nyship empire plan claims address

Dental care benefits. Use medication from your formulary list. The resources for our providers may differ between states. Large Group Box 1600 Kingston, NY 12402-1600 Prescription Drug Program CVS Caremark (claims only) P.O. Effective January 01, 2022. Cancer Resource Services . 1-877-7NYSHIP (1-877-769-7447), choose UnitedHealthcare . With The Empire Plan you can choose a participating provider or non-participating provider for medical services. Online: www.empireblue.com/nys/resources-forms. 2022 UnitedHealthcare Care Provider Administrative Guide; 2021 UnitedHealthcare Care Provider Administrative . If you are currently enrolled in SEHP for dental coverage, you will automatically Your share of the biweekly premium for medical and dental and vision coverage in The purpose of this communication is the solicitation of insurance. Claim Submission Instructions. When you get home, submit the original records to the appropriate Empire Plan carrier and retain a photo copy for your records. The Empire Plan Supplement will be included with the 2021 UnitedHealthcare Care Provider Administrative Guide. To access your SEHP dental care Kingston, NY 12402-1600 Medicare Complaints, Grievances & Appeals. These terms are defined in the Uniform Glossary, a non-customized companion document to the SBC. benefits was sent to you. MVP. A. The New York State Health Insurance Program (NYSHIP) offers eligible employees the option of choosing either The Empire Plan or a NYSHIP HMO for health insurance coverage. If you go to an Empire Plan participating provider, MPN Network provider, or a MultiPlan provider, all you have to do is ensure that the provider has accurate and up-to-date personal information (name, address, health insurance identification number, signature) needed to complete the claim form. Both for medical and dental solutions, statements kinds ca[Continue Reading], Printable Crossword Puzzles, Bingo Cards, Forms, Download and Print Printable Crossword Puzzles, mapquest driving directions free printable, driving directions mapquest free printable, 2021 2022 nfl football schedule printable, https://www athenahealthpatientportal net/, 100 Numberblocks Black And White Coloring Print. NYSHIP SEHP, are not covered under Network coverage. Fill out the requested fields which are colored in yellow. 25 Feb/23. Download and Print Printable Crossword Puzzles, Bingo Cards, Forms, Empire Plan Corrected Claim Form An ERISA Area 502(a) strategy might be stated in a number of methods. You may request this appeal on your own behalf or on behalf of a covered Individual. call the Empire Plan at 1-877-7-NYSHIP (1-877-769-7447), select option 4. You will need to submit claim forms and pay a higher share of the cost if you choose a non-participating provider or non-network provider. Do you have your doctor's phone number and your NYSHIP Empire Plan Benefit Card? your campus, usually in the Human Resources (Personnel) Office. Your SEHP medical coverage will be Welcome to the New York State Health Insurance Program (NYSHIP). Legal Information; We currently don't offer resources in your area, but you can select an option below to see information for that state. The second set . Always use pharmacies within your network. You can access claim forms in our Forms Library. . Log in to your member account to access your claims information. Your HBA, usually located in your agency's personnel office, can also print you . These definitions are intended to help improve consumer understanding and do not necessarily reflect your plans definition of the same term. (including alcoholism), please contact ValueOptions at 1-800-446-3995 for help The Summary of Benefits and Coverage is a standardized template and the cells cannot be altered, moved, or deleted by any plan. Contact Information: Jennifer Ayala Payroll Manager (631) 471-1324. Representatives are available Monday through Friday, 8 a.m. to 5 p.m., Eastern time. Recent cards also have the UnitedHealthcare logo. Blue Choice If you are currently enrolled in treatment for mental health/substance abuse (including alcoholism), please contact ValueOptions at 1-800-446-3995 for help in making the transition to your NYSHIP coverage. 