Emblemhealth doctors

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For Pharmacy Services Contacts, please go here. The table below includes a list of anesthesia groups whose doctors are available to come to your office so you can keep member care in-network. For Health Homes Contacts, please go here. Quest Diagnostics, Inc. We also contract with other free-standing independent laboratories for certain specialty tests. In addition, physicians may use network hospitals with their own EmblemHealth-contracted lab and pathology group s.

Some member benefit plans have higher cost-sharing for lab services through a network hospital. Please use these network laboratories when requesting lab services for our members. All services for out-of-network providers require Preauthorization. If you do not have an account with any of our network laboratories, please establish one as needed by calling the applicable phone number s.

For information on allowable in-office lab tests, please see Claims Corner. Contracted laboratories will provide a collection box and courier service to and from the practitioner's office for specimen collection. If specimens need to be drawn outside of the practitioner's office, members should be directed to the nearest contracted laboratory Patient Service Center and given the requisition form to hand-carry.

Practitioners may also consult their local Quest Diagnostics laboratory for more information. STAT results are reported by telephone as soon as available. CHCs are conveniently located in communities, and are staffed by personnel who understand the cultural, linguistic, and spiritual needs and beliefs of the patients they serve. To find a list of community health centers , use the Find a Doctor tool at emblemhealth. For urgent conditions that do not meet the layperson's definition of an emergency, all EmblemHealth plan members have access to network urgent care centers.

To find a list of network urgent care centers , use the Find a Doctor tool at emblemhealth. Dispute Resolution - Medicare. Free multi-language interpreter service is available to assist providers and their patients.

To access an interpreter, providers may call and a Provider Customer Care Advocate will assist you. If the member calls, he or she will be asked to have the provider contact EmblemHealth to arrange for the interpreter.

The Interview Unit will contact the member to confirm the interpreter arrangements. Lighthouse Guild is a leading worldwide resource on vision impairment and vision rehabilitation.

Through its work in vision rehabilitation services, education, research and advocacy, Lighthouse Guild enables people of all ages who are blind or partially sighted to lead independent and productive lives. The Early Intervention Program EIP providesevaluation and developmental services when a child has or is suspected of having a developmental delay.

The EIP has two components:. New York State law requires all primary referral sources e. Parental consent is required for referral. You may also call the LEIAs at:.

This program ensures such children are evaluated and receive needed special education and that disability-related health services are only provided by SSHSP providers approved by the Committee on Special Education.

The program is under no obligation to use providers in the child's health plan network. The school district bills the state for services rendered to Medicaid managed care members.

When the services rendered to non-Medicaid members are covered by a third party, the school district is authorized to bill the third party on behalf of the servicing provider. PHCP provides financial assistance for medical care and support services to children that have severe, long-term health problems and chronic disabilities. Eligible conditions include birth defects, physical handicaps, and other conditions that can be improved with treatment and early intervention.

Application for the Treatment Program must be made to the county in which the child resides. There are some variations between counties for conditions covered and financial eligibility. Financial criteria are designed to assist families with low incomes or inadequate private health insurance. Primary care physicians PCPs such as pediatricians and family practice doctors are often the first-place families go to seek help or information about emotional or behavioral concerns with their children.

Additionally, other prescribers who are providing ongoing treatment to children, such as Child and Adolescent Psychiatrists, General Psychiatrists, and Psychiatric Nurse Practitioners, may request a second opinion through consultation. 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.

Switch to: members brokers employers. Sign in Contact Us Search. Navigation Open. Switch to:. Medicare Dental Network. Medicare Advantage Plans To locate a network provider, find the name of your plan, choose when you will be the getting the plan services and start your search.

Small Group Plans Employers or unions with full-time equivalent employees. Bronze Plus H. Bronze Premier-M. Bronze Premier-P. Bronze Premier-S. Bronze Value-M. Bronze Value-P. Bronze Value-S. Gold Premier-M. Gold Premier-P. Gold Premier-S. Gold Value-M. Gold Value-P. Platinum Premier-M. Platinum Premier-P. Platinum Premier-S. Platinum Value-M. Platinum Value-P. Platinum Value-S. Silver Plus H. Silver Premier-M. Silver Premier-P. Silver Premier-S. Silver Value-M. Silver Value-P. Silver Value-S.

