Provider

PW_AD076907
 
 

PRECERTIFICATION, CASE MANAGEMENT AND OUT-OF-NETWORK REFERALS

Direct HMO1, HMO
Child Health PlusSM1
MediBlue1

Empire Medical Management
Phone: 1-800-441-2411
Fax: 1-800-241-5308

POS1, DirectShare POS

Empire Medical Management
Phone: 1-800-845-4741
Fax: 1-800-241-5308

EPO, PPO1, Empire Total BlueSM

Empire Medical Management
Phone: 1-800-982-8089

Traditional Indemnity

Refer to Member's ID Card

 

CLAIM STATUS/REVIEW, PATIENT ELIGIBILITY AND ORDERING REFERRAL FORMS

Direct HMO1, HMO
Child Health PlusSM1
MediBlue1
POS1, DirectShare POS
EPO, PPO1, Empire Total BlueSM

Managed Care Physician Services
1-800-552-6630

BlueCard PPO2 (For Out-of-Area Members Only)

Claim Status/Review:
1-800-713-4173
Eligibility:
1-800-676-BLUE (2583)

Traditional Indemnity

Empire Physician Services
1-800-343-7283

 

CLAIMS SUBMISSION

Direct HMO1, HMO
Child Health PlusSM1
MediBlue1
POS1, DirectShare POS

Empire
PO Box 1407, Church Street Station
New York, NY 10008-1407
Include YLN,YLP or unique prefix

EPO, PPO1, Empire Total BlueSM

Empire
PO Box 1407, Church Street Station
New York, NY 10008-1407
Include YLB, YLD, YLE, YLK or unique prefix

BlueCard PPO2 (For Out-of-Area Members Only)

Non-Empire member claims to:
Empire
BlueCard PPO Program
PO Box 3877, Church Street Station
New York, NY 10008-3877

Traditional Indemnity

Empire
PO Box 1407, Church Street Station
New York, NY 10008-1407
Include YLA or unique prefix

 

REFERRAL TO NETWORK PROVIDERS

Direct HMO1, HMO
Child Health PlusSM1
MediBlue1
POS1, DirectShare POS

PCPs, fax referral to: 1-800-522-5793
or mail referral to:
Empire
PO Box 1407, Church Street Station
New York, NY 10008-1407
No referrals required for Direct HMO and MediBlue

ELECTRONIC CLAIM SUBMISSION

All Plans

Electronic Commerce Services
1-866-889-7322

 

BEHAVIORAL HEALTH/SUBSTANCE ABUSE

Direct HMO1, HMO

Behavioral Healthcare Management Program
1-800-626-3643

Child Health PlusSM1
MediBlue1

Behavioral Healthcare Management Program
1-800-635-6626

POS1, DirectShare POS

Behavioral Healthcare Management Program
1-800-395-7792

EPO, PPO1, Empire Total BlueSM
BlueCard PPO2 For Out-of-Area Members Only

Behavioral Healthcare Management Program
1-800-626-3643

Traditional Indemnity

Refer to Member's ID Card

 

TO CHANGE YOUR DIRECTORY LISTING OR OTHER PROVIDER FILE INFORMATION

All Plans

Empire Practitioner Registry
PO Box, 3519, Church Street Station
New York, NY 10008-3519
Include your Empire Provider Number

 

EMPIRE MATERNITY CARE (FOR PCPs AND OB/GYNs)

Direct HMO1, HMO
Child Health PlusSM1
MediBlue1
POS1, DirectShare POS
EPO, PPO1, Empire Total BlueSM

Empire Medical Management
1-800-845-4742

 

MEMBER QUESTIONS

All Plans

Refer to Member's ID Card

Footer Links:

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