Atlantis Health Plan

Products Healthy New York Benefit Summaries Riders Rx Plans Forms Employer Information Eligibility Requirements Waiting Period Important Info Administrator Handbook Contact Us Clinical Review Criteria

Cabrini Medical Center Closing
Important Network Change
Timothy’s Law
Pharmacy Transition
Track Your Mail Order Prescription Packages

Cabrini Medical Center Closing

Cabrini Medical Center has closed effective March 14, 2008 and is no longer accessible to Atlantis Health Plan members.

Atlantis Health Plan members will continue to have access to hospital services through the 8 facilities in the New York City area that continue to participate in the Atlantis Health Plan provider network*.

Beth Israel Medical Center/Petrie Div. Provider ID: 9H0042 First Ave. At 16th St. New York, NY 10003 Phone: (212) 420-2000	St. Luke's Roosevelt Hospital Center Roosevelt Div. Provider ID: 9H0020 1000 Tenth Ave. New York, NY 10019 Phone: (212) 523-4000
Lenox Hill Hospital Provider ID: 9H0074 100 East 77 St. New York, NY 10021 Phone: (212) 434-2000	St. Luke's Roosevelt Hospital St. Luke's Div. Provider ID: 9H0020 1111 Amsterdam Ave. New York, NY 10025 Phone: (212) 523-4000
Manhattan Eye, Ear, and Throat Hospital Provider ID: 9H0048 210 East 64 St. New York, NY 10021 Phone: (212) 838-9200	St. Vincent's Hospital Manhattan Provider ID: 9H0084 153 West 11 St. New York, NY 10011 Phone: (212) 604-7000
New York Downtown Hospital Provider ID: 9H0094 170 William St. New York, NY 10038 Phone: (212) 312-5000	The New York Eye & Ear Infirmary Provider ID: 9H0150 310 East 14th St. New York, NY 10003 Phone: (212) 979-4000

*For emergency care, please go to the nearest facility, participating or non-participating.

If you need help locating a new provider, please call Atlantis Member Services at 866-747-8422 for assistance. We would be happy to help you locate a provider that best suits your needs.

If you will require ongoing care after March 14th, please call Atlantis Member Services at 866-747-8422.

If you have questions, or if you have been scheduled for a procedure or admission after this date, please call Atlantis Member Services toll-free at 866-747-8422.

Important Network Change

Dear Atlantis Health Plan Member:

We would like to make you aware of an important change to our provider network.

Effective May 31, 2007: Bronx Lebanon, Bronx Lebanon Provider Group, and the Bronx Lebanon affiliated outpatient facilities will no longer participate in the Atlantis Health Plan provider network.

Atlantis Health Plan members will continue to have access to hospital services through the 38 acute care facilities located in our service area that continue to participate in the Atlantis Health Plan provider network. Of those facilities, there are 4 participating hospitals in the Bronx:

Montefiore Medical Center/Henry
and Lucy Moses Div.
111 East 210th St.,
Bronx, NY 10467
(718) 920-4321 Our Lady of Mercy
Medical Center
600 E. 233rd St., Bronx, NY 10466
(718) 920-9000

Montefiore Medical Center/Jack D.
Weiler Div.
1825 Eastchester Rd.,
Bronx, NY 10461
(718) 904-2000 St. Barnabas Hospital
4422 Third Ave.,
Bronx, NY 10457
(718) 960-9000

*For emergency care, members should go to the nearest hospital.

If a member is in an ongoing course of treatment at the facility or with a Bronx Lebanon provider after May 31st, please call Atlantis Member Services at 866-747-8422. The Plan allows the member to continue in an ongoing course of treatment with this provider for a transitional period of up to 90 days from May 31, 2007; or, if the member has entered the second trimester of pregnancy, for a transitional period that includes the provision of post-partum care directly related to the delivery at the hospital. The member, their designee, or you should call Atlantis Member Services at 866-747-8422 to request such transitional care. Please note that the provider must agree to certain requirements for Atlantis to approve this request.

Timothy's Law

Dear Atlantis Member,

On January 1, 2007, New York State legislation known as "Timothy's Law" was enacted. The purpose of this notice is to briefly describe Timothy's Law and how it impacts your benefits with Atlantis Health Plan.

Timothy's Law changes the coverage requirements for the diagnosis and treatment of mental, nervous or emotional disorders under most group health insurance policies and contracts. The following is a summary of these changes.

Large Groups (group with more than 50 eligible employees):

Timothy's Law requires no less than 30 days of inpatient care and 20 days of outpatient care per calendar year for mental health services. Your current plan with Atlantis already includes these benefits; therefore you will experience no change.
Your coverage now includes benefits comparable to your medical benefits for the treatment of adults and children with biologically based conditions such as schizophrenia/psychotic disorder, major depression, bipolar disorder, delusional disorders, panic disorder, obsessive compulsive disorder, bulimia and anorexia.
Co-payments for outpatient mental health services are now the same amount as your office co-payment for specialists. Please refer to your summary of benefits for the office co-pay amount. A new summary of benefits will be mailed to you shortly.

Small Groups (under 50 eligible employees and associations)

Timothy's Law requires no less than 30 days of inpatient care and 20 days of outpatient care per calendar year for mental health services. Your current plan with Atlantis already includes these benefits; therefore you will experience no change.
Co-payments for outpatient mental health services are now the same amount as your office co-payment for specialists. Please refer to your summary of benefits for the office co-pay amount. A new summary of benefits will be mailed to you shortly.
Small Groups will have the option to purchase a rider that will include benefits comparable to your medical benefits for the treatment of adults and children with biologically based conditions such as schizophrenia/psychotic disorder, major depression, bipolar disorder, delusional disorders, panic disorder, obsessive compulsive disorder, bulimia and anorexia. Information on how your group can purchase this rider will be mailed to you shortly.

Because of the very short time frame between when the law was signed and when it took effect, we are not able to develop the necessary formal amendments to your contract and summary of benefits. However, you may be entitled to benefits right now even without formal change to your contract. You can find out more about your new benefits by calling your broker or Atlantis Member Services at 866-747-8422.

Sincerely,

Atlantis Health Plan

Note: Timothy's Law applies to POS and HMO group members only. It does not apply to members enrolled in Healthy New York and Direct Pay products.

Pharmacy Transition

As of January 1, 2007, Atlantis Health Plan’s pharmacy benefits will be transitioned to Catalyst Rx. Members will be receiving transition cards through December 31st. Please note Catalyst Rx Bin number is 005947. This number will be needed to secure prescriptions. To view a sample of the transition cards click here. If you do not receive your cards prior to January 1st, please call Catalyst Customer Service number at 1-888-341-8570.

Track Your Mail Order Prescription Packages

Effective July 1st, 2008, IPS will be providing delivery confirmation on all packages delivered via the United States Post Office; this is in addition to the confirmation already provided on parcels sent via UPS. This added feature will allow members to track packages through the postal system, and verify delivery status. This status can be checked via IPS’s website at www.ipsrx.com for any member who has registered as a Member Services user. Members without access to IPS’s web-site can call an IPS Customer Service Representative at 1-800-233-3872 for status updates.