To meet the growing demand for consumer-directed health care, EmblemHealth has created two high-deductible health plans (HDHP), ConsumerDirect EPO and ConsumerDirect PPO. These benefit plans allow employers and employees more power and choice in how to spend their health care dollars and in their health care decisions.
Members may also choose to activate a separate health savings account (HSA) to pay for qualified medical expenses with tax-free dollars. Individual HSAs are member-owned and contributions, interest and withdrawals are tax-free.
Some features for members of ConsumerDirect EPO and ConsumerDirect PPO benefit plans include:
ConsumerDirect features for practitioners
Member Payment Responsibility
Please submit your claims for medical care for members in ConsumerDirect EPO or ConsumerDirect PPO plans to EmblemHealth. You can expedite reimbursement and avoid payment errors by submitting your claim to us and billing your patient after you receive and review your Explanation of Benefits (EOB) for the claim.
Because member liability is determined after a claim is processed, the EOB will clearly state the member's payment responsibility. If any coinsurance or deductible remains, you may bill your patient directly for the balance.
These are samples of ConsumerDirect member ID cards.
|GHI and HIP are EmblemHealth companies. ©2013 EmblemHealth. All Rights Reserved. Last Updated 3-28-2012. Effective September 23, 2010, federal health reform may require changes to your coverage, depending on your plan. Get more information.|