711. The carriers will reimburse you directly for covered expenses. Here are some steps to make sure your claim is processed smoothly: Make sure the claim form from your benefits plan includes all required information, especially procedure codes (you can receive these from your doctor's office). Use the e-autograph tool to add an electronic . Empire Plan Prescription Drug Program: To obtain prescription drug claims or subrogation information during the following dates, contact: From January 1, 2014 to present date for Medicare primary enrollees: SilverScript Insurance Company . How you can fill out the Empire plan hEvalth insurance claim form on the internet: To begin the form, utilize the Fill camp; Sign Online button or tick the preview image of the blank. NYSHIP began providing SEHP dental care coverage, Sachem Life Insurance; New York Life Insurance Certificate; . deductions for health insurance will continue without interruption. File your paperwork promptly and within the time limit. A claims processor will check the claim for completeness, accuracy, and whether the service is covered by your plan. Do you have enough of your regular medications? We currently don't offer resources in your area, but you can select an option below to see information for that state. Click the green arrow with the inscription Next to move on from one field to another. If your state isn't listed, check out bcbs.com to find coverage in your area. . time have an incorrect Internet address for our website. NYHPA does not administer NYSHIP or the Empire Plan under NYSHIP. Contents of the Summary of Benefits and Coverage New York State Health Insurance Program - Empire Plan Health (1 days ago) WebNYSHIP covers over 1.2 million active and retired State and participating organizations' employees and their dependents (collectively referred to as members). To be eligible for coverage under a NYSHIP HMO, you must live or work in the HMOs service area. (877-769-7447) that you can call to contact the different programs and carriers. If the request is made within 30 days after the event date, then coverage becomes effective on the first day of the . Filing your claims should be simple. It shows the medical services that were provided to you. A. through insurance carriers under contract with NYSHIP: Empire Blue Cross Blue Shield (for hospital benefits), UnitedHealthcare Insurance Company of Simply put, a claim is what a doctor submits to Empire so they receive payment. The Empire Plan (NYSHIP) Breast reduction, The Empire Plan (NYSHIP), covers breast reductions based on United Health Care Coverage Guidelines. It is updated weekly. If you are a retiree, please visit NYSHIP Online for Retirees. Disease management. If problems are encountered at the pharmacy, call the Empire Plan at 1-877-7-NYSHIP (1-877-769-7447), select option 4. IEHP - Contact Us : Welcome to Inland Empire Health Plan \. It looks like you're in . P.O. Our DM care managers are licensed nurses and social workers and are available from 8:30 a.m. to 5:30 p.m. Eastern time, Monday through Friday. Category: Health Detail Health Box 52136, Phoenix, AZ 85072-2136. Log in to your member account to view your claims and EOBs. Provider Groups and Facilities may visit our provider portal or call our National Provider Service Line at 800-397-1630 to share your individual provider information. members are responsible for either notifying Empire Plan program vendors of certain services or for using network care providers for these services. Faxed claims are also acceptable and may be faxed to any of the following numbers: Predeterminations are requests that services or treatments be approved before they have been received (also known as preservice claim determinations). EMPIRE PLAN 1500 APPROVED BY NATIONAL UNIFORM CLAIM COMMITTEE 08/05. Your SBC may provide you with some information that will explain how you are covered for certain services, such as what your copayment is. Phone: 1-877-7-NYSHIP (1-877-769-7447) Mental health and substance use services: Beacon Health Options, Inc. Call our Customer Service number, (TTY: 711). Both for medical and dental solutions, statements kinds can be purchased. Empire Plan Medicare Rx R X C V S D . If you need a paper copy, call 1-877-7-NYSHIP (1-877-769-7447) and select the Medical/Surgical Program. Click here for a table of the counties each HMO serves in 2018. Different carriers manage coverage for The Empire Plan. YOU MUST CALL The Empire Plan toll free at 1-877-7-NYSHIP (1-877-769-7447) and choose the Medical/Surgical Program or call the Cancer Resource Services Typically, your doctor or provider, especially if theyre in your plan, will submit the claim for you. SUNY campuses), in addition to your NYSHIP SEHP coverage. Steps to getting contracted plus plan information, Phone numbers and links for connecting with us, List of contracted, high-quality independent lab providers, Update, verify and attest to your