How to check EmblemHealth Plan eligibility
A portal or phone check takes a front-desk staffer 10–15 minutes per patient. A real-time 270/271 check returns plan status, copays, deductibles, and out-of-pocket maximums in seconds.
- Payer ID
13551 - Real-time 270/271
Three ways to verify EmblemHealth Plan coverage
- Payer portal — free, but one patient at a time and 10–15 minutes each with logins.
- Phone (IVR) — hold times vary; no written record for the chart.
Automated 270/271 check
Full benefit detail in seconds, batched for your whole schedule — not one patient at a time.
From $0.50 per check, pay-as-you-go.
EmblemHealth Plan at a glance
What billers need before running a check.
Payer ID
13551Also known as 10407, 10616, 10808, 2744Real-time eligibility
AvailableResponses return in seconds, 24/7.Coverage
dental, medical, visionOperating area
New YorkPayer website
Supported transactions
What can be exchanged electronically with EmblemHealth Plan today.
Eligibility (270/271)
SUPPORTEDReal-time benefit and coverage checksClaim status (276/277)
SUPPORTEDWhere a submitted claim standsProfessional claims (837P)
SUPPORTEDPhysician and outpatient claimsInstitutional claims (837I)
SUPPORTEDFacility claimsDental claims (837D)
SUPPORTEDDental claimsRemittance (835 ERA)
ENROLLMENT REQUIREDElectronic remittance adviceCoordination of benefits
SUPPORTEDSecondary-payer routingClaim attachments (275)
NOT AVAILABLESupporting documentation
Portal vs. phone vs. automated
The same verification, three ways.
| Measure | Payer portal | Phone / IVR | Automated check |
|---|---|---|---|
| Time per patient | 10–15 min | 15–30 min | Seconds |
| Cost per check | Staff time, one login per patient | ~$8.57 in staff time* | from $0.50 |
| Record for the chart | Screenshot | None | Full audit trail |
| Whole-day schedule | One at a time | One at a time | Batched overnight |
*A manual eligibility check costs a medical practice $8.57; an electronic one costs $2.00. Source: 2024 CAQH Index.
What Medman does in practices today
- 65%
fewer denials at Valley Diabetes & Obesity
- 90%
of eligibility checks fully automated
- $107–149K
annual savings, small specialty practice
- 24 mo
in production
Frequently asked questions
What is the payer ID for EmblemHealth Plan?
EmblemHealth Plan uses payer ID 13551. It also appears as 10407, 10616, 10808, 2744 in some systems.
Does EmblemHealth Plan support real-time eligibility verification?
Yes. EmblemHealth Plan accepts real-time 270/271 eligibility transactions, so a check returns plan status and benefit detail in seconds instead of the 10–15 minutes a portal login takes.
How long does a EmblemHealth Plan eligibility check take?
A portal check takes 10–15 minutes of staff time per patient. An automated real-time check returns in seconds and can run for an entire day's schedule overnight.
Run your first EmblemHealth Plan eligibility check
From $0.50 per check, pay-as-you-go. No annual contract, no implementation project.
Billing more than EmblemHealth Plan? — upload it and see which of your payers run automatically.