GHI PPO/EPO and PPO/EPO Share - EmblemHealth

Important Contact InformationTo submit a written medical grievancerelated to a benefit determination or otherdetermination made by GHITo submit a written hospital grievancerelated to a benefit determination or otherdetermination made by GHITo return a Coordination of Benefits(“COB”) questionnaire or to submit acopy of your Medicare card to assure GHIautomatically coordinates secondaryMedicare claims with Medicare Part Bcarriers for services performed in certaingeographical areasGHIP.O. Box 1701New York, New York 10023-9476GHIP.O. Box 2828New York, New York 10116-2828GHICOB DepartmentP.O. Box 2804New York, New York 10116-2804Behavioral Management Program (BMP) forMental Health & Chemical DependencyTo submit a claim for OutpatientMental HealthGHI-BMPP.O. Box 2827New York, New York 10116-2827To submit a claim for Inpatient MentalHealth and Chemical DependencyNote: Generally, it is the provider’s/facility’sresponsibility to submit these claims.For providers to submit Outpatient treatmentreportsFor subscribers to submit a written inquiryregarding claims for Mental Health &Chemical DependencyGHI-BMPP.O. Box 2833New York, New York 10116-2833GHI-BMPP.O. Box 1884New York, New York 10116-1884GHI-BMPP.O. Box 1701New York, New York 10023-9476Vision Care (Optical) Through Davis VisionTo submit a paper claim or for a writteninquiry on any aspect of your Visioncoverage with Davis VisionDavis Vision CareVision Care Processing CenterP.O. Box 1525Latham, New York 12110Back to Tableof ContentsDownloadClaim FormsRegister at ​ghi.comDirectory of HealthCare Providers41