practice's demographic data, Provider search for doctors, clinics and facilities, plus dental and behavioral health, Policies for most plan types, plus protocols, guidelines and credentialing information, Specifically for Commercial and Medicare Advantage (MA) products, Pharmacy resources, tools, and references, Updates and getting started with our range of tools and programs, Reports and programs for operational efficiency and member support, Resources and support to prepare for and deliver care by telehealth, Tools, references and guides for supporting your practice, Log in for our suite of tools to assist you in caring for your patients. If you are not an HCS provider and are going to fit a patient for a hearing aid, first verify the members out-of-network benefits and then follow the protocol outlined in the following document: Sydney Care is offered through an arrangement with Carelon Digital Platforms, Inc. Sydney Health and Sydney Care are service marks of Carelon Digital Platforms, Inc., 2022. you wish to, but you do not need to notify the plan administrator.) TTY: 1-888-697-9054 The claim forms are in each provider's office. If the hospital does not deal directly with its local Blue Cross Plan: When filing the claim directly with the local Blue Cross Plan, refer the bill to: Code YLS, Empire BlueCross BlueShield. Need access to the UnitedHealthcare Provider Portal? Download your adjusted document, export it to the cloud, print it from the editor, or share it with other people via a Shareable . Network Benefits for the NYSHIP SEHP are available to you when you receive medically EDI provides a faster and cleaner method for delivering time-dependent data, saving you time compared to filing paper claims. in making the transition to your NYSHIP coverage. IMPORTANT REMINDER-To avoid having to submit a paper claim form: Always have your card available at time of purchase. Customer care representatives are available to assist you. Empire Plan Claim Submission Deadlines Generally, Empire Plan claims must be submitted to UnitedHealthcare no later than 120 days from the end . This online directory lists The Empire Plan's Participating providers. Click here to view a PDF copy that can be printed if necessary. Submit an inquiry and review the Claims Status Detail page. Any visits you make You can register here. This site uses cookies. Civil Service contracts with UnitedHealthcare Insurance Company of New York (United) to administer the medical/surgical portion of the Empire Plan and process and pay claims submitted by health care providers. The New York State Health Insurance Program (NYSHIP) provides health insurance coverage to over 1.2 million active and retired State, local government, and school district employees, and their dependents. There is a nationwide network of more than 1.2 million UnitedHealthcare Empire Plan participating providers, including over 70,000 Managed Physical Network (MPN) providers for chiropractic care and physical therapy. If you need medical be enrolled for medical, dental and vision coverage as of January 1, 2002. You can also visit bcbs.com to find resources for other states It looks like you're outside the United States. Tel: 631-632-6570. westchapter@uupsbu.org. Always refer to other plan material, such as Choices for 2019 for more information about The Empire Plan and NYSHIP HMOs if you are making a decision about your family's coverage. Providers, billing services and clearinghouses can register to exchange 270/271 (eligibility), 276/277 (claim status), and 835 (electronic remittance advice) X12 transactions for Empire BlueCross BlueShield HealthPlus members and claim payments. much more. The 2021 Administrative Guide Empire Plan Supplement will include the services, such as advanced radiology procedures, which will require prior notification. Main Campus Office: S-5415 Melville Library. Note an important change from your Univera north shore towers maintenance fees north shore towers maintenance fees (No Ratings Yet) . Not connected with or endorsed by the U.S. Government or the federal Medicare program. PLEASE MAIL CLAIMS TO: United HealthCare Insurance Company of New York P.O. qualifying event (for example, change of address outside of HMO area) . Beginning January 1, 2002, NYSHIP will replace Univera as administrator of You can also visit bcbs.com to find resources for other states. Claims submission . The Empire Plan, New York State Health Insurance Program. Representatives are available 24 hours a day, seven days a week. TTY: 711 For costs and complete details of the coverage, please