Provider Resources
Important provider resources, forms and guidelines for providers in the Partners Health Plan network.
Billing & Claims
Claims and billing submission guidelines, contact information, and other billing and claims resources
Authorizations & Appeals
Authorization requirements, request forms, and appeal / greivance information.
2023 Provider Manual
Provider Events & Webinars
Previous Provider Webinars
August 22, 2023 Provider Webinar: Medicaid Eligibility: Maintaining Benefits for the Intellectually and Developmentally Disabled in New York State
This webinar was in collaboration with Care Design NY and focused onchanges to Medicaid eligibility and recertifications, as well as the unwinding of the Public Health Emergency (PHE) as it relates to Medicaid coverage.
PRESENTED BY: Kristina Cunningham, Assistant Vice President of Member Benefits and Enrollment
Supporting Documents:
Webinar Slides | Qualifying Expenses - Spenddowns | 2023 Spenddown Calculation Example | 2023 SSI and Personal Allowance Amounts | 2023 Federal Poverty Level Guidelines
June 14, 2023 Provider Webinar: Medication Related Risk in the IDD Population
This webinar was in collaboration with Care Design NY and focused on:
- Medication Risks for the IDD Population
- PHP’s clinical pharmacy program
- Comprehensive Medication Therapy Reviews (CMTRs)
- What is a CMTR and how it is used
- Clinical Pharmacy program outcomes
PRESENTED BY: Scott Doolan RN BSN, MBA, Assistant Vice President of Health Care Management
March 22, 2023 Provider Webinar:
What is IDD Care Management and What Does It Mean To Me?
This webinar was in collaboration with Care Design NY and focused on how Care Management is different when in support of someone with an Intellectual or Developmental Disability (IDD) and the importance of collaboration between IDD Care Managers and the provider community.
PRESENTED BY: Steven Merahn, MD, Medical Director
February 24, 2022 Provider Webinar
in Collaboration with Care Design NY: The Life Plan Process
This webinar reviewed the CDNY & PHP alignment, the Life Plan process, the CDNY and PHP escalation process, and how to ensure effective communication and timely resolution.
October, 26, 2021 Provider Webinar:
Important Billing and Claims Updates and Reminders
This webinar reviewed Partners Health Plan’s Care Management model, the Life Plan, and important billing and claims reminders, how to appeal a claim denial and timely filing guidelines.
Provider News, Updates & Announcements
Stay up-to-date on important information for providers in the PHP Provider Network.

National Enteral Supply Shortage

Message from the Medical Director: COVID-19 Update

8.23.23 UPDATE: ARPA Workforce Stabilization Payment Initiative
Provider Newsletter Archive
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Information for Providers (ny.gov)
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