Your participation in the EmblemHealth dental networks gives you opportunities to:
- Attract new patients to your practice. Our dentist directories and online Find a Doctor tool make it easy for our members to find your practice and seek your services. The online directory includes maps with directions to your office.
- Take care of administrative tasks online at your convenience. Sign in to our secure provider Web site or register to start an account. From there you can:
- Submit electronic claims
- Check claims status
- Verify patient eligibility
- Check predeterminations
- Review plan designs
- View patient claims history
- Review tooth history
- Contact us
- You can also use our automated phone system for network providers. Call 1-212-501-4444 (in NYC) or 1-800-624-2414 (outside NYC). Enter the patient's member ID number when prompted. Also have handy your tax ID number filed with us, as well as the patient's date of birth.
- Participate with PPO dental plans. Our dental plans are not DHMO, capitation or prepaid plans. They are PPOs that reimburse network dentists on a fee-for-service basis. Patients can seek care from any dentist or dental specialist at the time care is needed. You won't have to serve as a “gatekeeper” or request our approval to refer patients to specialists.
- Get timely reimbursement. We pay network practices directly and make every effort to ensure you get paid quickly and accurately. Assignment of benefits is guaranteed.
- Rely on a claims system that is compliant with the latest dental procedure coding. Your submission of newly revised coding will be fully reflected in our claims processing and explanation of benefits (EOB) vouchers.
- Submit dental claims electronically at no cost to you. Reduce the time you spend on claims submissions and get faster reimbursement. To submit electronic claims, sign in your secure provider portal or register to start an account. Our Electronic Payer ID is 13551. For diagnostic submissions, such as X-rays, we have partnered with FastAttach and DentalXChange for the submission of attachments. To set up your FastAttach account, contact NEA at 800-782-5150, ext.2. You may also visit dentalxchange.com for more information. These are separate from your EmblemHealth provider portal account. Paper claims are still required for procedures that need coordination of benefits statements from a primary carrier. To learn more, please call our Provider Call Center at 866-447-9717, Monday through Friday, from 8 a.m. to 6 p.m. and a Customer Service representative will be happy to assist you.