contact your agent or the health plan. Our resources vary by state. P.O. Contact Us . If you have questions regarding specific benefits or claims, contact the appropriate Empire Plan administrator (see page 23). Should I use the Summary of Benefits and Coverage to decide which NYSHIP option is best for my family? Phone: 1- 877-7-NYSHIP (1-877-769-7447), Skilled nursing facilities that CDPHP Effortlessly add and underline text, insert images, checkmarks, and symbols, drop new fillable fields, and rearrange or remove pages from your document. If you use an Empire Plan participating provider, you will receive covered services and supplies at little or no cost and have no claim forms to fill out. Enter your official contact and identification details. No. The campus Student Health Center continues to be available to you (on most Box 52066 Phoenix, AZ 85072-2066 Hospital Program The Empire Plan is NYSHIP's unique health insurance plan designed exclusively for New York State's public employees and employers. Empire Plan benefit ID cards have New York State Health Insurance Program (NYSHIP) and The Empire Plan on the front of the card. The Empire Plan is available to New York . Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. Thats why Empire uses Availity, a secure, full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to healthcare professionals. Choose your location to get started. You will need to submit claim forms and pay a higher share of the cost if you choose a non-participating provider or non-network provider. PATIENT'S ADDRESS (No., Street) 1a. If you need an older version of an Administrative Guide or Care Provider Manual, please contact your Provider Advocate. The annual cost for Empire Plan Family coverage ranged from $20,570 to $28,953 during the audit NYSHIPthe "New York State Health Insurance Program"is a benefit program established to provide health insurance coverage to state and local government employees.. NYSHIP stands for the "New York State Health Insurance Program.". Welcome to NYSHIP Online, where you will find information on the New York State Health Insurance Program for State and Local Government for active employees. directory and Certificate of Insurance will come separately. You can use Availity to submit and check the status of all your claims and If you have other . After we complete our review of your claim, youll receive an Explanation of Benefits (EOB) showing what we paid, and what you owe. to your campus Student Health Center, which is not a network provider in the Payer ID: 87726 Continue to use the GHI card issued in July 2001. 1 . Sometimes, youll owe a part of the bill as well. rose bowl resident pass rose bowl resident pass. We look forward to working with you to provide quality service for our members. Box 1850, Hicksville, NY 11802, Claims submission fax: 855-378-8309 Box 1407, Church Street Station, New York, NY 10008-1407, Claims submission fax: 866-829-2395 Phoenix, AZ 85072-2067 From January 1, 2014 to present date for non-Medicare . Empire Plan Network Management contact. (filing, payments, reconsiderations), EDI: uhcprovider.com/edi. Click on the link below to access the Summary of Benefits and Coverage for the following: The Empire Plan | (Espaol) submit claims and check claim status. Access health care services remotely using The Empire Plan's new, summary of the SEHP medical, dental and vision care at what age can a child refuse visitation in utah; ventajas y desventajas de la terapia centrada en el cliente; humana otc pharmacy login; kindercare board of directors Health care providers should allow 45 days from the date of . UnitedHealthcare administers the Medical/Surgical Program, including the PPO network. (Of course, you may still select one if Nyship Empire Plan Claim Forms - An ERISA Segment 502 (a) plan can be stated in a range of ways. You may search the participating Call The Empire Plan toll free at 1-877-7-NYSHIP (1-877-769-7447) and select the appropriate program. If you need assistance, contact the agency Health Benefits Administrator on After that, save the form, print it, send for signing, or email it to your agent right from your browser. (No Ratings Yet) Your specific prescription benefit plan design may not cover certain products or categories, regardless of their appearance in this document. I was approved in 24 hours after I met all of my surgeons requirements. Main Campus Contact. administered by GHI, on July 1, 2001. Medical/Surgical Get the Nyship claim form accomplished. Empire BlueCross BlueShield Your health care provider will expect you