Provider Portal: New Way to See If a Provider Is In-Network for a Member

Now it’s easier than ever to see if you—or a provider you service—are in-network for an EmblemHealth or ConnectiCare member^* with our provider portal's Check Provider Network Status tool. Here’s how it works:

When you look up a member’s eligibility, use the Check Provider Network Status button on the “Member Details” page.
Clicking the button carries the member’s information forward to a new screen where you can search for the provider.
The search results display the provider’s network status for that member in the right-most column in the results table.

EmblemHealth: Try it now!

ConnectiCare: Try it now!

Why Use This Tool?

We offer a wide variety of networks and benefit plans. With this tool, you can:

Declutter your office by eliminating the list(s) you use to track your participation in our networks and plans.
Stop cross-checking the names of plans and networks on member ID cards with your provider agreements.
See if you are in-network for a member with a plan that gives access to multiple networks, offered by our affiliated company, EmblemHealth/ConnectiCare such as the Bridge Program.

More Improvements Coming

Soon you will be able to see Check Provider’s Network Status in the Member Management menu. You will also be able to search providers by Tax ID as well as NPI and name.

^*As with all member details shared on the portal, being in the member’s network is not a guarantee of payment. Payment is subject to the member’s participation, covered benefits, Managing Entity assignment, referrals, preauthorizations, etc., on the date(s) of service, as applicable.

Easier insurance coverage verification!

Try the Provider Portal’s New Check Provider Network Status Tool

Why Use This Tool?

More Improvements Coming

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