Announcements
Public Health Requirements and Recommendations
The Compendium of Public Health Requirements and Recommendations includes guidelines for the prevention, diagnosis, and management of diseases.
CenterCare Reduces Number of Services that Require Pre-Authorization
CenterCare will no longer require pre-authorization for chemotherapy administration, radiation therapy, dialysis, and most ambulatory surgery procedures with dates of service beginning April 1, 2008 that occur in the office, hospital outpatient or free standing surgical center.
CenterCare Claims Editing Software
CenterCare utilizes TriZetto's Claims Editing Software to automatically review and edit health care claims submitted by physicians and facilities.
Electronic Claims Submission Expedites Reimbursement Process
Important News for CenterCare Providers
National Provider Identifier: Know the facts and submit your information.
The NPI is the standard unique health identifier for health care providers. The NPI will replace the use of all legacy health care provider identifiers in standard transactions as of May 23, 2007.
NPI Contingency Plan
Effective May 23, 2007, HIPAA covered transactions must use the mandated NPI. The use of NPI is required by HIPAA regulation; failure to do so will delay reimbursement. Covered entities who can demonstrate good faith effort are eligible to participate in a contingency plan.
Options
Provider Manual
The answers to most questions can be found in our Provider Manual. Simply click on the appropriate topic to discover the information you need. Our manual also includes comprehensive information regarding our Child/Teen Health Program for those providers who are involved in pediatric care for Medicaid members under the age of 21.
Policy Updates
Periodically, CenterCare issues Policy Updates. Here you will find the latest changes, recommendations and guidelines regarding your CenterCare contract. If you cannot find an answer to your question or if you wish further clarification about a specific policy or procedure, please call our toll-free Provider Line at 1-800-545-0571.
Quality Management
Presents issues regarding quality management, including the Quality Assurance Reporting Requirement of New York State, the Quality Incentive Program, and the BabyCare Incentive Program.
Newsletters
Articles on medicine, policy, services, referrals, billings, procedures, benefits, services, and Fidelis Care.
CenterCare Formulary
CenterCare Provider Formularies
Provider Education and Resources
Provider Education offers physicians and other healthcare providers articles, newsletters and the latest information on a variety of medical topics.
Provider Transportation Application
CenterCare New York Provider Transportation Application For Members