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Write Us:
Partners Health Plan
2500 Halsey Street
Bronx, NY 10461

Call Us:
(855) 747-5483
TTY:711
8am-8pm, 7 days a week

For more information about enrolling in the
PHP Care Complete FIDA-IDD Plan

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Provider Assistance Mobile Code


Provider Ticket Submission Form
First Name  
Last Name  
Email  
Phone  
Provider/Agency Name  
Provider Tax ID  
Agency / Provider Type   
Region   
Category   
Subject  
Description of Assistance Need   
Priority   
Attachment   
Attach files
Each of your file(s) can be up to 20MB in size.
   
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Internal Provider Assistance Mobile Code

Internal Provider

Assistance

Please submit the form below to contact Provider Relations for assistance.  Required fields have a red line at the beginning of the field. Please fill out the form to the best of your ability with as much information as possible. Not all fields may apply to your request.

Assistance Category Definitions & Notes:

  • Provider recruitment requests – Ask non-par provider to join network

  • Single Case Agreement requests – CM sends provider/services needed for SCA

  • Provider information update – Provider information incorrect on provider file/search tool (phone number, address, services rendered, etc.)

  • Provider needs re-education – Par provider advises member/caregiver/CM that they are non-par

  • Claim or authorization issue – NDPR should only get these from providers, but in the case where a CM is informed of an issue related to a claim or auth, they can file it here

  • Directory assistance – This should only be used after reviewing provider directory and exhausting NDPR SharePoint resources

  • General inquiry/information only – miscellaneous

Internal Ticket Submission Form
Submitter First Name  
Submitter Last Name  
Submitter Email  
Submitter Phone  
Category   
Subject  
Description of Assistance Need   
Agency Type   
Region   
Provider Specialty  
Provider Name  
Provider Phone  
Member Name  
Member ID  
Member Date of Birth   
Member Phone  
Priority   
Attachment   
Attach files
Each of your file(s) can be up to 20MB in size.
   
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2-Person Care Team

Plan Benefits

2-Person Care Team

You can live with care, respect & dignity with Partners Health Plan’s 2-person care team that supports your goals & dreams!

See More Benefits

Man and woman standing behind older woman in wheelchair.

The 2-person care team is...

...an important part of your support system and helps coordinate appointments, equipment and activities that align with your goals.

Partners Health Plan currently employs a two-person Care Coordination Team model as part of its comprehensive managed care plan to cover health and IDD services for individuals with developmental disabilities and their families. 

The 2-person care team consists of a Qualified Intellectual Disabilities Professionals (QIDP) as the Care Manager, and a Licensed Health Professional as the Clinical Team Leader (CTL).  

How can you enjoy a 2-person Care Team? The Care Coordination Team model is employed for all PHP Care Complete FIDA-IDD Plan members. Members can contact their care team for more information. 

H9869_PHPWeb_2-Person Care Team_2022_Pending

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Photo Upload and Consent Form

Photo Upload and Consent Form

Submit A Photo To Accompany Your Story! Upload Your Photo And Complete And Sign The Media Release And Authorization Form Below.

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