• Provider Authorization Waiver COVID19

  • Affinity Health Plan has implemented changes to our prior authorization requirements in response to the New York State of Emergency to help contain the spread of COVID-19. Affinity will suspend prior authorization requirements for hospital admissions, hospital surgeries, hospital stays, and discharges to inpatient rehabilitation, skilled nursing facilities, and home health services following an inpatient admission.

    This change will apply to dates of service starting March 20, 2020. It will extend for 90 days. During this time period, Affinity will not require prior authorization approval to be obtained in advance of the service being provided. Instead, Affinity will perform retrospective authorization reviews for those cases after the above time period ends. Unless authorization is requested by the provider for the services listed above, claims will be paid without prior authorization. After such time as the state regulators deem appropriate, claims previously paid without a required authorization will be reviewed for medical necessity.

    For more information, visit Provider Notifications or Affinity’s Provider Portal. You also may contact your provider relations representative or email ProviderRelations@affinityplan.org.