October 13, 2011
CARECORE NATIONAL ANNOUNCEMENT LETTER
ATTENTION PROVIDERS PARTICIPATING IN PAYOR BENEFIT PLANS WITH
AMERIGROUP, FIDELIS AND WELLCARE UNDER the TERMS OF PAYORS
PARTICIPATION AGREEMENTS WITH NYNM.
CareCore National and New York Network Management LLC Introduces a New
Claims Services Agreement, Effective December 5, 2011
CareCore National (CCN) and New York Network Management LLC (NYNM) are excited to announce
a new claims services agreement, as CareCore National has developed a NEW ONLINE BILLING
SYSTEM AND PORTAL for NYNM IPA providers.
CareCore National currently manages treatment affecting more than 30 million people and is also
regarded highly for their use and development of leading healthcare technology today.
This new agreement includes provider access to the new web based billing portal called
ClaimsChannel360™. NYNM providers will be the first to have the ability to submit their claims
directly to Amerigroup, Fidelis and Wellcare payors at no cost. Billing requirements and
guidelines will remain the same for all other plans until further notice.
Claims Submissions on or after December 5, 2011 should be directed to CCN through direct electronic
submission via www.nynmonline.com billing tab or directly at: www.ClaimsChannel360.com
Clearing House and Paper Claims:
CareCore National will initially also accept electronic claims from Emdeon clearing house with the existing
NYNM Payor ID 11334 and paper claims from a dedicated new PO Box address. Send Paper Claims to:
NYNM IPA– Paper Claims
PO BOX 620 Lake Katrine, NY 12449
All Appeals and supporting documents:
CareCore National will accept appeals and supporting documents for these 3 payors and should also be sent to
a new dedicated PO Box:
NYNM – Appeals and COB
PO Box 640 Lake Katrine, NY 12449
Instructions:
In the coming weeks you will receive more instructions and process tutorials online at www.nynmonline.com.
An instructions booklet and e-learning module will be made available via the NYNM website. For more
information go to www.nynmonline.com and click on the billing tab.
{New York Network Management, LLC * 9201 4th Ave * 4th Floor * Brooklyn NY 11209}
www.nynmonline.com
Page 2.
Why are we doing this?
NYNM’s intention is to improve billing processes and to modernize the end-to-end billing cycle of medical
claims. By integrating the use of CCN’s customized billing portal ClaimsChannel360™ we have ensured
great improvements to this process. ClaimsChannel360™ removes the unnecessary excess of channels a
particular claim will have to pass through and directly submits to the payor on our provider’s behalf.
Several of ClaimsChannel360™ portal benefits:
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Receive electronic funds transfers and payments (EFT)
Send Electronic Claims Directly to payor at no charge
Upload Batch Claim Files
Conduct a claims status inquiry ONLINE with full reporting tools
Reduce filing times and cost by offering online submission
Reduce erroneous errors on claims with customized validation rules
How does it work?
Billing requirements remain that the Physician shall submit to NYNM IPA completed claims for all Covered
Services within twenty (20) days after the Covered Services are rendered.
Simply visit www.nynmonline.com today and click on the billing tab for more information, you will be guided
to the ClaimsChannel360™ portal for registration. Billing requirements and guidelines will remain the
same for all other plans until further notice.
When does this start?
Providers can begin registration promptly upon receipt of this notice and can register for Electronic Funds
Transfer (EFT) after receiving a secure login username and password from www.claimschannel360.com.
December 5th 2011 will be the go live date for claims processing via the new billing portal.
**It is however imperative that our providers sign up for the electronic funds transfer (EFT) within 10
business days and carefully review the new billing instructions for Wellcare, Amerigroup & Fidelis***
NYNM appreciates the care you deliver and values your participation in our provider network. We look
forward to working with CareCore National to ensure that our network receives the highest level of service in a
timely manner.
Also please note that this new claims services agreement with CareCore National and ClaimsChannel360™
has no relation to current authorization management services.
If you have questions about this new program please visit www.nynmonline.com to chat with customer
service online or call: 888-511-5208 Ext: 1
{New York Network Management, LLC * 9201 4th Ave * 4th Floor * Brooklyn NY 11209}
www.nynmonline.com