ATTENTION: Due to rising COVID cases, all Affinity Community Services Centers will be closed starting Wednesday, November 25th and remain closed until further notice. Visit AffinityPlan.org/Live to speak to a representative live via Zoom, or call 866.694.9815 (TTY 711). Also note, Affinity headquarters at Metro Center will be closed over the Thanksgiving holiday and reopen on Monday, November 30th.
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      Quality Reports
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      Member Eligibility
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      Claims Status
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      Member Clinical Profile

  • For Us, It's You First!

    • Affinity’s Shared Savings Program

      Affinity’s Shared Savings Program

      The Affinity Health Plan Shared Savings Program is designed to create greater alignment between Affinity and its participating providers in the areas of quality of services and cost effectiveness provided to members. The objectives of the program are for participating providers to earn incentive payments based on their level of quality achieved and level of shared savings generated. The Shared Savings Program is part of New York State Department of Health’s Value Based Payment requirement.
    • Claims Reconsideration Tool Online Now!

      Affinity Health Plan will now be accepting claim inquires on our provider portal.

      By sending claims through the provider portal, providers may: Submit reconsideration requests and upload related documents online anytime. Reduce overall turnaround request time by eliminating mail delays. Receive immediate confirmations and tracking numbers. Check statuses online anytime.

      Claims Reconsideration Tool Online Now!
    • New Appeals Tool is Live!

      New Appeals Tool is Live!

      Affinity Health Plan now accepts medical necessity appeals on our provider portal.

      Providers can submit medical necessity appeals and upload medical records and supporting documents anytime. The overall turnaround request time may be reduced, and providers will receive immediate confirmation of receipt and an email with an appeal reference number. Providers will be able to view appeal statuses at any time.

      This new option can be found on the provider portal home page under the authorizations tab.

    • Quality Is Key to Our Success!

      If you are curious to know how well or how to improve your quality performance before the end of 2020 and maximize your reward potential, the QIP Report will give you a breakdown by all qualifying measures across all lines of business.
      Providers also can visit the Affinity Health Plan website at https://www.affinityplan.org/Providers/Providers/ to learn more about CAHPS®, HEDIS ®/QARR Measures and Coding, Quality Incentive Program and Mandatory Reporting Requirements.  

      Quality Is Key to Our Success!