We are committed to going digital and simplifying how we do business with you. Our provider portal is key to that transformation. On the portal, all users can:
Clinical staff can:
- Submit documents in support of preauthorizations, concurrent reviews, and discharge plans.
- See the clinical information needed to expedite a review determination. Use simple check-off boxes to let us know what applies to your request.
- See utilization management determination letters for EmblemHealth’s commercial members.
- See a member’s care plan if they are participating in one of our care/case management programs.
- Submit appeals.
- Inpatient facilities can see a Concurrent Review Status Report and coordinate discharge planning.
Billing staff can:
- Look up claims’ status.
- Find copies of your Explanations of Payment.
- Send claim inquires and submit grievances.
- Submit medical records and other supporting documentation requested in the claim denial message.
If you need a provider portal account, speak to your organization’s assigned provider portal administrator/office manager. If you don’t know who that is, or your organization’s tax identification number has not been set up for a master account, submit your request through the new Provider Portal Registration Form and our Provider Customer Service team will be happy to help you.
JP 63744 11/2023
