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Provider Resources

Billing and Claims

Billing and Claims are made easy with Partners Health Plan.

Submit a Claim

To ensure prompt adjudication, please remember to send all claims to PHP using one of the following options: 

  • By Mail:

    Partners Health Plan
    P.O. Box 16309
    Lubbock, TX 79490

  • Electronic Submission:

    Set up electronic claims submission thorough 
    Change HealthCare EDI Claim Submission 

    • Change HealthCare Submitter ID: 14966
    • Change HealthCare / Phone: 888-363-3361 (Note: a fee will be charged for setting up electronic claims submission online)
    • You may also call HealthSmart Clearinghouse at 888-744-6638 to set up the electronic claim submission (free of charge).
  • Web-based Claims Submission:

    Providers can now easily create and upload a professional or institutional single claim as a pdf file via the provider portal (php.healthsmart.com). 

    • Web-based claims are considered paper claims and will follow all existing claim submission protocols.
    • Please note that only valid claim forms (CMS 1500 or UB 04) may be uploaded using this method.

Billing and Claims Reminders

PHP would like to remind our providers of the ease of establishing and submitting claims electronically. In addition, we would like to also remind everyone to regularly confirm with their billing service (Clearinghouse) that all electronic submissions have been successfully transmitted and received. If the claim is not successfully transmitted, there will be delays in PHP’s ability to adjudicate the claims on a timely basis. Please check all error logs and resubmit the claim accordingly – timely filing rules still apply for resubmissions.


Balance Billing is not Permitted: Please be reminded that under New York State Law, a Provider participating in the Medicaid program, or a Medicaid Managed Care plan, is prohibited from requesting any monetary compensation from a Medicaid beneficiary, or their responsible relative.  In addition, a Medicaid beneficiary, including a Medicaid managed care member, must not be referred to a collection agency for collection of unpaid medical bills or otherwise billed.

Claims and Billing Submission Guidelines

EDI Enrollment Packet

Overpayment Refund Notification Form

Waiver of Liability Form

ECHO Payment FAQ

Provider FAQ & Quick Reference Guide

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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Contact Us
  • Partners Health Plan
  • 2500 Halsey Street
    Bronx, NY 10461
  • (855) PHP-LIVE or (855) 747-5483
  • TTY:711
  • 8am-8pm, 7 days a week

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855-747-5483 | TTY/TDD:711
Partners Health Plan is a managed care plan that contracts with Medicare and the New York State Department of Health (Medicaid) to provide benefits to Participants through the Fully Integrated Duals Advantage for Individuals with Intellectual and Developmental Disabilities (FIDA-IDD) Demonstration.

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The State of New York has created a Participant Ombudsman Program called the Independent Consumer Advocacy Network (ICAN) to provide participants free, confidential assistance on any services offered by Partners Health Plan. ICAN may be reached toll-free at 1-844-614-8800 (TTY users call 711, then follow the prompts to dial 844-614-8800) or online at icannys.org.