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Provider Resources

Attention: Please note the below new address for all ATRIO claim submissions effective July 16, 2021.

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


Prior Authorizations

CAUTION: Please be sure to select the correct fax number on the Authorization Form for your county/service area. Use of an incorrect fax number may cause unnecessary delays in getting your authorization request to the appropriate medical review team.

Please remember that patient confidentiality and privacy is protected under HIPAA, so using the correct form and fax number will ensure to protect you against inappropriate disclosures.


Prior Authorization Requirements


Medical Prior Authorization


Pharmacy Prior Authorization

You can submit an Online Coverage Determination Form, an Electronic Coverage Determination through CoverMyMeds, or use the form below:

ATRIO Medimpact Medicare Part D Coverage Determination Request Form


Click below to watch a tutorial for more information on using CoverMyMeds, including:

  • How to log in
  • Submitting a new ePA
  • Checking the status of an existing request
  • Renewing a request


Provider Education


Transition Updates


Provider Updates

270_271 Transunion Eligibility Letter May 2021

Annual Wellness Visit vs. Annual Physical Exam February 2021

Provider Information Regarding COVID Vaccine Billing February 2021

Home Health RAP Payment Change Notice January 2021

Paper Claim Submission Changes September 2020

ATRIO Reprocessing Initiatives April 2020


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.


Coordinated Care Organizations

These are the Coordinated Care Organizations (CCO's) that ATRIO Health Plans is partnered with in our service areas.


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. For 2019, several new drug management programs are being put 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, effective 1/1/2019.

New Medicare Part D Prescription Opioid Policies for 2019


Payer IDs and Electronic Remittance Advice

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

Electronic Remittance Advice (835)

ATRIO Health Plans provides electronic Remittance Advice through a direct connection with the following clearinghouses:

  • Change Healthcare
  • Availity
  • Waystar

For all other clearinghouse vendors, a pass-through connection is available through Office Ally. Registration with Office Ally is required.

To register for electronic remittance advice or to update your clearinghouse vendor, please submit this form.