Coverage profile
Work EmblemHealth Plan across every published route
Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.
Claim status
EDI 276/277The Substrate Claim Status Agent can check clearinghouse claim status for your practice with EmblemHealth Plan.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with EmblemHealth Plan.
Coordination of benefits
Real-time checkThe Substrate Eligibility Agent can check coordination of benefits for other active coverage and primary or secondary order with EmblemHealth Plan.
Other aliases
Also known as
- 10407
- 10616
- 10808
- 13551
- 2744
- 6509
- EMBLEM
- EMBLM
- QTRDL
- SQJIW
- EmblemHealth - Group Health Incorporated
- GHI - New York
- Vytra
- EMBLEM HEALTH - GROUP HEALTH INCORPORATED (GHI)
- EMBLEMHLTH
- EMBLEM HEALTH
Frequently asked questions
EmblemHealth Plan payer FAQs
How do I check claim status with EmblemHealth Plan?
Providers check EmblemHealth Plan via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
What is the payer ID for EmblemHealth Plan?
The primary payer ID for EmblemHealth Plan is 13551. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.
What are the 837 payer IDs for EmblemHealth Plan?
The 837P and 837I payer ID for EmblemHealth Plan is 13551 via Stedi.
What is the 835 payer ID for EmblemHealth Plan?
The 835 payer ID for EmblemHealth Plan is 13551 via Stedi.
What is the 270 payer ID for EmblemHealth Plan?
The 270 payer IDs for EmblemHealth Plan are 13551 via Stedi and 13551 via Availity.
What is the 276 payer ID for EmblemHealth Plan?
The 276 payer ID for EmblemHealth Plan is 13551 via Stedi.
What is coordination of benefits on EmblemHealth Plan?
A coordination of benefits check for EmblemHealth Plan can return other active plans, whether coverage overlaps, and a primary or secondary order when that order can be determined. Results can be partial. Enrollment is not required for this check. It is separate from the 270 eligibility payer ID.
What state does EmblemHealth Plan operate in?
EmblemHealth Plan operates in NY.
Routing reference
EmblemHealth Plan payer IDs and operating states
Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.
| Payer name | EmblemHealth PlanSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | NYSource: Substrate payer directory · data last changed |
| 837P professional claims payer IDStedi | 13551Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | 13551Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 13551Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 13551Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | 13551Source: Availity payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDStedi | 13551Source: Stedi payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed ; checked .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: EmblemHealth Plan. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
- Availity payer catalogMatched by payer ID; matched record: EMBLEM HEALTH - GROUP HEALTH INCORPORATED (GHI). Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
- United Clearinghouse payer catalogMatched by payer name; matched record: EmblemHealth Plan. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.
Payer contact directory
EmblemHealth Plan phone and fax numbers
Phone menu guides
- (888) 447-7703EmblemHealth