Tag: #GHIPPO

Posted in Insurance, Updates

EmblemHealth GHI PPO-NYC members-member ID change

Posted on by KR2Medical Billing

Starting 07/01/2020, the claims for Emblem GHI PPO (NYC members) will be processed on another claims platform. In order to comply with this change the member ID’s will be changed to the format of K + 10 (numbers).

The Empire cards ( for hospital benefits) will also reflect this change- however they will display only 9 digits. Please see below:

Other notable changes:

+ Beacon Health Options will start to process Behavioral Health claims. Beacon Health Options information will be now included on the back of the EmblemHealth Cards.

+ In-office lab rules will apply to all EmblemHealth members, including GHI PPO (NYC members).

Posted in In The Know Series, Insurance, Training

Emblem GHI PPO (commercial members)-new member IDs for 2020

Posted on by KR2Medical Billing

Starting, in the beginning of 2020, Emblem GHI PPO commercial members will receive new ID numbers and new ID cards.

The following changes will take place:

  1. New ID numbers will start with a letter K
  2. New ID numbers will have only 8 number spaces
  3. The last 2 digit numbers will reflect the # for each dependent (eg. 01, 02, 03)
  4. Will be subject to the radiation therapy and cardiology imaging (eviCore) programs
  5. Will be subject to HIP radiology and self referral payment policy.

GHI PPO (City of New York members) are not affected by this change.

 Medicare PPO Members who are on Medicare Choice PPO network will have the new ID change but will not be subject to eviCore Programs.

The process is expected to continue through the end of 2020.