Provider Toolkit

Member Materials

Recent Additions

Welcome to EmblemHealth

Here is some information to help you get to know us and help you best serve our members, your patients.


Your Plan Members

Access to Care and Delivery System

Medical Record Guidelines


Visit Claims Corner for the latest information on our claims policies.

Care Management

Visit Clinical Corner for practice guidance resources.

Clinical Practice Guidelines

Domestic Violence Resources

Quality Improvement

Health Promotion and Disease Management

Behavioral Health Services

Pharmacy Services

Visit Clinical Corner for formulary updates.

Injectables and Specialty Pharmacy Program

  • Chemotherapy and Injectable Order Forms for HIP Drug Replacement Program

EmblemHealth Spine Surgery and Pain Management Therapies Program

Radiation Therapy, Cardiology Imaging and Radiology Programs

Physical and Occupational Therapy Program


Regulatory Mandatory Reporting

Fraud and Abuse

Required Provisions To Network Provider Agreements

Tips and Tools