DD Provider FAQ
& Reference Guide
For additional questions or assistance from the Network Development and Provider Relations team, please visit the Provider Assistance page and complete a Provider Ticket Submission Form.
Frequently Asked Questions
PHP will notify all DD providers that are associated with an enrolling or disenrolling member based on the member’s TABS report. An email will be sent to your agency before the first of the month in which the member is enrolling or disenrolling.
This notification will also provide helpful information about the members’ PHP plan and billing information for your agency. If you believe your organization is not receiving these notices, please contact Provider Relations for assistance here.
Please allow Care Managers reasonable time to respond to requests. For routine, non-urgent issues, expectations are that you should receive a response within 2 business days. If you do not receive a response within the expected time frame, please use the Care Management chain of command.
All Care Managers have their supervisor’s name and contact information listed in their email signature for ease of knowing who to contact.
You can call PHP’s Provider Services line at 855-747-5483 for this information.
PHP has a warm handoff process which includes the new Care Manager reaching out to providers to introduce themselves and connect with the team supporting the person supported. If you are unsure if a Care Manager change has occurred, please contact PHP's Provider Services line for assistance in identifying the current Care Manager.
PHP Care Managers are not available after business hours. Please wait for the following business day or call PHP's Nursing Advice Line at 1-855-769-2507 regarding any behavioral or medical concerns. The nursing advice line is available 24 hours a day, 365 days a year.
Partners Health Plan has 3 Regional Care Manager Directors:
Renata Goldman (Westchester, Rockland, NYC)
Giselle Peter (Brooklyn, Manhattan, Staten Island, and Queens)
Jennifer Rechner (Nassau, Suffolk, NYC)
PHP Care Managers will contact the member and/or their advocate monthly.
We encourage all providers to request Medisked portal access to view and approve plans. To request access please email
PHP’s Provider Search Tool is available on the PHP website. This search tool allows a person to search for healthcare providers, dentists, pharmacies and more. If further assistance is needed in finding the right provider, please contact Provider Relations here.
Please contact the member’s Care Manager.
Please contact the member’s Care Manager.
PHP Care Managers are responsible for comprehensive person-centered planning, including coordinating services and support for individuals they support. Knowing what preventive healthcare a person has received is a critical component of understanding supports that may be needed. Additionally, Care Managers receiving the appropriate documentation assures care has been rendered and allows the Care Manager to assist with any needed follow-up.
For more information on billing and claims submissions, please use this link to learn about your organization's claim submission options and general guidelines. PHP’s FAQ and Reference Guide also has helpful information specific to claims submissions. Lastly, Provider Relations can assist you with any questions. Reach out to Provider Relations here if needed.
For assistance with any provider-related questions or concerns, please complete the Provider Relations Help form on our website linked here. Once the form has been submitted, a Provider Relations team member will get back to you shortly. Please include as much detail on the ticket submission request as possible so our team can provide you with the most timely and thorough feedback.
PHP’s Provider Relations team is happy to share any program opportunities, workshops, or other relevant information with our Care Management teams. Please reach out to Provider Relations using this link to share any information you feel will be beneficial for PHP’s Care Management team and members. The Provider Relations team can also discuss any further information-sharing opportunities with your organization as needed.
Quick Reference Guide
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Provider Relations
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Provider Services:Member Eligibility • Claim Inquiries • Benefit Coverage
Phone: 855.747.5483
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CredentialingInquiries • Demographic Updates
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Utilization ManagementPrior Authorizations
Phone: 1-855-769-2508
Fax: 1-855-769-2509
Mail: P.O. Box 240356
Apple Valley, MN, 55124Authorization Requirements: Visit the Authorizations & Appeals page.
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Prescription DrugsCoverage Determinations • Inquiries
Phone: 1-888-648-6759
Fax: 1-858-790-7100
Mail: 10181 Scripps Gateway Court
San Diego, CA 92131Formulary: Visit the Formulary page.
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Provider PortalMember Eligibility • Claim Status
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Claims SubmissionPaper • Electronic/EDI • Web-based
Visit the Billing & Claims information page.
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Pre-Certification / Utilization Management
Phone: 855.769.2508
Fax: 855.769.2509. -
Optum Submitter ID
Submitter ID: 14966
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Provider Demographic/ Information Updates
Submit provider demographic updates to Provider Relations via the email box listed above.
Need Provider Assistance?
The Partners Health Plan Network Development and Provider Relations team is here to assist you with your billing, claims, authorization, education, and any other general inquiry. Use the Contact Us button below to complete a Provider Ticket Submission Form.
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