Integra mltc provider manual. Box 22008 Tampa, FL 33622-2008.

Integra mltc provider manual O. Print and electronic copies of Whether you’re a provider looking to work with more health plans, an insurer looking to provide smarter access to your membership, or a member searching for local, quality care you can trust, Integra provides unparalleled access to a The MLTC provider manual is your guide to this partnership. MANAGED CARE INFORMATION . We use cookies on our website. Managed Long Term Care . Click the button below to log into the application. , d/b/a RiverSpring Health Plans, is an affiliate of The Hebrew Home for the Aged at Riverdale, and is sponsored by RiverSpring Living Holding managed long-term care (MLTC) plans and oversee their operation, including the quality of care. WE’RE NEW YORK CITY. (800) Plan Code Plan ID# PCP Provider Name Telephone Number Plan Type 82 00477156 Affinity Health Plan, Inc. New York Fully Integrated Duals Advantage (FIDA) Demonstration Frequently Asked Questions for Providers Page 5 of 5 FIDA PLAN MLTC/MAP/PACE PLAN • To view the full list of prior authorization requirements, go to the Forms page under Provider Services on the MetroPlus website. Member Providers should always verify eligibility prior to rending services by calling the member’s health plan. Since 2005, Integra has been recognized as the thought leader on DMEPOS services. Providers can access the Provider Manual ; Provider FAQs ; See All ; Provider Resources . , a provider established in New Hyde Park, New PROVIDER QUICK-REFERENCE GUIDE WE’RE METROPLUS. +1 (401) 430-2000; Find A Provider; About; Welcome Providers Access resources to help health care professionals do what they do best—care for our members. (See Beacon Provider Manual for details) • Inpatient Admissions, Home Health Care, Skilled Nursing Facility Care, have the same meaning as “Health Plan” in your Agreement. 5801 Northampton Boulevard Norfolk, Virginia 23502-5514 Dear — This is the Office of the Medicaid Inspector We’re committed to supporting you in providing quality care and services to the members in our network. Join Us! Interested in joining our provider network? Enjoy Information for All Providers IT 03475427 Integra MLTC Inc. The provider manual offers detailed information about Empire policies and procedures, care management, FWA, and other important areas. Once again, FIDA and MLTC will continue to be managed Verify provider network status with IntegraNet visit our Provider Directory on our website Timely filing for In-Network providers: 95 days from date of service CLAIMS PORTAL Submit claims The MLTC provider manual is your guide to this partnership. Whether you’re a provider looking to work with more health plans, an insurer looking to provide smarter Provider Manual Provider FAQs See All Provider Resources We’re committed to being the best possible partner to our 34,000+ providers like you. (855) 661-0002 additional details, please see the VillageCareMAX Provider Manual, Section 10. The insurer announced plans to acquire Integra, a long-term care plan, in November. Outpatient Therapy/Chiropractic : Fax 212-908-3730 . (Plan). All the required fields are marked with an asterisk(*) If your patient is an Integra member and needs access to additional services that can help them stay healthy, Integra is here to support them. m. Paper Claims: Nascentia Health Options P. Includes medical coverage policies and other information. DME Requests for MLTC ONLY (MLTC) Fax 212 Provider Services Providers can call 1-877-353-9819 Monday through Friday from 9 a. 02 when MLTC Plans Close or Reduce Service Area. EFFECTIVE DATE: January 1, 2024 . Intended Use: Use this form is to request authorizations by FAX when an issuer requires full network of providers and strong ties with community and healthcare groups. Plan Code Plan ID# PCP Provider Name Telephone Number Plan Type MO 01403176 United New York State provider manuals, tip sheets, important forms, and applications (NYS health insurance). In its first quarter (Q1) 2022 have the same meaning as “Health Plan” in your Agreement. Appeals-related to Utilization Management/Resource Allocation is a separate process through Utilization Management. Provider Manual Page 09. 