EmblemHealth partners with various organizations to give our members the benefit of value-based care, administrative efficiencies and specialized expertise. Where appropriate, EmblemHealth has entered into agreements with these partners to perform credentialing on EmblemHealth’s behalf. EmblemHealth has a stringent oversight processes to ensure these partners meet our high standards. In certain circumstances, health care professionals are required to sign direct agreements with these partners and go through their credentialing processes.
Depending on your specialty, you may need to apply for participation through one of EmblemHealth’s partners. Based on your specialty, click on the link below to get more information about credentialing. If your specialty is not listed, download and complete the EmblemHealth credentialing documents under “Before You Apply”.
Musculoskeletal Services (Physical Therapy, Occupational Therapy, Chiropractic)
EmblemHealth has partnered with Palladian Muscular Skeletal Health (Palladian), a specialty network and utilization management organization, to arrange chiropractic or physical and occupational therapy services for our members. Through this partnership, Palladian is responsible for credentialing and recredentialing for HIP. EmblemHealth EPO/PPO and GHI PPO providers contract directly with the plan.
Please refer to the chart below:
|Medicare Choice PPO
For further information on credentialing with Palladian, contact Palladian’s Customer Service at 877-774-7693.
(Applied Behavior Analysis, Psychiatry, Psychology, Counseling, Psychiatric Nurse)
EmblemHealth has partnered with Beacon Health Options to manage behavioral health and substance use services for our members. Through this partnership, Beacon Health Options is responsible for provider credentialing and recredentialing. For more information, contact the Beacon Health Options National Provider Line at 800-397-1630 from 8 a.m. to 8 p.m.
For more information about our partnership with Beacon Health Options, please see the Behavioral Health Services chapter of our Provider Manual.
EmblemHealth has partnered with DentaQuest to manage the dental benefits. Through this partnership, providers contract directly with DentaQuest. Go to DentaQuest for more details or call DentaQuest at 844-822-8108, Monday to Friday from 8 a.m. to 5 p.m.
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 claim appeals will continue to be managed by EmblemHealth.
There are exceptions to these partnerships, if you are part of Health Care Partners, Montefiore CMO, a federally qualified health center or a diagnostic and treatment center please contact your Administrator regarding participating with EmblemHealth.