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EmblemHealth Plan

EmblemHealth Plan

This page contains information you can use to exchange healthcare transactions with EmblemHealth Plan using Stedi.
Use any of the following payer IDs to send transactions to EmblemHealth Plan using Stedi APIs or SFTP. Read the docs
Primary Payer ID
13551
Stedi Payer ID
DCFYM
Payer ID aliases
10616, 13551, 2744, 6509, EMBLEM, EMBLM
Parent group
EmblemHealth Group
Coverage types
Dental, Medical

Supported transactions

Use Stedi to exchange the following transactions with EmblemHealth Plan using APIs or SFTP. Send transactions as JSON or raw EDI files.
Eligibility & benefit verification
Supported

Eligibility checks

(270/271)
Verify member coverage and benefits by sending real-time and batch eligibility checks to EmblemHealth Plan.
Supported

Coordination of benefits checks

(COB)
Submit coordination of benefit checks to EmblemHealth Plan to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.
Claims processing
Supported

Real-time claim status

(276/277)
Check on the status of a claim previously submitted to EmblemHealth Plan in real-time by sending a claim status check (276/277).
Supported

Professional claims

(837P)
Submit professional claims to EmblemHealth Plan and receive 277 claim acknowledgments asynchronously.
Supported

Institutional claims

(837I)
Submit institutional claims to EmblemHealth Plan and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required

Claim payments

(835 ERA)
Receive electronic remittance advice (ERAs) from EmblemHealth Plan to review full payment details.
Not supported

Dental claims

(837D)
Submit dental claims to EmblemHealth Plan and receive 277 claim acknowledgments asynchronously.
Not supported

Unsolicited claim attachments

(275)
Receive unsolicited attachments for claims submitted to EmblemHealth Plan.
Get started
Use Stedi's APIs to get fast and reliable connectivity to EmblemHealth Plan and start processing healthcare claims and eligibility checks within minutes.
Start processing healthcare claims and eligibility checks with Stedi and EmblemHealth Plan today.
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Other names
Alternative known names, networks, or health plans for this payer that may appear on insurance cards, claims, or other correspondence.
  • EmblemHealth - Group Health Incorporated
  • GHI - New York
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