Provider FAQs

General

Who is HealthCare Partners (HCP)? How is HCP different from an insurance company or health plan?

HealthCare Partners (HCP) Independent Practice Association (IPA) is made up of more than 2,000 primary care providers (PCPs) and more than 5,000 specialists serving over 125,000 residents of New York, extending from Staten Island to Montauk, from Brooklyn to Westchester.

Founded over 20 years ago, HCP has grown to become the premier IPA in the New York Metropolitan Area. Our NY-based IPA is supported by the HealthCare Partners Management Services Organization (MSO) based in Garden City on Long Island, with nearly 250 staff members who offer clinical and administrative expertise to all of the HCP practices. By helping our practices, we let our doctors do what they do best – take care of patients.

Our goal at HCP is to foster an ever-stronger partnership with our providers and their patients through our commitment to transparency, communication and support. We exist to keep our providers independent so they can provide the best possible care to their patients. We do this by providing clinical and financial support and easing the administrative burden on our providers.

We are not an insurance company or health plan. We contract with insurance companies and health plans to support our providers in accessing the best coverage possible for their patients.

Providers and patients also benefit from our MSO support by gaining access to an array of programs and services such as Population Health, Case Management, Pharmacy, Member Advocate home visits, and Social Determinants programs and resources.

Is HealthCare Partners in New York affiliated with HealthCare Partners in California?

No. HealthCare Partners of New York is an entirely separate organization unrelated to California’s HealthCare Partners.

What is the New Era at HealthCare Partners?

HCP leadership team has heard from partners, providers, and staff on how we can best support our physicians.

In the rapidly changing healthcare market, we understand that our physicians need financial stability and security. We also understand that providers have choices in the marketplace. It is our mission to provide them with the best value. Our ultimate goal is to ensure that our physicians can remain independent so they can focus on providing the best care possible to their patients.

For the first time in over twenty years, we are a physician-led organization. This helps us to understand more intimately the pain points our providers face. In moving our organization forward, our leadership team is focused on establishing best practices and delivering positive changes that will improve the work and lives of providers and patients.

Our providers and their office staff will see significant progress in the coming weeks and months, starting with the launch of our new website and followed by the rollout of new claims and reimbursement processes and more than 5,000 vetted Preferred Specialists. We look forward to working hand-in-hand with you to implement these changes. We always welcome any thoughts on how we can continue to improve.

Learn more about A New Era at HCP

Physicians

How do I become an HCP Direct provider?

Providers can take advantage of all the benefits available to HCP Direct providers by Joining our IPA.

If I become an HCP Direct provider, how is my membership in other IPAs impacted?

HCP is one of the only IPAs in the NY Metro Area that accepts full-risk payer contracts. As such, HCP allows participation with other IPAs, but members of any full-risk contracts that HCP holds must remain with HCP.

How will the changes at HCP help my practice stay independent and financially viable / increase revenue?

HCP is committed to helping PCPs optimize their revenue and earn incentive bonuses, and we have employees on staff to assist providers and their staff. In addition, our support of CMS-driven reimbursement enhancements in primary care will also increase PCP revenue while proving patient outcomes.

Learn more about we support your financial success

Do my patients have to stop seeing the specialists they have previously seen in favor of a Preferred Specialist? Can they maintain current relationships?

Engaging with these 5,000+ specialists will allow you and other HCP providers to provide the highest quality outpatient care to your patients. As a PCP, you have the final say in who you refer your patients to. HCP has developed a pathway to facilitate access to Preferred Specialists to allow your patients to get the care they need without delay. However, Referrals and Authorization Requests for care by non- Preferred Specialists can be submitted online.

Specialists

How do I know if I am an HCP Preferred Specialist?

All HCP Preferred Specialists will be receiving communications notifying them that they have been selected to be a Preferred Specialist. You can also check using our Preferred Specialist Search Tool.

Prior Authorization Process

How will these changes, new processes, and tools affect the authorization process?

HCP is focused on ensuring members have timely access to the care they need. By reducing the Prior Authorization requirements for services performed in office-based settings we expect more timely care and a decrease in the need for patients to access hospital-based services.

Will we need authorizations for every service?

Going forward, providers will not need Prior Authorization for most office-based services, particularly those performed in an office-based setting versus a hospital. You will find more information on our Prior Authorization Process page.

What is the general timeframe for a Prior Authorization request?

HCP follows all federal, state, and NCQA requirements in responding to requests for referrals, authorizations, and claims payments.

Learn more about the Prior Authorization Process

Our New Website

How will HCP’s website help me?

The primary goal of our website is to provide comprehensive, accurate and timely resources to our providers, and their patients. The site includes information and tools to help providers and staff easily navigate the resources they use every day.

Transparency is one of our key goals on this site. You will find information and tools more easily and readily available.

The site will serve as a digital reference manual for our provider offices with step-by-step instructions on how to perform daily tasks all in one place.

Accessing HCP’s previous web address will redirect you to this site.

Can I submit Referrals through the HCP website?

Yes. Referrals are easily accomplished via the HCP website. You can also make Prior Authorization and Referral requests through our web-based application: EZ-Net.

Provider Resources

HCPartners in Care

Provider Communications

Become a HealthCare Partners Provider

Career Seekers

About HealthCare Partners

A New Era for HCP

Quick Links