Use the links below to find helpful documents, forms and other resources.
If you can’t find what you’re looking for, or have any questions or concerns, please contact our Provider Relations Team.
Provider Relations:
Phone: 315-477-9280
Email: providerrelations@nascentiahealth.org
Claims Processing
Claims Processing
Paper Claims:
Nascentia Health Plus
P.O. Box 981814
El Paso, TX 79998-1814
Electronic Submission:
Payor ID 45529
Claims Customer Service:
315-477-9509
Electronic Remittance Advice (835) and EFT Authorization Agreement
Electronic Remittance Advice (835) and EFT Authorization Agreement
Download the Electronic Remittance Advice (835) and EFT Authorization Agreement (pdf). Please complete all applicable sections.
Submit a copy of your W-9 with this completed form to us:
- through secure encryption to spenddown@nascentiahealth.org
- or mail the completed form to:
Nascentia Health
Attn: Claims Manager
1050 West Genesee St
Syracuse, NY 13204
Exception Request Form
Exception Request Form
Download the Exception Request Form
Medicare Advantage Waiver of Liability Statement
Medicare Advantage Waiver of Liability Statement
Download the Medicare Advantage Waiver of Liability Statement (pdf)
Model of Care Training
Model of Care Training
Nascentia Health Plus Model of Care (MOC) provides the basic framework under which our plan meets the needs of our enrollees. The MOC is a key quality improvement tool and essential element in ensuring that the unique needs of each of our enrollees are identified and addressed through our care management practices.
Complete Model of Care Training
Nascentia Health Plus Overview
Nascentia Health Plus Overview
The mission of Nascentia Health is to be the premier home and community-based care system for the regions we serve. As such, we hold ourselves to the highest standard of excellence as a healthcare leader and promise to deliver exceptional care. At the heart of Nascentia are the people who define our healthcare system and who make positive results possible. We take pride in our work and in helping the people we serve.
To learn more about Nascentia Health Plus, download the Nascentia Health Plus Overview (pdf).
Prior Authorizations
Prior Authorizations
Prior authorization is not required for emergency or urgent care.
To request prior authorization, please submit your request via fax or phone:
- Referrals Department: 1-800-477-0090
- Outpatient Authorizations Fax: 1-315-870-7788
- Inpatient Admissions Fax: 1-315-870-7788
A Prior Authorization is not a guarantee of payment; Payment is subject to member eligibility and benefits at the time of service.
The Medical Management Department will notify you of their decision by secure email, mail or phone.
- Download the Prior Authorization Requirements (pdf), updated 1/1/2024.
- Download the Prior Authorization Request Form (pdf).
Provider Manual
Provider Manual
This Provider Manual serves as a supplement to the Nascentia Health Provider Services Agreement concerning the management and care of Nascentia Health Plus members. The information contained within this manual is a reference tool that contains eligibility, benefits, policies, procedures and contact information for services provided and administered through Nascentia Health Plus.
Download the Nascentia Health Plus Provider Manual (pdf)
Provider Portal
Provider Portal
Visit the Nascentia Health Provider Portal
Summary of Plan Benefits
Summary of Plan Benefits
- Summary of Benefits – Nascentia Dual Advantage (D-SNP) (pdf)
- Summary of Benefits – Nascentia Skilled Nursing Facility (I-SNP) (pdf)
Last Updated on April 3, 2024
