HIP / EmblemHealth Insurance Company (GHI HMO)
dentalmedical
Summary
HIP / EmblemHealth Insurance Company (GHI HMO) is a dental and medical payer. Claims route under payer ID 25531, with 2 alternate IDs in use across clearinghouses. 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
25531Also seen as 1578, 1784- Also known as
- Group Health Incorporated Health Maintenance Organization
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 (GHI HMO)?
- The payer ID for HIP / EmblemHealth Insurance Company (GHI HMO) is 25531. Alternate IDs seen across clearinghouses include 1578, 1784.
- Does HIP / EmblemHealth Insurance Company (GHI HMO) require ERA enrollment?
- Yes. HIP / EmblemHealth Insurance Company (GHI HMO) requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes several weeks.
- What types of coverage does HIP / EmblemHealth Insurance Company (GHI HMO) offer?
- HIP / EmblemHealth Insurance Company (GHI HMO) covers dental and medical.
- Can I submit claims to HIP / EmblemHealth Insurance Company (GHI HMO) electronically?
- Yes. HIP / EmblemHealth Insurance Company (GHI HMO) is reachable through clearinghouses for eligibility checks, professional claims, institutional claims, and electronic remittance. Electronic claims are supported for professional (837P) and institutional (837I).
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 Spot something out of date?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.