Use the links below to access claims information, forms, and provider tools.
If you can’t find what you’re looking for or have any questions, please contact our Provider Relations team.
Provider Relations
Phone: 315-477-9280 | Email: providerrelations@nascentiahealth.org
Claims Processing
Paper Claims:
Nascentia Health Options
P.O. Box 22008
Tampa, FL 33622-2008
Electronic Submission:
Payor ID 31626
Claims Customer Service:
(315) 477-9509
Prior Authorizations
- Prior Authorization Requirements (pdf)
- Public Reporting of Prior Authorization Metrics – Calendar Year 2025 (pdf)
Online Forms
- Electronic Remittance Advice (835) and EFT Authorization Agreement (pdf)
- Contact Information Update
- General Information Update
- Health Insurance Claim (1500) (pdf)
- New Service Provider Application
- Recredentialing Form
- Physician Attestation/Mileage Reimbursement Form (pdf)
- Physician’s Order For Personal Care/Consumer Directed Personal Assistance Services (pdf)
- Provider Compliance Program Attestation
Last Updated on March 31, 2026