HIP / EmblemHealth Insurance Company
Part of EmblemHealth, Inc.
Summary
HIP / EmblemHealth Insurance Company is a regional health plan, part of EmblemHealth, Inc., offering dental, medical, and vision coverage operating in New York, New Jersey, and Connecticut. Claims route under payer ID 55247, with 6 alternate IDs in use across clearinghouses. Provider enrollment typically takes 60-90 days, with applications through EmblemHealth Provider Portal, and CAQH is used for credentialing data. Through clearinghouses it supports eligibility checks, professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and takes several weeks.
At a glance
- Payer ID
55247Also seen as 10406, 1896, 55247MA, 8599, E5247, XCBVF- Also known as
- EmblemHealth, HIP Health Insurance Plan of Greater New York, HIPIC
- Uses CAQH
- YesApplication route: CAQH application only
- Service area
- NY, NJ, CT
Clearinghouse transaction setup
Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.
| Transaction | Enrollment | Typical setup |
|---|---|---|
| Eligibility checks (270/271) | Not required | Immediate |
| Professional claims (837P) | Not required | Immediate |
| Institutional claims (837I) | Not required | Immediate |
| ERA / remittance (835) | Required | Several weeks |
Common questions
- What is the payer ID for HIP / EmblemHealth Insurance Company?
- The payer ID for HIP / EmblemHealth Insurance Company is 55247. Alternate IDs seen across clearinghouses include 10406, 1896, 55247MA, 8599.
- How long does HIP / EmblemHealth Insurance Company provider enrollment take?
- HIP / EmblemHealth Insurance Company provider enrollment typically takes 60-90 days from application to effective date. Timelines vary by state, plan, and how complete the application is.
- Does HIP / EmblemHealth Insurance Company require CAQH?
- Yes. HIP / EmblemHealth Insurance Company uses CAQH for credentialing data, so keep the provider's CAQH profile current and attested before applying.
- Does HIP / EmblemHealth Insurance Company require ERA enrollment?
- Yes. HIP / EmblemHealth Insurance Company requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes several weeks.
- What states does HIP / EmblemHealth Insurance Company cover?
- HIP / EmblemHealth Insurance Company operates in NY, NJ, CT. Coverage can differ by plan and product line, so confirm the specific plan before you file.
Related payers
Compiled from public payer resources and clearinghouse catalogs. Details change often, so confirm with the payer before relying on them. Spot something out of date? Tell us and we will fix it.