RCIPA Partners
RCIPA contracts with the following insurers and third party administrators to provide a network of physicians and allied health professionals to treat their Rochester-area members. Please contact the RCIPA office if you have any questions regarding these lines of business.
Aetna
Providers who have met the CMS deeming requirements are not required to complete our Aetna Medicare Fraud Waste and Abuse training, however you are still required to complete Aetna's Medicare compliance training. The FWA and Compliance training will be offered as two separate courses on Aetna's Education portal, www.Aetna.com under For Health Care Professionals.
Plans: Self-Insured Medical Plans (Aetna, UR Aetna), Student Health, Aetna Medicare Advantage
Provider Services: 1-888-632-3862 / Aetna Medicare Provider Services: 1-800-624-0756
Payer ID: # 60054
Provider Website: Via Navinet
Paper Claims: PO Box 981106, El Paso TX 79998
Paper addresses can be used for electronic submission as well since Payer ID is what drives the electronic submission.
Local Aetna Provider Representative: Jane Parry, parryj@aetna.com, 585-671-0797
New Providers:
Contact RCIPA by calling 585-454-1490 or via the Contact Form. Please provide the provider's name, specialty, NPI, tax ID, billing location address, service location address and you will be contacted within 48 hours.
Ensure provider has completed a CAQH application: CAQH.
Complete the Aetna Medical Application Request to allow Aetna to add provider to the Aetna CAQH roster and to access the provider's CAQH application: Aetna Medical Application Request
Credentialing typically takes 12 weeks. Aetna will send you a letter with the provider's Aetna PIN number. For a provider's credentialing status, you may call the Aetna Main Credentialing line at 1-800-353-1232.
Formulary Information: Aetna Formulary
Clinical Policy Bulletins: Aetna CPB
POMCO
Plans: All Self-Insured Medical Plans
Provider Services: 1-800-766-2687
Payer ID: # 16111
Provider Website: POMCO
Paper Claims: PO Box 6329, Syracuse, NY 13217
New Providers: Contact RCIPA by calling 585-454-1490 or via the Contact Form. Please provide the provider's name, specialty, NPI, tax ID, billing location address, service location address and you will be contacted within 48 hours.
Independent Health (non-HMO) / Nova Healthcare Administrators
Plans:
Non-HMO Plans (Article 431 and Self-Funded Plans 2)
RCIPA providers do NOT participate in Independent Health HMO plans but may see HMO members with an authorized out of area referral
1 Article 43 Plans will have IHC Network on the member's ID card. A listing of the current IH Article 43 plans is shown below.
2 Self-Funded Plans will have a T at the end of the Group number on the member's ID card.
Independent Health (non-HMO)
Provider Services: 1-800-736-5771
Payer ID: # 95308
Provider Website:
Independent Health
Paper Claims: PO Box 1017, Buffalo, NY 14231
IH Article 43 Plans
| Easy Access | Easy Access Advantage HealthyFamily | Easy Access Advantage HealthyLife | Empower HDHP |
| Empower POS | Encompass Elect Plus B1 | Encompass Essential Plus | Encompass Plus A1 |
| Encompass Plus A3 | Encompass Plus A5 | Encompass Plus B1 | Encompass Plus B2 |
| Encompass Plus B3 | Encompass Plus B4 | Encompass Plus B5 | Encompass Plus C1 |
| Encompass Plus C2 | Encompass Plus C3 | Encompass Plus C4 | Encompass Plus C5 |
| Encompass Plus D3 | Encompass Plus D4 | Encompass Plus D5 | Encompass Plus D6 |
| FEHB HDHP | FlexFit Active Provider | FlexFit Family | FlexFit Independent |
| FlexFit Select Active | FlexFit Select Family | FlexFit Select Independent | iDirect 1 Series |
| iDirect 2 Series | iDirect 3 Series | iDirect 4 Series | iDirect 5 Series |
| Passport Plan | Passport Plan Advantage | Passport Plan Select | Traditional |
Nova Healthcare Administrators
Provider Services: Uniland & Northstar: 1-877-538-5501; all others: 1-800-999-5703
Payer ID: # 16644
Provider Website:
Nova Healthcare Administrators
Paper Claims: PO Box 9050, Williamsville, NY 14231
New Providers: Contact RCIPA by calling 585-454-1490 or via the Contact Form. Please provide the provider's name, specialty, NPI, tax ID, billing location address, service location address and you will be contacted within 48 hours.
