Atlantis Health Plan - Provider's Section (provider faq's)


		Provider Relations FAQ Frequently Asked Questions for Provider Relations Does Atlantis pay its providers through capitation or fee for service? How long does it take to become a provider in the Atlantis Network? Is there a fee to join the provider network? How quickly are claims processed? Are there referral forms to be filled out? Do I need to precertify procedures, or get authorization before performing a service? Do you have a Provider Directory? Do you have many hospitals in the network? Does Atlantis pay its providers through capitation or fee for service? We pay fee for service for all of our network providers. Back to the Top How long does it take to become a provider in the Atlantis Network? We are able to process provider applications within 45 days of receipt of a complete application. Back to the Top Is there a fee to join the provider network? No. Providers can participate in our network at no cost. Back to the Top How quickly are claims processed? Atlantis is processing claims within 15 days of receipt of a clean claim. More information about our claims submission and processing procedures can be found on page 16 of our Provider Manual. Back to the Top Are there referral forms to be filled out? Yes. All Primary Care Physicians should utilize Atlantis Health Plan Referral forms when referring members to specialists. More information about our referral process can be found on page 19 of our Provider Manual. Back to the Top Do I need to precertify procedures, or get authorization before performing a service? Yes. Some procedures require that you contact Atlantis for pre authorization prior to treating the member. Details about our precertification process can be found on page 22 of our Provider Manual. A complete listing of the procedures that require pre authorization can be found on pages 41-44 of our Provider Manual. Back to the Top Do you have a Provider Directory? Yes. You may access our provider network information through our provider search function, available on line. Back to the Top Do you have many hospitals in the network? Yes. We have most of all the major hospitals under contract in NYC and the surrounding counties, and our provider network is expanding rapidly. You can access a list of the contracted hospitals by using our provider search function, available on line. Back to the Top

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