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Member Identification Cards | EmblemHealth

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This section shows generic examples of the ID cards you may see. diagrams indicate where to find key coverage details and contact information. actual cards will be personalized per member policy. The first section of the card images shows the standard templates used by most members. The second section of card images shows the templates used for our New York City members.

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key to logos used on cards

Member ID cards may have logos to manage entities or extended networks that affect utilization management, claims submission, admission/newborn notification, member access to specific networks, and more. a key to these networks and entities appears below the member identification diagrams.

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section 1: standard templates

These first two examples are the ID card templates used for most emblemhealth 2021 plans and emblemhealth 2022 plans. these are the most common designs you will see.

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The third example is the ID card template used for child health plus members. child health plus members access the main network.

Reading: What is a plan id on insurance card

See also : Understanding Life Insurance Policy Ownership | The American College of Trust and Estate Counsel

Variations of the standard templates are used for the bridge program. see our bridge program page for sample identification cards and instructions on how to use them to identify program members and the administrative processes that follow.

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Section 2: New York City ID Card Templates

The following three images are examples of ID cards used by New York City members. city ​​members with a ghi ppo plan receive two ID cards: one from emblemhealth and one from empire. both companies use the same member identification number; however, empire adds the nyc prefix and only uses the first 9 digits of the emblemhealth id number, for example: nyc k10000000. keep this in mind when switching between the emblemhealth and empire systems.

managing entities

Health Care Partners: Member is assigned an HCP Primary Care Physician. the managing entity is responsible for utilization management, claims processing, and admissions/newborn notifications for assigned members. members are exempt from many of our special utilization management programs. see program descriptions to determine if hpc members are excluded.

Montefiore Medical Center: Member is assigned to a Montefiore Primary Care Physician. the managing entity is responsible for utilization management, claims processing, and admissions/newborn notifications for assigned members. members are exempt from many of our special utilization management programs. see program descriptions to determine if montefiore members are excluded.

Somos: Member is assigned to a Somos Primary Care Physician. the managing entity is responsible for most utilization management, claims processing, and admissions/newborn notifications for assigned members. however, somos members participate in emblemhealth’s special utilization management programs.

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extended networks

See also : What to know about COVID-19 testing and treatment costs

Bridge Program: Members who have the Bridge Program on their member ID cards are from large fully insured groups and self-funded employer groups for which emblemhealth and connecticare provide administrative services and access to five of our business networks (emblemhealth insurance company (formerly hipic) main network, emblemhealth plan inc. (formerly ghi) national network, connecticare, inc. choice network, of qualcare and the network of first health).

See our bridge program page for sample ID cards and instructions on how to use them.

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Member Identification Cards | EmblemHealth

connecticare: Some members who access care through the emblemhealth prime network can also access care through connecticare in connecticut. similarly, some connecticare members can access care through emblemhealth’s core network. see the chapter provider networks and member benefit plans for the corresponding plan.

First Health Network: A national network for members to receive in-network coverage outside of the tri-state area.

Reading: What is a plan id on insurance card

phcs/multiplan: Members with access to the emblemhealth plan, inc. they have access to phcs/multiplan outside of new york.

qualcare: certain members with access to the main network also have access to the qualcare network in new jersey. see the chapter on provider networks and member benefit plans for applicable plans.

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