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 HIP plans branded Vytra HMO: 22264 |
Vendor or direct submission | EmblemHealth PO Box 2845 New York, NY 10116-2845 |
emblemhealth.com/providers or 866-447-9717 |
| HIP / EmblemHealth Insurance Company (formerly HIPIC) | Bridge Enhanced Care Prime Prime VIP Prime Bold Reserve Millennium Select Care |
Facility claims | HIP/HIPIC/ Bridge: 55247 HIP plans branded GHI HMO: 25531 |
Vendor or direct submission | EmblemHealth PO Box 2803 New York, NY 10116-2803 |
emblemhealth.com/providers or 866-447-9717 |
| EmblemHealth Plan, Inc. (formerly GHI) | Bridge CBP Tristate National Network Access Medicare Choice |
Professional claims, member-submitted | 13551 | Vendor or direct submission | EmblemHealth PO Box 3000 New York, NY 10116-3000 |
emblemhealth.com/providers or 212-501-4444 |
| EmblemHealth Plan, Inc. (formerly GHI) | Bridge CBP Tristate National Network Access Medicare Choice |
Professional claims, provider-submitted | 13551 | Vendor or direct submission | EmblemHealth PO Box 2832 New York, NY 10116-2832 |
emblemhealth.com/providers or 212-501-4444 |
| EmblemHealth Plan, Inc. (formerly GHI) | Bridge CBP Tristate National Network Access Medicare Choice |
Facility claims | 13551 | Vendor or direct submission | EmblemHealth PO Box 2833 New York, NY 10116-2833 |
emblemhealth.com/providers or 212-501-4444 |
| EmblemHealth Plan, Inc. (formerly GHI) | GHI PPO Dental | Dental claims | Not applicable | Vendor or direct submission | EmblemHealth PO Box 2838 New York, NY 10116-2838 |
emblemhealth.com/providers or 212-615-4EMC |
| ConnectiCare | Choice Flex Passage |
CCI VIP Medicare Advantage claims | 78375 | Vendor | ConnectiCare PO Box 4000 Farmington, CT 06034-4000 |
877-224-8230 |