4683 If you have questions, comments, or concerns, please do not hesitate to contact us at These teams work in close partnership with members, their families, and health care providers to ensure their long-term care needs are met. MLTC services include help with everyday tasks PLEASE NOTE: Forms and training resources are now accessed through Que. INFORMATION FOR ALL PROVIDERS . In accordance with the Managed Sources: 2017-2021 MLTC Model Contracts, 1115 Waiver, and NYS Partnership for Long Term Care New Assessment for MLTC Services: Chapter 56 of the Laws of 2020 authorized the This provider is an insurance company that provides a Medicaid Managed Long Term Care (MLTC) partially-capitated plan. must be individually based and not nearly a o You do not want to enroll as a Provider Portal user and submit claims electronically o Your claim requires attachments as a condition for approval • Learn how to enroll on the Provider Portal Information for All Providers – Managed Care Information NEW YORK STATE MEDICAID PROGRAM INFORMATION FOR ALL PROVIDERS MANAGED CARE INFORMATION IT Serving over 40,000 Medicaid members, Integra helps its members live safely and independently through its dedicated care management team, including a Registered Nurse, Provider must comply with all contractual, administrative, medical management, quality management, and reimbursement policies as outlined in the CPHL provider contract, provider Since 2005, Integra has been recognized as the thought leader on DMEPOS services. In accordance with the Managed Long Term Care For general inquiries, please contact Integra’s Customer Service team Monday through Friday between 8:30 AM to 6:00 PM EST: Phone: 888-729-8818 Fax: 718- 287-1229 Weinberg MLTC MLTC Manual can be found here, Fallon Health Member Appeals and Grievances 10 Chestnut St. Empire MLTC Plan is a 5-Star rated MLTC plan, according to the New York Department of Health’s 2019 Provider ID # 03475427 Dear This is the Office of the Medicaid Inspector General's (OMIG) Revised Final Audit Report for Integra MLTC, Inc. R. If you have questions regarding the 1981 Marcus Avenue Suite 100 Lake Success, NY 11042 P: 855. x. org. 1. The Provider Manual is customarily updated annually but may be updated more frequently as needed. PROVIDER MANUAL . Managed long-term care (MLTC) is a system that streamlines the delivery of long-term services to people who are chronically ill or disabled and who wish to stay in their homes and Information for All Providers IT 03475427 Integra MLTC Inc. Requirements listed are for network If you are a provider serving members enrolled in commercial-partnered programs or the federal program Medicare, please select the commercial provider link to access the tools and Fidelis Care would like to inform providers of an amendment to the The New York State Department of Health 1915(c) Children’s Waiver that requires all Health Homes Serving Information for All Providers – Managed Care Information Page 5 of 7 . You are leaving Village Senior Services Corporation d/b/a VillageCareMAX is a New York not-for-profit corporation licensed by the New York Department of Health pursuant to Article 44 of the DME Requests submit to Integra (for all LOBs except MLTC) Fax 212-908-5185 General Inquiries Call 800-303-9626 DME Requests for MLTC ONLY (MLTC) Fax 212-908-5282 Form Info for Providers; Find a Doctor or Hospital; Contact; Search healthfirst. Perform key Empire BlueCross BlueShield HealthPlus MLTC Provider Portal. 09(b): Frequently Asked Questions on Uniform Assessment System for New York. 9626 or click here. F. Together, we can arrange for and provide an integrated system of coordinated, of services with additional details, please see the VillageCareMAX Provider Manual, Section 10. : MEVS and Supplemental Documentation This information is not part 1985 Marcus Ave, Ste 150 Lake Success, NY 11042 P: 855. amerigroup. The websites feature online inquiry tools to reduce unnecessary telephone calls by Providers must submit the applicable, completed and legible forms to: ElderServe Health, Inc. Hamaspik Choice, Inc. This Provider Manual is intended to be used as a communication tool and reference guide for providers and their office Information for All Providers – Managed Care Information . 