Q. What service does Emerald Health provide in processing my claim?
A. Emerald Health provides a network of healthcare providers selected by your insurance carrier or third party administrator (TPA). We pre-process medical claims, determining if a network provider was utilized, and if so, apply the contractual discount to the cost of the medical procedure received. The claim is then forwarded to your insurance carrier, or third party administrator within 48 hours. They then make the payment to the provider according to your benefit plan.



Q. How do I find a network provider in my area?
A. You can access the Provider Search feature on this website, or you may contact our Customer Service department between the hours of 8:30am to 5:00pm (EST) Monday through Friday. The Human Resources representative through your employer may also have a supply of directories in their office.



Q. Who is responsible for paying my claims?
A. The third party administrator (TPA) or your insurance carrier.



Q. Why hasn’t my claim been paid?
A. Emerald Health does not pay claims. Your third party administrator or insurance carrier pays your claim costs according to your benefit plan. Emerald Health pre-processes your claim information and applies the contractual discount to the cost(s) when a network provider has been utilized.



Q. How do I obtain my health plan benefit information?
A. Contact your third party administrator or insurance carrier.



Q. How do I find out the name and phone number of my third party administrator or insurance carrier?
A. That information is printed on your identification card or you may contact our Customer Service department between the hours of 8:30am and 5:00pm (EST) Monday through Friday.



Q. Where should the healthcare provider send my claim(s)?
The Emerald Health Network
P.O. Box 94808
Cleveland, OH 44101



Q. How long does it take for Emerald Health to pre-process my claim?
A. Emerald Health is committed to a 48-hour turnaround in pre-processing and forwarding your claim to your third party administrator or insurance carrier.