At Senior Whole Health of New York, we value you as a provider in our network. That’s why we work hard to provide you with the resources you need to help care for our members.
Looking for Senior Whole Health of New York MLTC provider materials? Follow this link
PCP Behavioral Health Toolkit (available through Beacon Health)
SWH Dental Provider Manual (available through SKYGEN USA’s Provider Portal)
Pharmacy & Prescription Drug Materials
Frequently Used Forms
Guidance on Suspended Health Plan Utilization Review Requirements
The New York State Department of Health (NYSDOH) has provided guidance on suspension of health plan utilization review requirements for inpatient rehabilitation facilities, skilled nursing facilities and other health care providers.
Cost Sharing Waiver
The New York State Department of Financial Services (DFS), the New York State Department of Health, and the federal government are directing payers to waive patient copays, coinsurance and deductibles for certain testing and treatment due to the COVID-19 emergency.
New York State Coronavirus 1135 Waiver
New York State was granted a Medicaid 1135 waiver from CMS on March 26, 2020. For a complete and updated list of CMS actions, and other information specific to CMS, please visit the CMS Current Emergencies WebsiteMS Current Emergencies Website.
How to build resilience and adaptive skills during the pandemic Tips for caring for the emotional health and wellness of you and your family during these uncertain times. Learn more. If you missed the live webinar, the recording is posted here.
Optum Non-covered Indications Update (April 15, 2021)
Updates to Prior Authorization Drug List (April 1, 2021)
Optum Pre-Pay Audit FAQ for MLTC Providers (March 26, 2021)
Important Molina Acquisition Information for Providers (Feb. 22, 2021)
MLTC Payer ID and Claims Address Change Reminder (Feb. 10, 2021)
MLTC Payer ID and Claims Address Change (Jan. 29, 2021)
MLTC Payer ID Change (Jan. 19, 2021)
UM Sepsis Policy Update (Jan. 11, 2021)
Changes to Claims Processing System (Jan. 11, 2021)
Pre-Molina QNXT Pre-Payment Editing Notification (Jan. 8, 2021)
DentaQuest Transition FAQ (Oct. 29, 2020)
DentaQuest Provider Announcement (Oct. 1, 2020)
Part B Prior Authorization Drug List (Sept. 21, 2020)
October 1 Changes to Prior Authorization Requirements (Sept. 1, 2020)
Incontinence Supply Change (Aug. 17, 2020)