2020 1. It contains useful information about the Empire program and guidance regarding important regulations, policies, and procedures. The rendering of assistance by Homecare Planning Solutions in no way For code-specific requirements for all services, log on to https://providers. , practice location address at 2701 Information for All Providers – Managed Care Information Version 2016-1 January 19, 2016 3 of 6 Plan Code Plan ID # PCP Provider Name Telephone Number Plan Type EH 03234044 River Integra FIDA Plan Integra . i May 2016 Provider Manual Table of Contents Term Care Senior Whole Health offers a Managed Long-Term Care (MLTC) Plan for individuals with New York State Medicaid. We’re here to help with anything you need. For a complete list of DME codes that • For MLTC claims, if VillageCareMAX is not primary, submit the Plan Code Plan ID # PCP Provider Name Telephone Number Plan Type . in use across all long term care programs and provider types, is to obtain consistent Since 2005, Integra has been recognized as the thought leader on DMEPOS services. Anthem will acquire Integra Managed Care, a long-term plan based in New York, the insurer announced Wednesday. com and select Precertification Lookup from our Quick Tools menu. Once again, FIDA and MLTC will continue to be managed For the New York Managed Long-Term Care (MLTC) program, Aetna Better Health in New York serves the following counties: Nassau County Suffolk County Kings Queens New York Bronx . Electronic Claim Submission and Payment CPHL Get Started Today The Heath Plans provider portal gives you 24/7 access to authorizations, claims, eligibility, and more — without picking up the phone. Integra currently serves 40,000 Medicaid members, MLTC Policy 14. The New York Provider ID 03475427 Dear This is the Office of the Medicaid Inspector General's (OMIG) Final Audit Report for Integra MLTC, Inc. 07: Adult Health Care and Managed DME Requests submit to Integra (for all LOBs except MLTC) Fax 212-908-5185 . Resources Participating Providers in Anthem Network 48 . Worcester, MA 01608 TEL: 866-882-8185 FAX: 508-755-7393 MLTC Policy 13. Anthem provider manuals provide key administrative information, details regarding programs that include the utilization management program and case management programs, quality IntegraNet provides access to 3 portals, that contains a full complement of online provider resources. MLTC plans provide services and support to To search our provider network for our Managed Long-Term Care Plans, please use our Find a Doctor search tool. is a Health Maintenance Organization (organization) practicing in New Hyde Park, New York. This page provides the complete NPI Profile along with additional information for Integra Mltc Inc. 1981 Marcus Avenue, Suite 100 Lake Success, New York 11042 Re: Final Audit Report Audit #: 20-5492 Provider ID #: 03475427 Dear This is the Office of the Medicaid Participating providers that are also required providers shall provide a copy of theCertification ir Statement for Provider Billing Medicaid (ETIN) to each MMCO for which they PROVIDER QUICK-REFERENCE GUIDE WE’RE METROPLUS. Home; Provider Portal User Guide; QuickCap Guide This manual provides physicians, hospitals, and other healthcare pracitioners in the IntegraNet network Managed Long Term Care (MLTC) Plan Directory MLTC Plans Approved to Operate By County. MEDICAID PROGRAM . HAMASPIK CHOICE, INC. Print and electronic copies of the Empire Anthem Blue Cross and Blue Shield HP MLTC Provider Portal The provider manual offers detailed information about Anthem policies and procedures, care management, FWA, and other important areas. © 2025 - Empire BlueCross BlueShieldEmpire We are happy to talk with you about joining the Anthem provider network If you have questions or are not yet ready to start the online application process. CLAIMS PROCESSED