Posted in Insurance, Training, Updates

EmblemHealth & SOMOS IPA LLC. (NY Providers)-Managing Entity, effective 10/01/2020

As of October 1,2020 Somos IPA partnered up with EmblemHealth, to become a managing entity for some Medicaid, ChildHealth Plus, HARP. And Essential Plan members.

Below are the examples of SOMOS Emblem Health Cards: Notice SOMOS.

SOMOS IPA LLC-will conduct utilization management and will process claims for their assigned memberships. Providers that belong to SOMOS IPA and EmblemHealth, that provide services for SOMOS members, will need to contact SOMOS for prior authorizations and send their claims to SOMOS address. (see below)

Contact Information:

  1. Member eligibility – please call EmblemHealth provider number 866-447-9717
  2. Provider Contact Information for SOMOS IPA, LLC:
  3. Claims Submission: PO Box 211473, Eagan, MN 55121
  4. Claim Inquires: P: 844-990-0255
  5. Preauthorizations: Online https://smnyportal.valence.care P: 844-990-0255/F: 877-590-8003

Note: providers should check to see if they are in-network and are able to see SOMOS patients.

For a complete announcement from SOMOS Community, please click here .

For an EmblemHealth announcement, please click here.

#EmblemHealth, #SOMOS,#IPA

Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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