Keeping us up to date on your contact information is vital to our members’ ability to find you and schedule appointments and enables us to pay you quickly and efficiently for your services.
Starting Dec. 9, 2024, we are adopting daily file feeds from CAQH for non-delegated professional providers’ demographic information based on an NPI and tax ID combination. If changes are needed to your directory information, you should make them in the CAQH application. Changes made in our provider portal will be overwritten with CAQH’s information.
Sign in to our provider portal at emblemhealth.com/providers to review your directory profile(s) and payment information. Then if changes are needed, make them in CAQH, unless one of the following exceptions apply.
Exceptions
- Your organization has a delegated credentialing relationship with us (see listing on our Join our Networks web page).
- Send changes via the established dataset process.
- The following data updates cannot be made via CAQH. Email changes EmblemHealth:
- Hospital-based/non-credentialed providers: all changes.
- Facilities: all changes.
- Primary care providers: to open and close a primary care provider’s panel.
- EmblemHealth doulas.
- Doulas who need to update their contact information should contact medicaidproduct@emblemhealth.com.
Reporting Change of Address and Contact Notification to Fee for Service Medicaid Program
Providers must notify Medicaid of any change of address, telephone number, or other pertinent information within 15 days of the change. For more detail on this requirement and how to submit changes, click here.
eMedNY distributes provider checks and paper remittances using the Pay-To Address kept on file. Other mail, including important updates, is directed to the Correspondence Address kept on file for providers. Providers may be missing out on important notifications if their address on file is outdated. Occasionally, eMedNY provider representatives will need to contact providers by telephone with important information that may impact claims processing and payment.
How to Update Information:
To update provider addresses and telephone information, providers must complete their designated Change of Address form. Each Change of Address form contains detailed instructions for submission based on provider type and license/registration address.
- Fee-for-Service (FFS) providers (such as practitioners, DME, laboratories, transportation, etc.): Practitioners, Businesses and Groups Change of Address Form
- Rate-based (Institutional) providers: NYS Medicaid Institutional/Rate Based Provider Change of Address Form
Change of Address forms can be completed online using the fillable option or printed. Providers must sign using their original signature in ink without using white-out, red ink, or double-sided forms. Both forms must be mailed to:
eMedNY
P.O. Box 4610
Rensselaer, NY 12144-4610
With respect to participation in Federal Employees Health Benefits (FEHB), providers and facilities must have in place business processes to ensure the timely provision of provider directory information to EmblemHealth:
1. when the provider or facility begins a network agreement with EmblemHealth,
2. when the provider or facility terminates a network agreement with EmblemHealth,
3. when there are material changes to the content of provider directory information,
4. upon request by EmblemHealth and
5. at any other time determined appropriate by the provider, facility or U.S. Department of Health and Human Services.
JP66061 11/2024