Provider Resources
Claims submission Address:
Saint Mary's ATRIO Health Plans
338 Jericho Turnpike #135
Syosset, NY 11791
Please send REFUND CHECKS to:
Saint Mary's ATRIO Health Plans
2965 Ryan Drive SE
Salem, OR 97301
Provider Education
- Provider Manual (effective 1/1/2023)
- Issuing an Advanced Written Notice of Non-Coverage
- Fraud, Waste and Abuse Compliance Training
- CAHPS Information
- Clinical Practice Guidelines (CPG)
Provider Updates
- American Specialty Health (ASH) Contracting Letter
- Annual Wellness Visit vs. Annual Physical Exam
Tools and Resources
- Provider Appeal Form - Electronic
- Provider Appeal Form - Fillable PDF
- PCP Attestation Form
- Medicare Advantage Formulary Information
- Medicare Advantage Plans Benefit Information
- Medicare Advantage Provider Directory
- Notice of Medicare Non-Coverage (NOMNC)
- Notice of Medicare Non-Coverage (NOMNC) - Instructions
- Notice of Medicare Non-Coverage (NOMNC) - SNF Checklist
- Waiver of Liability Form
- Protected Health Information Disclosure Form
- Appointment of Representative Form (CMS - 1696) (For Medicare Appeals, Grievances, and Coverage Requests only)
- Provider Policy Listing
Medicare Star Rating Resources
View Saint Mary's ATRIO's Star Ratings Program page for measure descriptions and resource materials. For questions on the Star Ratings Program, please click here to contact Saint Mary's ATRIO Quality Improvement.
Opioid Information for Prescribers
Opioid drugs (“opioids”) have serious risks such as addiction, overdose, and death. CMS is very concerned about the opioid epidemic and its effect on our communities, and is committed to a complete strategy to combat this public health emergency. Several drug management programs are in place to prevent and combat opioid overuse.
Click here to see the formulary-level opioid safety edits at the point of sale, as recommended by CMS.
Medicare Part D Prescription Opioid Policies
Payer IDs
ATRIO Health Plans accepts claims submissions electronically through the following clearinghouses:
Clearinghouse | Payer Name | Payer ID |
Availity | ATRIO Health Plans | ATRIO |
Cortex EDI | ATRIO | CX031 |
Trizetto Gateway EDI | ATRIO | ATRIO |
Office Ally | ATRIO Health Plans | ATRIO |
Change Healthcare
Also Includes: Previously Emdeon |
ATRIO | MPCHA |
Relay Health
Also Includes: Previously McKesson |
ATRIO |
ATRIO |
Waystar
Also includes: Navicure, Zirmed or Recondo |
ATRIO Health Plans | Z1351 |