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Providers > FAQ's

Frequently Asked Questions for Provider Relations

  1. Does Atlantis pay its providers through capitation or fee for service?
  2. How long does it take to become a provider in the Atlantis Network?
  3. Is there a fee to join the provider network?
  4. How quickly are claims processed?
  5. Do I need to precertify procedures, or get authorization before performing a service?
  6. Do you have a Provider Directory?
  7. Do you have many hospitals in the network?
  8. How can providers assist members in saving on copayments by prescribing generic prescriptions through the Atlantis Generic Mail Order Pharmacy?

Does Atlantis pay its providers through capitation or fee for service?
We pay fee for service for all of our network providers.

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How long does it take to become a provider in the Atlantis Network?
We are able to process complete provider applications within 45 days of receipt.

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Is there a fee to join the provider network?
No. Providers may participate in our network at no cost.

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How quickly are claims processed?
Atlantis processes claims within 30 days of receipt of a clean claim submitted by EDI and 45 days of receipt of a clean claim submitted by paper (HCFA1500). More information about our claims submission and processing procedures can be found on page 14 of our Provider Manual.

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Do I need to precertify procedures, or get authorization before performing a service?
Yes. Certain procedures require that you contact Atlantis for pre-authorization prior to treating the member. Details about our pre-certification process can be found on your Quick Reference Pre-Authorization Guide. This list is updated by the plan from time to time. To request the most current list, please call Member Services Department at 1-866-747-8422.

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Do you have a Provider Directory?
Yes. You may access our provider network information through our provider search function, available on line.

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Do you have many hospitals in the network?
Yes. We have most of 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.

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How can providers assist members in saving on copayments by prescribing generic prescriptions through the Atlantis Generic Mail Order Pharmacy?
Providers can help members access our $0 copayment generic prescription drug program by submitting through Atlantisí Generic Mail Order Pharmacy, HealthWarehouse.com. The ordering process is fast and easy. To take advantage of this valuable service, you and/or your Atlantis patient must complete the HealthWarehouse Generic Mail Order Form. For more information on the program and to access the HealthWarehouse Generic Mail Order Form please visit the following link: HealthwarehouseIntro_Web.pdf

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