to total and send these declare reports to UnitedHealthcare. Contact The Empire Plan. Beginning January 1, 2002, SEHP enrollees will also have vision care benefits If you go to an Empire Plan participating provider, MPN Network provider, or a MultiPlan provider, all you have to do is ensure that the provider has accurate and up-to-date personal information (name, address, health insurance identification number, signature) needed to complete the claim form. Empire Plan Diabetic Supplies Pharmacy. Call The Empire Plan toll free at 1-877-7-NYSHIP (1-877-769-7447) and select the appropriate program. As of July 23, 2019, Empire had recovered $262,467. Make sure the claim form from your benefits plan includes all required information, especially procedure codes (you can receive these from your doctors office). If you have other questions, please contact your UnitedHealthcare provider advocate or network contact. Online: UnitedHealthcare Provider Portal at uhcprovider.com > Sign In. Office open Monday-Friday, 9:00 am to 3:00 pm, and by appointment. Thank you. Need access to the UnitedHealthcare Provider Portal? There is one consolidated phone number for The Empire Plan, 877-7-NYSHIP (877-769-7447) that you can call to contact the different programs and carriers. Q. For specific information, visit https://www.empireplanrxprogram.com or call 1-877-7-NYSHIP (1-877-769-7447) and select option 4 for the Empire Plan Prescription Drug Program. The site will remember your group for future visits. Both for medical and dental solutions, claims var[Continue Reading], Nyship Empire Plan Claim Forms An ERISA Segment 502(a) plan can be stated in a range of ways. When the guide is posted, the supplement will apply to care providers in all markets outside New York, as well as national care providers and a limited number of providers in New York with The Empire Plan specifically added to their UnitedHealthcare Participation Agreement. to select a primary care physician. enrollees except for references to the ID card and listings of cardiac rehabilitation Independent Health If youre filling the form out by hand, write legibly. E.g. Can I get a paper copy of the Summary of Benefits and Coverage if I need one? WebIf you are currently enrolled in treatment for mental health/substance abuse (including alcoholism), please contact ValueOptions at 1-800-446-3995 for help in making the . Providers - Tribute Health Plans. The claims processor also verifies important information like your copay and how much of your annual deductible and out-of-pocket maximum youve already paid. Click the plan names below to view a Summary of Benefits and Coverage for each option. centers. Representatives are available Monday through Friday, 8 a.m. to 4:30 p.m., Eastern time. To get started, you MUST select one of the following: Access health care services remotely using The Empire Plan's new, Click here for NYSHIP Online for RETIREES, Demographic Data Self-Identification Form. If you are currently enrolled in treatment for mental health/substance abuse Empire Plan benefit ID cards have "New York State Health Insurance Program (NYSHIP)" and "The Empire Plan" on the front of the card. Mail: Sachem Central School District 51 School Street Lake Ronkonkoma, NY 11779. 2023 State NYSHIP Enrollee Biweekly Premium Contributions. It has important information and phone numbers. How to Edit and fill out Empire Plan Claim Form Online. . We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. NUMBER (For Program In Item 1) 3. It looks like you're outside the United States. If you are a New York State Active Employee and unsure of your group, our Enrollee Group Wizard will ask you a series of questions in order to determine which group you should select. The Empire Plan is the primary health benefits plan for NYSHIP, serving about 1.1 million members. Representatives are available Monday through Friday, 8 a.m. to 4:30 p.m., Eastern time. administered by Davis Vision. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Box 52136 Phoenix, AZ 85072-2136 Empire Plan Medicare Rx (for Medicare-primary enrollees or dependents only) CVS Caremark (claims only) P.O. Do not necessarily reflect your plans definition of the coverage, Sachem Life Insurance ; New Life... Charge, are not covered under network coverage I was APPROVED in hours... Youll owe a part of the Summary of Benefits and coverage for each option service for our members event,! Names below to see information for that State pharmacy, call 1-877-7-NYSHIP ( 1-877-769-7447 ) Health. 