Suffolk Health Plan



SHP is introducing new online features! Click here and please register or login to get information about member eligibility, see claims status for your patients, submit claims, and more!



Information on Specialty Pharmacy Drugs

Pharmacy Benefits

Benefit Changes and Updates

Benefit/Authorization Guide

Cosmetic Surgery Codes that Require Prior Authorization

InterQual® Advanced Imaging Criteria - for CT/MRI/MRA/PET Scans

DME/Prosthetics/Orthotics Authorization Requirements


Appointment Availability and Access Standards

Personal Care Coverage











Staying Healthy


Click here for helpful information about keeping yourself and your family healthy!



Member Newsletter

Winter 2012 Newsletter





Member
Complaint/Appeal
Forms


Member Complaint/Grievance Form

Member Complaint/Grievance Appeal Form

Member Appeal Form




Child Health Plus
Updated October 2011

Child Health Plus Subscriber Contract

CHP Formulary



Family Health Plus
Updated October 2011

FHP Member Handbook
English Version

Spanish Version

FHP Handbook Updates
(1/1/2012)


Full Time Student Information

FHP Formulary

Click Here for Information on Recent Changes to FHP Benefits



Medicaid
Managed Care

Updated October 2011

Medicaid Member Handbook
English Version

Spanish Version

Medicaid Handbook Updates
(1/1/2012)


Full Time Student Information

Medicaid Formulary

Click Here for Information on Recent Changes to Medicaid Benefits



Provider Newsletter
Fall 2012





Provider Manual
Updated October 2012

To see the Diabetic Risk Test on the American Diabetes Assoc. website click here

To view the New York State Dept. of Health's "Breast Cancer Treatment - What You Should Know" patient booklet click here

To view guidelines on ADHD Medication Treatment, click here

To view the New York State Requirements for HIV Testing click here

Helpful Links and Resources for Providers



Provider Forms

Important Information about SHP

Imporant Information about Hurricane Sandy

Practice Information Change Form

Prior Authorization Form

Prior Authorization Form for Advanced Imaging-CT/MRI/PET








More Details

If you need help, Call us!
1-800-763-9132

SHP Member/Provider Services
Telephone: 1-877-SHP-6789
(1-877-747-6789)
P.O. Box 19769
Charlotte , NC 28219-9769

Suffolk Health Plan
Claims Department
Phone: 1-877-747-6789
Fax: 1-888-892-6130

Utilization Review
Precertification: 1-800-250-5007
Fax: 1-877-267-7900

To request any of the information on this website in another
language, please call SHP’s Member Services:
1-877-747-6789 (TTY/TTD 1-800-662-1220)

You and your children may be eligible for FREE
Or low-cost health insurance
Join the Suffolk Health Plan (SHP)

Our Medicaid, Family Health Plus and Child Health Plus services include:

  • All primary care at our Health Centers
  • Access to a complete network of community-based specialists
  • Emergency care, 24 hours a day
  • Annual physical exams
  • Child care, including all immunizations
  • Prenatal care and delivery
  • Routine in-patient/out-patient services at nearby hospitals you know and more...

If you have Medicaid, you can enroll in SHP

If you need Child Health Plus, you can also enroll in SHP


New York State's Health Plan for Kids

Children qualify if they:

  • are under the age of 19;
  • are not eligible for Medicaid; and
  • do not have equivalent health care coverage.
  • are residents of Suffolk County, New York

The cost of Child Health Plus coverage varies according to household income. In many cases, New York State will pay full cost. Otherwise, depending on family income, Child Health Plus coverage can cost you as little as $9 per child per month!

 

SHP HEALTH TIPS

Partner with your Doctor to Stay Healthy!!
It's very important that you
and your family see your
doctor at least once a year
to receive preventative
health care.
Preventative health care
can help detect illnesses
Schedule an appointment
with your doctor for you
and your children.
Make sure your children
stay healthy by getting all
their immunizations. Make
sure you stay healthy by
getting your health screenings
Early detection of problems
can help save your life.
Live Healthy!! Make your appointment today!

Family & Community Health Information from New York State Department of Health

Family Health Plus is a public health insurance program for adults between the ages of 19 and 64 who do not have health insurance - either on their own or through their employers - but have income or resources too high to qualify for Medicaid. Family Health Plus is available to single adults, couples without children, and parents with limited income who are residents of New York State and are United States citizens or fall under one of many immigration categories.