Affinity Health Plan

    • Customer Service Hours

      New Customer Service Hours

      Affinity changes its hours of operation, effective January 1, 2014.

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    • New Providers

      Affinity expands Provider Network

      We've added Mt. Sinai to our Health Insurance Marketplace Plan provider network, and expanded our partnerships with NY-Presbyterian and Hospital for Special Surgery.

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    • Insurance Marketplace Fact Sheet

      Health Insurance Marketplace

      Fact Sheet for Providers: What you need to know

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    • Medicare expanded coverage

      Our Medicare community is expanding!

      Affinity now offers Medicare Advantage programs to residents of Nassau, Suffolk, Westchester, Rockland and Orange counties.

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    • MRT - New benefits

      Important Update

      These services are now included as part of the Affinity Medicaid Managed Care benefit package.

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    • Authorization changes

      Authorization Changes

      Affinity Health Plan is changing its authorization guidelines for Occupational Therapy, Physical Therapy, Speech Therapy, Durable Medical Equipment (DME) and ambulatory surgery to help streamline our processes.

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  • Join our community of health providers

    Affinity partners with its provider network to improve the health of underserved populations. As our Mission states, “[Together], we strive to improve care-seeking and care-giving.” Providers interested in joining our network will find useful information about Affinity. You can get helpful details about submitting claims, learn about special programs we offer, and receive answers to frequently asked questions. Contracted Affinity providers can use our Web portal to check Member eligibility and claim status, look up Affinity providers for referrals and more.

    Click here for more information on joining our network.

    Has your contact information changed? Let us know!
    If you are a current provider, you can update your address, phone or fax number, or other contact information by completing and returning our Provider Information Update Form.

    Keeping you informed
    Affinity is committed to nurturing a fruitful relationship with its network providers. Our provider relations, contracting & credentialing unit engages with participants in our provider network to keep you informed about our policies, procedures, requirements and expectations. Field representatives make regular site visits to address administrative concerns of physicians and medical office staff. We always strive to streamline and simplify your transactions with us. 

    Affinity Health Plan’s Compliance Training
    The Centers for Medicare and Medicaid Services (CMS) guidelines require that we provide annual training on select topics related to public health programs.

    • Fraud, Waste, and Abuse (FWA): The FWA module encompasses key requirements related to the detection, prevention, correction, and reporting of fraud, waste, and abuse. All personnel/entities that qualify as a First-Tier, Downstream, or a Related Entity (“FDR”) must receive this annual training.
    • Special Needs Plan Model of Care (SNP MOC): The SNP MOC module covers metrics designed to improve Members’ access to medical, social, and mental health services and transitions of care across health care settings. All personnel/entities that are part of Affinity’s provider network must receive this annual training.

    For the SNP MOC and FWA training modules, click here.

    Contacts
    For general concerns, please contact our customer service staff at 1.866.247.5678. For specific issues, you may reach us at one of these numbers:

    Provider Relations: Bruce Waugaman, Director: 718.794.7183

    Contracting: Ajhezza Gonzalez, Director: 718.794.3128

    Here are other Affinity departments who serve our provider network.