Welcome to MetroPlusHealth!

We’re happy to have you join us.

With a focus on primary and preventive health care for people not profit, we’ve been providing a caring, high-quality customer experience for New Yorkers since 1985.

 

Important & Urgent Notifications

October 09, 2024
Important Reminder: Model of Care Training due by 12/31/2024
October 08, 2024
Comprehensive Guidance Regarding Use of Telehealth including Telephonic Services After the Coronavirus Disease 2019 Public Health Emergency
September 23, 2024
2024 NYSDOH Breast Cancer Surgery Policy Letter
September 16, 2024
Payment Policy: E&M and Preventive Medicine Policy
September 16, 2024
Updated Foster Care Provider Education Letter
September 12, 2024
Model of Care Webinar
September 11, 2024
Managed Long Term Care (MLTC) Policy 24.01: Non-Emergency Medical Transportation and Social Adult Day Cares
September 10, 2024
End of Change Healthcare Appeal Timeframe
August 28, 2024
Status Update of OASAS Part 822 Comprehensive Outpatient Treatment Program (COP)
getty-images-9WRVm5y6mio-unsplash

Already part of our network?

The Provider Portal is your one-stop shop for:

  • Checking member eligibility and authorization statuses
  • Tracking submitted claims
  • Accessing information like orientation materials, benefit changes, and membership rosters
  • Procuring membership and utilization reports
  • Browsing provider performance profiles and diagnosis code lists
  • And more!

Change Healthcare (CHC) Outage Updates

Change Healthcare was the target of a cyberattack on February 21 that disrupted a number of its services and systems. To address the outside threat, Change Healthcare took immediate action, including disconnecting internal systems to safeguard sensitive information and prevent further impact. Change Healthcare is carefully monitoring the situation and will provide updates on efforts to resolve the threat and return to normal operations. In the meantime, providers should be aware of the following key impacts.

MetroPlusHealth is here to help you.

We exist to serve the community. That means helping providers like you deliver the best health care in the city while growing your business along the way.

How large is the MetroPlusHealth network?

Our network is always expanding! But to date, our network includes more than 34,000 providers like you, 40 hospitals, 110 urgent care centers, and 500 local and national pharmacies. Our Provider Search is a great place to get specifics.

What is the billing process?

We accept both electronic and paper-based claims. Log into the Provider Portal to any time.

What does the reimbursement process look like?

Both capitation and fee-for-service claims have to include a detailing of all services rendered within 90 days of the date of service. We ask our providers to kindly allow 30 days for the reimbursement of electronic claims and 45 days for the reimbursement of paper claims.

What does the authorization process look like?

We issue an Explanation of Payment (EOP) for every claim and adjustment regardless of whether payment or denial. Our EOPs offer a summary of payment or denial information for each billed service.

How many specialists are in network?

Our network is comprised of over 34,000 providers and specialists.

How many hospitals are in network?

There are more than 40 hospitals and urgent care centers in our network including NYC Health + Hospitals, NYU Langone, Mt. Sinai, CityMD, Montefiore, Labcorp, Lenox Hill Radiology, and more.

last updated: June 20, 2024

Become a Provider

Sign up in a New York minute.

Find it. Do it. Faster.

Already A Provider?

Talk To Us About Any Questions or Concerns

Monday–Friday | 8 a.m.–6 p.m. (ET)