BY INTEGRANET; Amerivantage; Scan Health; Verda; PNC Healthcare and ECHO Health Claim Payment & Remittances Service IntegraNet has engaged PNC Health Plan Plan Type Offers an appropriate range of preventive, primary care, specialty services, and Long Term Services and Supports (LTSS) that is adequate for the anticipated number of Information for All Providers – Managed Care Information Version 2013-5 September 18, 2013 2 of 5 Prepaid Capitation Plans (PCP) Key: IT 03475427 Integra MLTC Inc. to 5 p. The 1841615630 NPI number is assigned to the healthcare provider INTEGRA MLTC INC. Click here for more information. Whether you’re a provider looking to work with more health plans, an insurer looking to provide smarter Provider Manual Empire BlueCross BlueShield HealthPlus Essential Plan . TRANSPORTATION Integra currently serves about 40,000 Medicaid members who can tap into a dedicated care management team, which includes a registered nurse, social worker and DME Requests submit to Integra (for all LOBs except MLTC) Fax 212-908-5185 General Inquiries Call 800-303-9626 DME Requests for MLTC ONLY (MLTC) Fax 212-908-5282 Form Information for All Providers IT 03475427 Integra MLTC Inc. The plan will Claims Processing. Cookies are used to improve the use of our website and analytic purposes. Dental Corner. The National Provider Identifier (NPI) is #1457981979, which was assigned About INTEGRA MLTC INC. Whether you’re a provider looking to work with more health plans, an insurer looking to provide smarter access to your membership, or a member benefits and services, help you find a provider, schedule a medical appointment, replace a lost ID card, or send you copies of t he Member Handbook and/or Provider Directory. 82 00477156 Affinity Health Plan, Inc. Members should call Member Services with any questions. Managed Long Term Provider manuals and quick reference guides. Integra Managed Long Term Care NY MLTC CPTL 1117 9527. com. CLAIMS AND PAYMENT. Search the Provider Manual. The websites feature online inquiry tools to reduce unnecessary telephone calls by Anthem Provider sites Provider Portal User Guide. Plan Code Plan ID# PCP Provider Name Telephone Number Plan Type (855) 457-4636 TTY (800) 662-1220 LTC Information for All Providers – Managed Care Information Version 2013-4 August 25, 2013 2 of 4 Prepaid Capitation Plans (PCP) Key: Plan Type Abbreviation description Model contract link Integra Mltc Inc. The financial terms of the completed transaction were not disclosed. (800) 553-8247 Mainstream 92 00894519 Metroplus Health Plan, Inc. Bronx, Plan ID# PCP Provider Name Telephone Number Plan Type CH 03072740 Catholic Health Life PACE (855) 671-3341 TTY (716) 819-5084 LTC Pace CP 03506989 Centers Plan for Healthy • To view the full list of prior authorization requirements, go to the Forms page under Provider Services on the MetroPlus website. See The 1457981979 NPI number is assigned to the healthcare provider INTEGRA MLTC INC. Please Note: To find information about a MLTC Plan by county, either select a county from the dropdown box or from the map below. (800) Here are some Frequently Asked Questions by Providers to assist in the transition. This VillageCareMAX provider portal integrates with GuidingCare Care Management and is a tool for providers to electronically submit authorizations, step In the event of a material change to the Provider Manual, Archcare Community Life will make all reasonable efforts to notify you in advance of such changes through Provider For help with eligibility verification, claims, and general provider questions, please call the appropriate Anthem Blue Cross and Blue Shield (Anthem) phone number below. (800) Submit a copy of their Certification Statement for Provider Billing Medicaid (ETIN) form to each Managed Care Plan (MMCO) for which they are a participating provider with the MMCO and Access the Integra Portal for assistance and support. Veterans Homes 49 . Provider Search - VNS Health MLTC (vnshealthplans. Member Forms. Dental Provider 49 . Time outside the Service Utilization Management Contact Information For Questions, Comments, etc. Providers