Important Contacts
Main Corporate Telephone Number & Directory
Monday through Friday from 8:30 a.m. to 5:30 p.m.
1(888) 746-2200
Customer Engagement Center
1(800) 877-7587 available 24/7
Provider Network Services
Email: provrel@hcpipa.com
Authorizations
Authorization Submission
Information on how to submit a request for services.
Customer Engagement Center: 1(800) 877-7587
Submit an Authorization via FAX: 1(888) 746-6433
Authorization Status
To check the status of previously submitted services. (Please allow at least two business days for processing of non-urgent requests).
EmblemHealth HCP Direct patients: 1(800) 877-7587
EmblemHealth Cohort 2 patients: 1(844) 346-1499
Empire: 1(844) 638-0404
Specialist Referrals and The Fast Track Line
Assistance with locating a Preferred Network Specialist, providing NOTIFICATION for EmblemHealth Cohort2 services, and scheduling an appointment for patients.
Fast Track Line: 1(855) 324-9400
Peer-to-Peer Review
Speak with an HCP Medical Director to discuss an authorization denial or for a consultation about a patient’s medical condition.
Peer-to-Peer Review Line: 1(516) 394-5790
Notification of Hospital Admissions
Notify HCP of scheduled/emergency hospital admissions.
Hospital Admission Notification via FAX: 1(516) 515-8808
Claims Submission
Information on how to submit claims electronically or by mail.
Claims Submission for EmblemHealth Patients
EmblemHealth HCP DIRECT
EDI via Change Healthcare use Payer ID: 11328
Paper:
HealthCare Partners, MSO
Attn: Claims
501 Franklin Avenue, Suite 300
Garden City, NY 11530
EmblemHealth Cohort 2
EDI via Change Healthcare use Payer ID: 55247
Paper:
EmblemHealth
P.O. Box 2845
New York, NY 10116
EmblemHealth Behavioral Health
EDI: Contact Beacon Health Options
Paper:
EmblemHealth Behavioral Health Claim Services
P.O. Box 1850
Hicksville, NY 11802-1850
Palladian Physical and Occupational Therapy
EDI via Change Healthcare use Payer ID: 37268
Paper:
Palladian Muscular Skeletal Health
PO Box 366
Lancaster, NY 14086
Claims Submission for Empire Medicare Advantage Patients
Empire HCP DIRECT Medicare Advantage
EDI via Change Healthcare use Payer ID: 11328
Paper:
HealthCare Partners
Attn: Claims
501 Franklin Avenue, Suite 300
Garden City, NY 11530
All other Empire Medicare Advantage
Submit electronically through Availity
Claims Status
To check claim status and receive explanation of processing for previously submitted claims. Please allow 30 days from the date of submission for processing.
Emblem Health HCP DIRECT: 1(800) 877-7587
Emblem Health Cohort 2: 1(866) 447-9717
Empire: 1(844) 638-0404
email claims@hcpipa.com (secure email only)
Membership Eligibility
To verify the eligibility of a member, including effective dates and the assigned PCP.
Emblem Health HCP DIRECT: 1(800) 877-7587
Emblem Health Cohort 2: 1(866) 447-9717
Empire: 1(844) 638-0404
Managing Patient Care
Real Time Resolution™ Line
Assistance with urgent, time-sensitive clinical needs
1(866) 685-8996 available 24/7
Case Management
Connect with a nurse case manager to receive timely assistance in managing patients with a higher than normal risk for developing a particular disease defined by a measurable parameter.
1(888) 258-0309
Hospice and Palliative Care
Information about referring patients for a Hospice or Palliative Care evaluation
1(516) 515-8847
Quality Team
Inquiries & support for physicians and members related to achieving HEDIS, STAR and quality measures
1(800) 877-7587
Risk Adjustment Hotline
Connect with a dedicated team of specialists, analysts, clinicians, and other personnel committed to ensuring that risk scores for HCP members appropriately represent their acuity.
1(516) 394-5660