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ATRIO has changed payment and remittance advice vendors effective November 16, 2021. If a provider is unable to locate a payment or a remittance advice please contact ATRIO customer service at 877-672-8620.

Provider Resources

Claims submission Address:

ATRIO Health Plans
338 Jericho Turnpike #135
Syosset, NY 11791

Please continue to send REFUND CHECKS to:

ATRIO Health Plans
2965 Ryan Drive SE
Salem, OR 97301

VSP Information:


VSP Provider Customer Service Line:
1.800.615.1883 Monday – Saturday: 6:00 a.m. – 5:00 p.m. PST
Sunday: Closed
Additional helpful provider information can be found at the following link:
https://www.vspproviderhub.com/
To learn more about becoming an in network VSP provider please see link below:
https://www.vspproviderhub.com/working-with-vsp/be-a-vsp-doctor.html

Extra Benefits:


To see extra benefits ATRIO offers, please select the link below:
https://www.atriohp.com/extra-benefits/

Provider Education

Pharmacy

  • Inflation Reduction Act
    • Insulins – Zero copay for initial coverage until the member reaches the coverage gap. When in the coverage gap, member copay will be capped at $35 for 30-day supply even if member has not met their annual deductible

    • Part D vaccines - Zero copay
    • Generic drugs for management of chronic conditions: Diabetic medications, ACE-I/ARBs or statins
CMS IRA Insulin Coverage (Part D) - Go-Live 1/18/2023
  • Formulary insulin (refer to table below) is zero copay until the member reaches the coverage gap. When in the coverage gap, member copay will be capped at $35 per insulin type for a 30-day supply even if member has not met their annual deductible
  • Between 1/1 /2023 – 1/18/2023, members may be charged more than $35 if they are in the coverage gap or if they receive a non-formulary insulin (e.g. Lantus) during transition fills
    • What should members do? Members can call ARTIO Customer Service and ask for Direct Member Reimbursement.
    • What can providers do? Switch to formulary insulin if clinically appropriate.

Vaccines (Part D) - ZERO copay for all vaccines that Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) recommended for adults (shingle vaccines)

Provider Updates

Provider Newsletter

American Specialty Health (ASH) Contracting Letter

Annual Wellness Visit vs. Annual Physical Exam


Tools and Resources

Medicare Star Rating Resources

View ATRIO’s Star Ratings Program page for measure descriptions and resource materials.

For questions on the Star Ratings Program, please click here to contact 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