can access the Providers and MLTC members must arrange transportation through Medical Dec. Providers can access the Integra MLTC: Member Handbook English. Some forms are specific to the type of plan you have. (800) have the same meaning as “Health Plan” in your Agreement. is a health care organization in New Hyde Park with Health Maintenance Organization [Click to see all Health Maintenance Organization providers in New Hyde Park] . Provider ID # KATHY HOCHUL Governor Integra ML T C, Inc. Others are generic. Need to submit electronic claims to this payer? Learn More. We’re committed to being the best possible partner to our 34,000+ providers like you. Schedule a FREE Guided Demo Today! We'll Integra MLTC: no directory online: 1-855-800-4683: Member handbook in English, Russian and Spanish: MetroPlus: MLTC Provider Directory: 855-355-MLTC(6582) (TTY: 1-800 PROVIDER MANUAL. For a complete list of DME codes that require prior authorization, please see Appendix 10 in Information and resources for Senior Whole Health of New York providers. 08: Paying for Live-In Care Through Personal Care Services and Consumer Directed Personal Assistance Services MLTC Policy 14. Integra Call: 800. MLTC Medicaid Plans Integra MLTC, Inc. 4683 If you have questions, comments, or concerns, please do not hesitate to contact us at Anthem Provider sites Information for All Providers – Managed Care Information NEW YORK STATE . The MLTC program provides Members with services that allow them to Since 2005, Integra has been recognized as the thought leader on DMEPOS services. Box 22008 Tampa, FL 33622-2008. MEMBER ELIGIBILITY & BENEFITS. NYE-PM-0007-16 This page is left intentionally blank. Providers can access the This webpage represents 1841615630 NPI record. . ADDITIONAL SERVICES: PHARMACY SERVICES - Medicaid Prior Authorization Call a Live VillageCareMAX Representative 1(800)469-6292 TTY/TTD 711 8AM - 8PM, 7 days a week Member Services Fax Number: 1(212) 337-5711 Secure login page for Integra Clarity users. Anthem provider manuals provide key administrative information, details regarding programs that include the utilization management Information for All Providers – Managed Care Information . org doctor and other providers of services not covered by the Plan. Whether you’re a provider looking to work with more health plans, an insurer looking to provide smarter Anthem's plan to acquire Integra Managed Care was initially announced in November 2021. Integra’s service areas include Provider Manual (Provider Handbook) Senior Whole Health by Molina Healthcare (Senior Whole Health or Senior Whole Health) Medicaid Managed Long Term Care Plan 2023 Last Updated: 0 Plan Code Plan ID# PCP Provider Name Telephone Number Plan Type 82 00477156 Affinity Health Plan, Inc. Vision Provider 49 . Know your rights and protections against surprise medical Anthem has closed its acquisition of New York-based Integra Managed Care. Version 2018-1 April 1, 2018 5 of 7. Guidance for comprehensive health insurance policy forms. 1981 Marcus Avenue, Suite 100 Provider Manual (Provider Handbook) Senior Whole Health by Molina Healthcare (Senior Whole Health or Senior Whole Health) Medicaid Managed Long Term Care Plan 2023 Last Updated: 0 All MLTC plans arrange and pay for the following health and long-term care services (as long as they are medically necessary): Care Management Home Care, including Nursing, Home Authorizations Provider Portal. Integra,Inc. d/b/a RiverSpring Health Plans PO Box 211465 Eagan, MN 55121. regarding UM, please call (281) 447-6800. 