• Save time with these useful features

    • qualityReports
      Quality Reports
    • memberEligibility
      Member Eligibility
    • claimsStatus
      Claims Status
    • memberClinicalProfile
      Member Clinical Profile

  • For Us, It's You First!

    • New Self-Service Negative Balance Tool

      New Self-Service Negative Balance Tool

      Affinity has added a new self-service tool that enables providers and their staff to generate negative balance reports and reduction history details for specific time periods. A negative balance occurs when a claim is adjusted to reduce the original payment, creating a balance due to Affinity. Providers can review which claims were reduced to cause a negative balance. You can find this tool on Affinity’s provider portal home page under the claims tab.
    • Affinity’s Shared Savings Program

      The Affinity Health Plan Shared Savings Program is designed to create greater alignment between Affinity and its participating providers in the areas of quality of services and cost effectiveness provided to members. The objectives of the program are for participating providers to earn incentive payments based on their level of quality achieved and level of shared savings generated. The Shared Savings Program is part of New York State Department of Health’s Value Based Payment requirement.
      Affinity’s Shared Savings Program
    • Claims Reconsideration Tool Online Now!

      Claims Reconsideration Tool Online Now!

      Affinity Health Plan will now be accepting claim inquires on our provider portal.

      By sending claims through the provider portal, providers may: Submit reconsideration requests and upload related documents online anytime. Reduce overall turnaround request time by eliminating mail delays. Receive immediate confirmations and tracking numbers. Check statuses online anytime.

    • New Appeals Tool is Live!

      Affinity Health Plan now accepts medical necessity appeals on our provider portal.

      Providers can submit medical necessity appeals and upload medical records and supporting documents anytime. The overall turnaround request time may be reduced, and providers will receive immediate confirmation of receipt and an email with an appeal reference number. Providers will be able to view appeal statuses at any time.

      This new option can be found on the provider portal home page under the authorizations tab.

      New Appeals Tool is Live!