Large Group Plans For employers and unions with more than employees. Consumer Direct EPO. Consumer Direct PPO. HIPaccess I.

HIPaccess II. InBalance EPO. InBalance PPO. DC37 Med-Team. New York City Transit. New York City Transit Retirees. NY State Employee Dental plan. HIP Standard Option plan. Federal Employees and Retirees. Dental Preferred Plus. Dental Access. Dental Spectrum. EH Employees Preferred Plus. EH Employees Preferred Premier. Vision Access. Enhanced Care Medicaid Managed Care. Find a doctor or medical office. All Rights Reserved.

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New York State law requires all primary referral sources e. Parental consent is required for referral. You may also call the LEIAs at:. This program ensures such children are evaluated and receive needed special education and that disability-related health services are only provided by SSHSP providers approved by the Committee on Special Education.

The program is under no obligation to use providers in the child's health plan network. The school district bills the state for services rendered to Medicaid managed care members. When the services rendered to non-Medicaid members are covered by a third party, the school district is authorized to bill the third party on behalf of the servicing provider. PHCP provides financial assistance for medical care and support services to children that have severe, long-term health problems and chronic disabilities.

Eligible conditions include birth defects, physical handicaps, and other conditions that can be improved with treatment and early intervention. Application for the Treatment Program must be made to the county in which the child resides. There are some variations between counties for conditions covered and financial eligibility.

Financial criteria are designed to assist families with low incomes or inadequate private health insurance. Primary care physicians PCPs such as pediatricians and family practice doctors are often the first-place families go to seek help or information about emotional or behavioral concerns with their children.

Additionally, other prescribers who are providing ongoing treatment to children, such as Child and Adolescent Psychiatrists, General Psychiatrists, and Psychiatric Nurse Practitioners, may request a second opinion through consultation.

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.

Switch to: members brokers employers. Sign in Contact Us Search. Navigation Open. Switch to:. Clinical Corner. Quality Improvement Find our Quality Improvement programs and resources here. Search Our Quality Improvement Page. Claims Corner. Reimbursement Policies Payment processes unique to our health plans Payment Integrity Policies How we pursue payment accuracy.

Provider Manual. Provider Manual Find the specific content you are looking for from our extensive Provider Manual. Search the Provider Manual. Dental Corner. Welcome Dental Providers Find a Dentist. Home Home Provider Manual Directory. Chapter 2: Directory. Table of Contents. EmblemHealth Contact Information. Claims Contacts. Who to Contact for Preauthorization. Pharmacy Services.

Health Homes. Network Laboratory Services. Community Health Centers. Urgent Care Centers. Complaints, Grievances, and Appeals Practitioners and Members. Interpreter Services. Language Line: Interpreter Service Free multi-language interpreter service is available to assist providers and their patients. Services for the Visually Impaired.

Lighthouse Guild www. Resources for Children with Special Needs. Only children with a risk factor for developmental delay should be referred to this component. Medicare Advantage Plans To locate a network provider, find the name of your plan, choose when you will be the getting the plan services and start your search. Small Group Plans Employers or unions with full-time equivalent employees.

Bronze Plus H. Bronze Premier-M. Bronze Premier-P. Bronze Premier-S. Bronze Value-M. Bronze Value-P. Bronze Value-S. Gold Premier-M. Gold Premier-P. Gold Premier-S.

Gold Value-M. Gold Value-P. Platinum Premier-M. Platinum Premier-P. Platinum Premier-S. Platinum Value-M. Platinum Value-P. Platinum Value-S. Silver Plus H. Silver Premier-M. Silver Premier-P. Silver Premier-S. Silver Value-M. Silver Value-P. Silver Value-S. Large Group Plans For employers and unions with more than employees. Consumer Direct EPO. Consumer Direct PPO. HIPaccess I. HIPaccess II. InBalance EPO. InBalance PPO. DC37 Med-Team. New York City Transit.

New York City Transit Retirees. NY State Employee Dental plan. HIP Standard Option plan. Federal Employees and Retirees. Dental Preferred Plus. Dental Access. Dental Spectrum. EH Employees Preferred Plus. EH Employees Preferred Premier.

Vision Access. Enhanced Care Medicaid Managed Care. Find a doctor or medical office. All Rights Reserved. Back to Top.