Frequently Asked Questions

Get the answers to your questions.

How can I change or update my provider demographic information?

You may complete the Provider Information Update Form and email it to

How do I verify a member’s eligibility?

You must contact the payer or TPA listed on the back of the member’s ID card directly to obtain member eligibility information.

How do I submit claims?

For information on claims submission, please contact the relevant payer or TPA provided on the back of the member’s ID card.

How do I search for other participating providers?

The Embright network directory is easily searchable, and you can review it online here. If you have questions, you may contact

Does Embright replace my existing TPA or payer contract(s)?

No. Embright partners with TPA’s and payers to create stand-alone network solutions that are in addition to existing plans, such as PPO or OAP networks you may already participate in. Unique, Embright-branded member ID cards will be in place to allow for staff to differentiate between an Embright member and a non-Embright member.

How do I contact Embright’s provider support team?

You may contact the provider support team via email at

How is credentialing managed at Embright?

As part of our commitment to bring a stand-alone network solution to the market, Embright is delegated by TPA’s and Payer partners to credential our network. Embright then sub-delegates credentialing to network members to avoid duplicating work.

Because Embright has been delegated credentialing responsibility for our network, even if you are already credentialed with an Embright TPA partner, you still are required to satisfy Embright’s credentialing requirements.  

Where sub-delegation is not an option and direct credentialing is indicated, Embright leverages existing solutions such as OneHealthPort to simplify the credentialing process as much as possible for network participants.

How are service rates determined?

Embright has developed comprehensive rate corridors with the approval of its Board that are the result of input and research including appropriate market intelligence, feedback from network members, adjustments for geographic differences, and allowances for certain higher cost specialties.  

Fee for service rates that fall within these corridors are agreed to with TPA and Payer partners and loaded to their claims systems to support claims administration.

Consistency in rates across purchaser agreements is the goal whenever possible, and all FFS rates will be communicated to network providers as an addendum to the Provider Participation Agreement (“PPA”). 

These rates are specific to Embright products and do not replace any existing TPA or Payer contracts you may have in place.

What expectations fall to the network participants as part of joining Embright’s CIN?

As a clinically integrated network (CIN), Embright relies on collaboration with network participants to fulfill our vision of being the highest performing provider network and the network of choice for the communities we serve. Key components in this collaboration include:

  • Data Exchange: The Embright PPA requires providers to offer access to data “necessary to track and report [his/her/their] performance in connection with Embright network participation”. This standard is intended to account for differences in provider group size and specialty areas that would indicate a need for greater or lesser access to data. 
    • If you are already providing access to your clinical and claims data to an existing Embright network member, it may be possible to leverage that data connection rather than create a new direct connection with Embright.
  • Cost and Quality: The Embright PPA also requires providers to “abide by all Embright quality improvement policies”. This language is intended to support the Triple Aim and ensure success in value-based purchasing arrangements. The degree to which any specific cost or quality initiative will apply to an Embright network member can vary depending on a groups’ size and specialty.

Are there any fees to participate?

Section 3 of the Embright PPA allows Embright to establish participation fees for non-investor network members. Currently, no such fees are in place for joining or participating in the network. Should Embright determine in the future that a participation fee is appropriate, notice will be provided to impacted network participants. The Embright Operating Agreement allows for network feedback on any future participation fees through the Participant Roundtable.

How are decisions made around what groups are invited to join Embright?

The Embright network is comprised of providers and health systems who share Embright’s values of integrity, innovation, collaboration, agility, respect, and excellence. Potential additions to the Embright network must fill network adequacy or marketability need, and the provider must align with Embright values, meet operational requirements such as board certification or eligibility, and have value-based care experience or the necessary foundation to begin a value-based journey. Additional requirements for joining the network are found in Embright Network Policies and available upon request.