Clearing House | Paper Claim Submission Address | Contact for Inquiries |
|---|---|---|---|---|---|---|
| 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.
Healthplex
PO Box 30605
Salt Lake City, UT 84130-0605
| 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 |
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Any information provided on this Website is for informational purposes only. It is not medical advice and should not be substituted for regular consultation with your health care provider. If you have any concerns about your health, please contact your health care provider's office.
Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage.