INSURER FILING GUIDE
EmblemHealth
Use this public information to prepare your packet, then confirm the route on the insurer's own page.
AT A GLANCE
Claim facts
| Member form | Mental Health / Substance Abuse Treatment Claim Form Number: Not published by the insurer Revision: Not published by the insurer Open the insurer form |
|---|---|
| Portal upload | YES |
| Portal path | Emblem Mental Health Claims > Submit your claim online > Carelon login > follow the prompts |
| Mail address | PLAN-DEPENDENT: Mail your form to the address on your member ID card. |
| Fax | Not published by the insurer |
| Attachments | Provider address and telephone; provider license or certification number; provider Tax ID or Social Security number; provider NPI; provider signature, stamp, computer-generated signature, or printed name; diagnosis; service or procedure; date of service; place of service; amount paid; provider specialty |
| Deadline | Not published by the insurer |
| Outcome and status | Carelon member portal claim view; exact status path Not published by the insurer |
| Processing time | Not published by the insurer |
| Caveats | Carelon administers the behavioral claim route. Not all plans reimburse out-of-network mental health care. Medicare Advantage and Medicaid are outside this read. |
STEP BY STEP
Filing steps
Source: https://www.carelonbh.com/content/dam/mhsud/emblem/documents/Member_Claim_Form_Carelon.pdf
Read date: 10-09-2026
Research steps
- Confirm that the member plan reimburses out-of-network mental health care. EmblemHealth says that not all plans include this reimbursement. https://www.emblemhealth.com/live-well/mental-health/claims
- Download the Carelon Mental Health / Substance Abuse Treatment Claim Form. Complete all of Part I. https://www.carelonbh.com/content/dam/mhsud/emblem/documents/Member_Claim_Form_Carelon.pdf
- Ask the therapist to complete Part II for the visit. A custom provider form may be attached, but the provider must still complete the stated identifying box and the Carelon form remains required. https://www.emblemhealth.com/live-well/mental-health/claims
- To keep payment with the member, check No for authorization to pay the provider. Sign and date all three indicated member sections. https://www.emblemhealth.com/live-well/mental-health/claims
- Save the completed form, select Submit your claim online, sign in to Carelon, and follow the prompts to upload it. Prepare one claim for each regular visit. https://www.emblemhealth.com/live-well/mental-health/claims
- NOT PUBLISHED: accepted file types, size limit, maximum files, upload confirmation, claim-status menu path, processing time, and filing deadline. https://www.emblemhealth.com/live-well/mental-health/claims
Filing facts
- Portal upload: YES
- Portal: Carelon Behavioral Health member portal
- Portal path: Emblem Mental Health Claims > Submit your claim online > Carelon login > follow the prompts
- Mail address: PLAN-DEPENDENT: Mail your form to the address on your member ID card.
- Fax: NOT PUBLISHED
- Attach: provider address and telephone; provider license or certification number; provider Tax ID or Social Security number; provider NPI; provider signature, stamp, computer-generated signature, or printed name; diagnosis; service or procedure; date of service; place of service; amount paid; provider specialty
- File types: NOT PUBLISHED
- File size limit: NOT PUBLISHED
- Maximum files: NOT PUBLISHED
- One file or separate files: One claim form for each regular visit; upload packaging details NOT PUBLISHED
- Confirmation: NOT PUBLISHED
- Status check: Carelon member portal claim view; exact status path NOT PUBLISHED
- Processing time: NOT PUBLISHED
- Member deadline: NOT PUBLISHED
- Deadline basis: Member plan document controls; the public therapy page does not publish a filing limit
- Mental health route: Carelon Behavioral Health
Confirm the address, fax number or portal path on the insurer's own claims page before you send; read on 10-09-2026.
Read on 10-09-2026 from https://www.carelonbh.com/content/dam/mhsud/emblem/documents/Member_Claim_Form_Carelon.pdf;https://www.emblemhealth.com/live-well/mental-health/claims. Confirm the address, fax number or portal path on the insurer's own claims page before you send.