Payer ID
55247
55247 is for HIP plans; GHI plans use separate IDs. Confirm which legacy plan the member has via EmblemHealth's Claims Contacts chart.
Timely Filing Limit (TFL)
18 months commercial; 15 months Medicaid & Child Health Plus; 365 days Medicare (from date of service)
Appeal Window
Varies — confirm via portal / clearinghouse
Clearinghouse
TriZetto Provider Solutions (preferred)
Provider Services
877-597-5489
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
EmblemHealth, P.O. Box 2845, New York, NY 10116-2845 (HIP professional)
Provider Portal
https://www.emblemhealth.com/providers
NY umbrella brand for two legacy plans, HIP and GHI, which carry distinct payer IDs — confirm the member's plan before submitting.
Values vary by plan, region, and contract and can change. Confirm in the payer portal or with your clearinghouse before filing.
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