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Atlantis Outpatient Centers


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Submitting Claims

Atlantis Health Plan is a pre-paid managed care plan. Accordingly, most claims for services will be paid directly by Atlantis Health Plan. Because of this process, you will probably never receive a bill for appropriately referred medically necessary covered services. However, there are some instances where you or another group health plan is responsible for the bill. Examples of these instances follow:

  1. If Atlantis Health Plan is not the primary insurance carrier as more fully described in the Coordination of Benefits section of your Subscriber Contract.
  2. If you receive services which are not covered by Atlantis Health Plan as more fully described in the Exclusions and Limitations section of your Subscriber Contract.
  3. If you receive services, or care from a doctor or hospital (when the situation is not an emergency) without obtaining a referral first.
  4. If you receive care in an emergency facility in your service area when it was not an emergency, or if you receive follow-up care as a result of an emergency when the follow-up care was not authorized by your Primary Care Physician.
Should you receive a bill which you feel is Atlantis Health Plan's financial responsibility even after reviewing the above listed examples, please send it to us clearly marked with your name and Atlantis Health Plan identification number for payment consideration to the following address:
Atlantis Health Plan
PO Box 873
Bowling Green Station
New York NY, 100274-0873
Be sure the bill contains the name and address of the provider of services, the nature of the emergency and the date and amount billed for each service.

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