Provider Tools
The MetroPlusHealth Provider Tools page is your go-to resource for managing patient care efficiently and effectively. From checking member eligibility and submitting claims to accessing authorization forms and policy updates, our suite of digital tools is designed to support your day-to-day workflow. Whether you’re a primary care provider, specialist, or facility, MetroPlusHealth is committed to making it easier for you to deliver quality care with the right tools at your fingertips.
New York State Department of Health Updates:
Provider Access and Availability Standards
Partnership in Care Rewards Program
Tell your patients living with HIV about the MetroPlusHealth Rewards Program. Your patients enrolled in Partnership in Care can get rewarded for health screenings and activities. There is even a substantial reward just for attending clinic appointments for their HIV care. Learn more about the program here.
Self-Disclosure Notification Protocol
The Office of Mental Health (OMH) is informing Providers of their responsibility to notify OMH when a self-disclosure of a Medicaid overpayment is made to the Office of the Medicaid Inspector General (OMIG) using the Full Self-Disclosure Process.
Medicaid providers are required to report, return, and explain any overpayments they have received to the OMIG Self-Disclosure Program within sixty (60) days of identification, or by the date any corresponding cost report was due, whichever is later. Upon receiving this notice, the OMH Medicaid Compliance Office will review and issue a statement confirming that the oversight agency has been notified.