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Office of Managed Care Operations
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Quick Reference Guide |
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Telephone Guide |
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Claims Address |
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Empire Blue Bross Blue Shield Website (This link is provided for the convenience of our website visitors. UMDNJ University Hospital takes no responsibility for the information or proprietary of the web sites listed above.) |
Facility/Provider # 310019
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| INPATIENT ADMISSION | Authorization Required by Admitting Physician or Hospital |
| SAME DAY SURGERY |
Authorization Required by Admitting Physician or Hospital |
| OUT PATIENT PROCEDURE |
Authorization Required by Admitting Physician or Hospital |
NOTE: Admitting Physician or Hospital must call to obtain authorization (precertification). Hospital Admitting Department must call Empire Blue Cross prior to admission or surgery to make sure admission or surgery has been authorized.
NOTE: For all Empire Blue Cross patients, please check patients Identification Card to get Precertication Department Telephone #.
| EMERGENCY ROOM VISIT |
No Authorization required. PCP or Hospital must notify Empire Blue Cross within 23-hrs. |
| EMERGENCY ADMISSION | Authorization Required (24-hr notification required by Hospital) |
| DIRECT ADMISSION | Authorization Required (24-hr notification required by Hospital) |
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MENTAL HEALTH/ADMISSION SUBSTANCE ABUSE |
See note below |
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NON EMERGENCY MENTAL HEALTH SUBSTANCE ABUSE |
See note below |
NOTE: For all Mental Health & Substance Abuse please contact 1-800-626-3643.
| REFERRAL REQUIRED-OUTPATIENT | PRE AUTHORIZATION REQUIRED-OUTPATIENT | ||||
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MRA |
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NOTE: For All Mental Health & Substance Abuse call Merit Behavioral Health Care. See patient Identification Card for Telephone #.
| Maria Pawlik Hospital Provider Representative |
718-312-4018 |
| Empire Blue Cross Provider Services Dept. | 1-800-992-2583 Office(office closed between 12:00 a.m.-2:00 a.m.) |
Empire Blue Cross Provider Service Dept. For Blue Card (For Out –of-Area Members Only) |
Claim Status/Review – 1-800-713-4173 Eligibility – 1-800-676-2583 |
| Empire Medical (Direct HMO) Management Department. |
1-800-441-2411 Fax: 1-800-241-5308 Monday – Friday 8:30 a.m. – 5:00 p.m. |
Empire Medical (POS) Management Department |
1-800-845-4741 Fax: 1-800-241-5308 |
Empire Medical ( EPO & PPO) Management Department |
1-800-982-8089 |
| Nurse Call Center | 1-877-825-5276 24 Hours a day/ 7 days a week |
| Empire Maternity Care (For PCP’s and OB/GYNs) |
1-800-845-4742 |
| Behavioral Health/Substance Abuse (Direct HMO) | Behavioral Healthcare Management Program 1-800-626-3643 |
| Behavioral Health/Substance Abuse (Child Health Plus) | Behavioral Healthcare Management Program 1-800-635-6626 |
Behavioral Health/Substance Abuse (POS Direct Share) |
Behavioral Healthcare Management Program 1-800-395-7792 |
| Behavioral Health/Substance Abuse (EPO & PPO) | Behavioral Healthcare Management Program 1-800-626-3643 |
| Empire Electronic Claim Submission | Electronic Commerce Station 1-866-889-7322 |
Note: Empire Claims must be submitted within 180 days from date of service.
NOTE: For Accurate Telephone for Provider Relations & Precert Department, Please check patient’s Insurance Card.
EMPIRE BLUE CROSS & BLUE SHIELD (Direct HMO & POS Direct Share Claims)
EMPIRE
P.O. BOX 1407 Church Street Station
NEW YORK, NY 10008-1407
Include YLN, YLP or unique prefix
EMPIRE BLUE CROSS & BLUE SHIELD (EPO & PPO Claims)
EMPIRE
P.O. BOX 11812 Church Street Station
New York, NY 10008-1407
Include YLB, YLD, YLE, YLK or unique prefix
EMPIRE BLUE CROSS & BLUE SHIELD (Blue Card)
Non-Empire Member Claims to:
EMPIRE
Blue Card Program
P O Box 3877, Church Street Station
New York, NY 10008-3877
NOTE: For Accurate Mailing Address, Please check patient’s Insurance Card.
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(all information subject to change without notice) |
Last Reviewed:January 2009
All contents copyright © 1997-8
UMDNJ. All rights reserved
All information within this site subject to change without notice.
University Hospital
150 Bergen Street
Newark, NJ 07103 USA
(973) 972 - 4300