IMPORTANT UPDATE: We are in receipt of NYS Dept of Financial Services Insurance Circular Letter 17Open a PDF issued December 23, 2020 and will follow the provisions of the state guidance as it applies to our health plan. Please refer to our communication for additional details.
Learn how to use our new CareAdvance tool with training materials located on our website under Resources > Staff Training > Presentations & Guidebooks. For additional information view FAQ's Open a PDF. If you have any questions, please contact your Provider Relations Representative.

Authorizations

  • Please review the eMedNY website for benefit coverage of specific codes prior to submitting a preauthorization request for MMC or HARP members.

The medical services including provider administered drugs below require prior review by the plan to determine clinical medical necessity.

Referral & Authorization Guidelines

New to CareAdvance Provider? | CareAdvance Provider FAQ'sOpen a PDF | Admission Procedures Now AvailableOpen a PDF

Univera Healthcare MyHealthSM, Child Health Plus and MyHealth PlusSM