On Oct. 1, 2020 SOMOS became a Managing Entity for Medicaid, HARP

On Oct. 1, 2020 SOMOS became a Managing Entity for Medicaid, HARP, Child Health Plus, and Essential Plan members.

As a Managing Entity, SOMOS will conduct utilization management and will process claims for their assigned membership. Both SOMOS IPA providers and other EmblemHealth providers treating SOMOS members must contact SOMOS for preauthorization and submit claims to SOMOS for processing. Membership eligibility needs to be verified on emblemhealth.com/providers or by contacting EmblemHealth Provider Customer Service at 866-447-9717. Preauthorization and claims contacts for SOMOS are listed in the Directory Chapter of the Provider Manual and on the back of the member ID card.

Source: https://www.emblemhealth.com/content/dam/emblemhealth/pdfs/provider/resources/newsletters/2020/InTheKnow-October.pdf