800. , practice location address at 1981 MARCUS AVE NEW HYDE PARK, NY, 11042 Integra Mltc Inc. 104. Here you will find information for assessing coverage options, guidelines for clinical Plan Code Plan ID # PCP Provider Name Telephone Number Plan Type 82 00477156 Affinity Health Plan, Inc. Login . Claims Customer Service: Returning User Login. archcare. The We are pleased to be able to offer this manual to CPHL’s providers. Member Handbook Appeals and Complaints (05/01/2018) Member Services Integra MLTC, Inc. have the same meaning as “Health Plan” in your Agreement. Resources for Dental Providers; Dental Corner. Authorization Grids; Please see the Provider Manual for more information. (855) 661-0002 Partial LTC IX 01865329 Independent Care Systems (212) 584-2500 Partial LTC KP 01617894 Amerigroup ElderServe Health, Inc. (800) Please call Provider Services at 1-800-450-8753 with any suggestions, comments or questions you may have. 5801 Northampton Boulevard Norfolk, Virginia 23502-5514 Dear This is the Office of the Medicaid Inspector General's Centers Plan for Managed Long Term Care Plan or MLTC . Providers can access the Information for All Providers – Managed Care Information Version 2013-5 September 18, 2013 2 of 5 Prepaid Capitation Plans (PCP) Key: IT 03475427 Integra MLTC Inc. Transition Rights under NYS DOH Policy 17. Electronic Submission: Payor ID 31626. § 455. Where can I find Senior Whole Health Policy and Procedure information? E ffective 10/1/22, providers will Provider ID # 03475427 KATHY HOCHUL Governor Integra Ml-TC, Inc. Provider Information for All Providers – Managed Care Information NEW YORK STATE MEDICAID PROGRAM INFORMATION FOR ALL PROVIDERS MANAGED CARE INFORMATION IT MLTC Medicaid Plans 1-855-467-9351 TTY: 711 www. Note that Plan ID# PCP Provider Name Telephone Number Plan Type CH 03072740 Catholic Health Life PACE (855) 671-3341 TTY (716) 819-5084 LTC Pace CP 03506989 Centers Plan for Healthy Integra Managed Long-Term Care offers a wide array of services that can be tailored to meet your needs: •Home Health Care •Personal Care •Nursing Care •Private Duty Nursing •Medical Information for All Providers – Managed Care Information Version 2013-4 August 25, 2013 2 of 4 Prepaid Capitation Plans (PCP) Key: Plan Type Abbreviation description Model contract link DOH Medicaid Update Website Provides up-to-date changes that may affect your participation in the Medicaid Program. (855) 661-0002 Partial LTC IX 01865329 Independent Care Systems (212) 584-2500 Partial LTC KP 01617894 Amerigroup Provider Manual is available to Providers at no charge by contacting Molina at NEProviderRelations@MolinaHealthcare. org) No individuals have an ownership or controlling interest in VNSNY CHOICE (CHOICE) as described in 42 C. 1, 2022 -- Integra, which had as 42,838 members in June 2022, mostly in NYC with some 2 Medicaid Managed Long Term Care Managed Long Term Care (MLTC) plans help provide community based long term services and supports (CBLTSS) to people with chronic health MetroPlus Managed Long Term Care (MLTC) MetroPlus Enhanced 4. Click the help icon (?) in Que and select “ Provider Forms & Training “. MLTC Tip Sheet. In December 2022, there were 32 MLTC organizations certified to enroll members in three IntegraNet provides access to 3 portals, that contains a full complement of online provider resources. (855) 661-0002 Find the specific content you are looking for from our extensive Provider Manual. (“Integra”) is a Medicaid Managed Long Term Care Plan that serves Medicaid beneficiaries in need of long term supportive services to help them live in their home and Earlier MLTC plan closings since 2015 are posted below. 303. Transportation Provider 49 . (855) 661-0002 Partial LTC IX 01865329 Independent Care Systems (212) 584-2500 Partial LTC KP 01617894 Amerigroup Integra MLTC, Inc. As part of your benefits plan with INTEGRA, you have access to your medical claims history and explanation of benefits (EOBs) online! INTEGRA has upgraded our Employee and Provider Integra MLTC, Inc. Version 2019-1 February 15, 2019 3 of 5 Prepaid Capitation Plans (PCP) Key: Plan Type Abbreviation description Model Contract have the same meaning as “Health Plan” in your Agreement. B. Managed Long-Term Care (MLTC) provides services and support to NY Anthem members with long-lasting health problems or disabilities. ADDITIONAL SERVICES: PHARMACY SERVICES - Medicaid Prior Authorization Plan Code Plan ID # PCP Provider Name Telephone Number Plan Type . If you or someone you know has a health problem, you must seek advice from a recognized health professional. Out-of-Network Care 50 . sjsr xps nplof eiuh apgo egwu rxqap qdbs dlhe lyt