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Have questions about
claims or our network?


Our automated phone system is available:
24 hours a day 7 days a week

Live Phone Representatives are available:
Monday-Friday,
9:00 am to 5:00 pm
1-888-801-1660

New York Claims Submission Address:
P.O Box 958438
Lake Mary, FL 32795

New York Request for Review and Reconsideration:
P.O Box 958438
Lake Mary, FL 32795

Electronic Payor ID: 80141

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Industry Changes

 

Important Information on Growth Hormone Coverage for Idiopathic Stature

Effective 5/3/2012, New York State Medicaid will no longer cover Growth Hormone (GH) for patients with a diagnosis of Idiopathic Short Stature (ISS).

The Medicaid Redesign Team (MRT) Basic Benefit Review Work Group Phase II recommendations included the elimination of coverage of GH for treatment of ISS.  The MRT work group determined that coverage for ISS is not medically necessary but cosmetic in purpose and does not treat a medical condition defined by growth hormone deficiency.

For additional information please visit the MRT Website:  http://www.health.ny.gov/health_care/medicaid/redesign/


Medication Therapy Management Program

Medication Therapy Management Program Provider Letter PDF icon image

 


Educational Materials

Community Health Worker Asthma Educator Certification Preparation Course Application

 

Restricted Recipients: Medicaid and Family Health Plus Programs

What is the Restricted Recipient Program PDF icon image
Restricted Recipient Provider Letter PDF icon image

Personal Care: Medicaid and Family Health Plus Programs

Personal Care Letter and Frequently Asked Questions for Providers

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Personal Care Letter and Frequently Asked Questions for Administrative Staff

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Medical Request For Home Care (M-11Q form) - Please fax completed forms to 1-646-313-4603 PDF icon image

Pharmacy Benefits: Medicaid and Family Health Plus Programs

Prior Authorization Process

Physicians will be asked to contact CVS CareMark Prior Authorization department:

  • Medicaid: 877-433-7643
  • Medicare: 855-344-0930
  • Commercial:  800-294-5979

Fax numbers:  

  • Medicaid: 866-848-5088
  • Medicare: 855-633-7673
  • Commercial: 888-836-0730