Emblem Health members have been issued new IDs effective Jan.1 for Medicare, Medicaid, Part B, Medicaid/Medicare, Exchanges and Commercial plans. If Emblem Health claims initially reject, please ask the member for their new ID card and reprocess the claim. Please note: if the claim initially rejects with NCPDP reject 07 "M/I Cardholder ID", the correct member ID will be displayed in the secondary message.

Emblem Health BIN/PCN Reminder

Please see the chart below for a comprehensive review of the BIN/PCN combinations for all Emblem Health lines of business. Please note the chart also contains Rx Groups. For Medicare claims, the Rx Group should be submitted as indicated on the member ID card. If an Rx Group does not appear on the member ID card, this field should be left blank in order for the claim to process.

*Please see attached for more information.