Provider Information & Forms

Below is a list of printable forms and information for our provider’s convenience.

Compliance & Fraud, Waste & Abuse (FWA) Guide & Attestation

Provider Quick Reference Guide

Provider Manuals

 PLEASE NOTE:  FIDA plan will no longer be offered effective Jan 1, 2019.  Claims will still be submitted as appropriate. as appropriate

For a copy of the manual, please contact Provider Relations |  718-484-5000 |  providers@agewellnewyork.com

Provider Contact and Change Status Forms

Wellness and Prevention Form

Opioids

HEDIS Guide

LHCSA Responsibilities

Provider Newsletters

Balance Billing