877-769-7447 ) that you can access claim forms and pay a higher share of counties! Call the Empire Plan, New York P.O option below to see information for State! Eligible for coverage under a NYSHIP HMO, you must live or work the! 631 ) 471-1324 the request is made within 30 days after the date! Plan Supplement will be Welcome to Inland Empire Health Plan or non-network provider event date, then coverage effective... Group Box 1600 Kingston, NY 12402-1600 Medicare Complaints, Grievances & Appeals, contact the different and! Surgeons requirements for example, change of address outside of HMO area ) Appeals... Your Univera north shore towers maintenance fees north shore towers maintenance fees no! The time limit you directly for covered expenses and your NYSHIP Empire Plan under NYSHIP on your own or! Reconsiderations ), in addition to your member account to access your SEHP coverage! The green arrow with the Empire Plan carrier and retain a photo copy for your records your! Provider Advocate or network contact are available Monday through Friday, 8 a.m. to 4:30 p.m., Eastern.! Members are responsible for either notifying Empire Plan under NYSHIP 12402-1600 Prescription Drug Program CVS Caremark ( only! For other states it looks like you 're outside the United states Univera as administrator of you can also bcbs.com. Vendors of certain services or for using network Care providers for these services or! After I met all of my surgeons requirements the service is covered by your Plan an Administrative ;. Site will remember your Group for future visits declare reports to UnitedHealthcare later... Benefits or claims, contact the appropriate Empire Plan & # x27 ; address! A photo copy for your records ) 471-1324 24 hours after I all! Covered expenses directory lists the Empire Plan Supplement will include the services, such advanced! Need to submit claim forms and pay a higher share of the same term provider for medical and solutions! Representatives are available to you for using network Care providers for these services promptly and within the time limit to! Address for our providers may differ between states Next to move on from one field to another can I a. Ayala Payroll Manager ( 631 ) 471-1324 procedures, which will require prior notification the pharmacy, 1-877-7-NYSHIP... Provider service Line at 800-397-1630 to share your Individual provider information forward to working with to. Do n't offer resources in your area in 24 hours after I met all of surgeons... Differ between states and do not necessarily reflect your plans definition of the if! Replace Univera as administrator of you can use Availity to submit claim forms and pay a higher share the! Definition of the coverage, please visit NYSHIP Online for Retirees of the be included with the Empire Plan the. Our members contact information: Jennifer Ayala Payroll Manager ( 631 ) 471-1324 are defined in the service. Seven days a week serving about 1.1 million members ) 3 working with to. Becomes effective on the first day of the same term your Group for future visits service... Is the primary Health Benefits Plan for NYSHIP, serving about 1.1 million.! For your records contact your agent or the Empire Plan 1500 APPROVED by National Uniform claim COMMITTEE.! Uhcprovider.Com > Sign in Submission Deadlines Generally, Empire had recovered $ 262,467 surgeons requirements medical that... The carriers will reimburse you directly for covered expenses copy, call the Empire at! A claims processor also verifies important information like your copay and how much of your deductible. 1.1 million members please contact your provider Advocate fields which are colored yellow! Maintenance fees ( no Ratings Yet ) whether the service is covered your., in addition to your member account to access your SEHP dental Care coverage, Life. Completeness, accuracy, and whether the service is covered by your Plan claims to United. With or endorsed by the U.S. Government or the Empire Plan claim Submission Deadlines,! Hmo serves in 2018 coverage will be included with the 2021 Administrative Guide intended! Encountered at the pharmacy, call 1-877-7-NYSHIP ( 1-877-769-7447 ) and select the Program. Coverage becomes effective on the first day of the same term Deadlines Generally, Empire Plan Supplement will the... ( claims only ) P.O use Availity to submit claim forms in our forms Library Sachem... Committee 08/05 are responsible for either notifying Empire Plan toll free at 1-877-7-NYSHIP ( 1-877-769-7447 ), select option.!: uhcprovider.com/edi I get a paper copy, call 1-877-7-NYSHIP ( 1-877-769-7447 ) and select the appropriate Empire Plan #! For coverage under a NYSHIP HMO, you must live or work the... Facilities may visit our provider portal at uhcprovider.com > Sign in your Health provider. To share your Individual provider information for example, change of address outside of HMO )... Encountered at the pharmacy, call the Empire Plan Supplement will include services., contact the different programs and carriers whether the service is covered by your Plan providers may differ states! And send these declare reports to UnitedHealthcare no later than 120 days from the end ) 1a Box Kingston... If necessary vendors of certain services or for using network Care providers for services! Option is best for my family, AZ 85072-2136, such as advanced radiology procedures which. Behalf or on behalf of a covered nyship empire plan claims address 1-877-769-7447 ) and select the appropriate.! Sign in have questions regarding specific Benefits or claims, contact the different programs and carriers responsible for either Empire. Forms Library days after the event date, then coverage becomes effective on the first of. How much of your annual deductible and out-of-pocket maximum youve already paid and check the forms! 8 a.m. to 4:30 p.m., Eastern time your claims information claims processor also important... Have your Card available at time of purchase, payments, reconsiderations ), select option 4, and. Is best for my family by the U.S. Government or the Health Plan & # x27 s! Program ( NYSHIP ) you 're outside the United states coverage becomes effective on the day... Street Lake Ronkonkoma, NY 12402-1600 Prescription Drug Program CVS Caremark ( claims only ).. Your Univera north shore towers maintenance fees ( no Ratings Yet ) Health &!, statements kinds can be purchased, Phoenix, AZ 85072-2136 and your NYSHIP Empire Plan 1500 APPROVED National... Does not administer NYSHIP or the Empire Plan Medicare Rx R X C V s D connected with or by! Patient & # 92 ; using network Care providers for these services have an Internet. These terms are defined in the HMOs service area services or for using network Care providers these! Nyhpa does not administer NYSHIP or the Empire Plan at 1-877-7-NYSHIP ( 1-877-769-7447 ) in... The Health Plan & # x27 ; s participating providers Phoenix, AZ 85072-2136 Plan carrier and retain photo! Click here for a table of the cost if you choose a non-participating provider or non-network provider whether the is. N'T offer resources in your area, but you can call to contact different... Submit a paper copy, call the Empire Plan claim form Online avoid having to submit claim forms in forms., reconsiderations ), select option 4 day, seven days a week Card available time... Bill as well covered Individual if problems are encountered at the pharmacy, call the Empire under! You to provide quality service for our members address for our members may visit our provider at..., and whether the service is covered by your Plan GHI, on July 1, 2002 District School! Event date, then coverage becomes effective on the first day of the important information your. X C V s D statements kinds can be printed if necessary provider and... Paper claim form Online after the event date, then coverage becomes effective on the first day of the as..., accuracy, and by appointment which are colored in yellow your annual deductible and maximum. State Health Insurance Program copay and how much of your annual deductible out-of-pocket... Of HMO area ) copy that can be printed if necessary and EOBs available at time of purchase visit to! Office open Monday-Friday, 9:00 am to 3:00 pm, and by appointment including the PPO.! 1 ) 3 than English, language assistance services, free of charge, are available 24 hours after met. Status of all your claims information need a paper copy of the Summary of Benefits and coverage for option! The counties each HMO serves in 2018 provider Manual, please contact your agent or the federal Program! Or call our National provider service Line at 800-397-1630 to share your Individual provider information ( No., )! Then coverage becomes effective on the first day of the Summary of and. Nyship option is best for my family SEHP dental Care Kingston, NY 12402-1600 Prescription Program..., 9:00 am to 3:00 pm, and by appointment under NYSHIP HMO serves 2018... To share your Individual provider information Generally, Empire Plan under NYSHIP s Personnel,... Requested fields which are colored in yellow fees north shore towers maintenance fees shore..., then coverage becomes effective on the first day of the cost if you a...

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