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. As a RCIPA participating physician you participate in Aetna and Independent Health (non-HMO) plans (in the past these self-insured plans were referred to as "Doctors' Health Plan"). Please contact the RCIPA office if you have any questions regarding these lines of business.

Aetna | Independent Health


reviewed October 2020


Aetna Medicare Advantage & Rochester Regional Health Reminder

Effective January 1st, 2020, Rochester General Hospital, Newark Wayne Community Hospital and Unity Hospital and their associated employed physicians and healthcare providers will be participating in Aetna's Medicare Advantage products in addition to the Aetna commercial plans and products Rochester Regional Health physicians and healthcare providers are already participating with.

Aetna acquired Coventry Health Care, Inc.

On May 7, 2013 Aetna acquired Coventry Health Care, Inc. Aetna and Coventry share a commitment to creating mutually beneficial relationships with providers. You do not need to take any action now. Keep working with Aetna and Coventry and servicing all of the patients as you always have been. There are no changes with your RCIPA contract as a result of the Coventry acquisition. We'll keep you updated and let you know about future changes.

eviCore Preauthorization for Aetna members.

eviCore (formerly CareCore National) preauthorization for Aetna members is effective 04/01/2015. These authorization requests should be called into EviCore at 1-888-622-7329 Monday-Friday 7 am to 7 pm ET or requested online at www.evicore.com available 24 hours per day, 7 days a week.

Counties: Genesee, Livingston, Monroe, Ontario, Orleans, Seneca, Wayne, Yates

Plans: Self-Insured Medical Plans (Aetna, UR Aetna), Student Health, Aetna Signature Administrators, Meritian, NY Signature, Aetna Medicare Advantage. For a complete list of participating Aetna plans: AetnaBenefitProducts.pdf.

Provider Services: 1-888-632-3862 / Aetna Medicare Provider Services: 1-800-624-0756
Payer ID: # 60054
Provider Website: Aetna | Availity 1-800-AVAILITY (282-4548)
Paper Claims: PO Box 981106, El Paso TX 79998-1106
Aetna ERA, EFT & Electronic EOBs: Information and links.

New Providers:

Formulary Information: Aetna Formulary
Clinical Policy Bulletins: Aetna CPB

As a RCIPA participating provider, you are credentialed by Aetna, but contracted through RCIPA.

Independent Health (non-HMO) / Nova Healthcare Administrators

reviewed December 2019

Counties: Genesee, Livingston, Monroe, Ontario, Orleans, Seneca, Wayne, Wyoming, Yates


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 id cards with self-funded services in the upper right hand corner of the 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

Independent Health Article 43 Plans

✱Please call IH and confirm participation in the IHC network for the following plans- Flex Fit Active, Flex Fit Family , FlexFit Select.✱

Activate GoldChoice PlusChoice Plus Gold Choice Plus PlatinumChoice Plus Silver HSAQCitibank North America
Easy AccessEncompass Essential PlusEncompass Plus AEncompass Plus A PPOEncompass Plus BEncompass Plus B PPO
Encompass Plus B SelectEncompass Plus CEncompass Plus C PPOEncompass Plus DEncompass Plus D PPOEvolve
FEHB HDHPFEHB High OptionFEHB Standard OptionFlex Fit Active*Flex Fit Family*Flex Fit Select Active
Flex Fit Select FamilyFlexFit PlatinumFlexFit Platinum OONFlexFit Select*Healthy New YorkiDirect 1 Series
iDirect 2 SeriesiDirect 3 SeriesiDirect 4 SeriesiDirect 5 SeriesiDirect 6 Series iDirect Bronze Blended HSAQ
iDirect Bronze Coinsurance HSAQiDirect Bronze Enhanced HSAQiDirect Bronze MViDirect Bronze MV HSAQiDirect Gold CopayiDirect Gold Copay HSAQ
iDirect PlatinumiDirect Silver BlendediDirect Silver Blended HSAQiDirect Silver Coinsurance HSAQiDirect Silver CopayiDirect Silver Copay HSAQ
iShare GoldiShare PlatinumMax GoldMax SilverNY PA GoldNY PA Silver HSAQ
Passport PlanPassport Plan Local Bronze HSAQPassport Plan Local Gold HSAQPassport Plan Local PlatinumPassport Plan Local Silver HSAQPassport Plan National Bronze HSAQ
Passport Plan National Gold HSAQPassport Plan National PlatinumPassport Plan National Silver HSAQPassport Plan SelectStandard BronzeStandard Catastrophic
Standard GoldStandard Healthy NY GoldStandard PlatinumStandard SilverTraditional 

✱Please call IH and confirm participation in the IHC network for the following plans- Flex Fit Active, Flex Fit Family , FlexFit Select.✱

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

Eligibility & Claims

Please use WNYHealtheNet: www.wnyhealthenet.org. Log onto the site and go to the Sign-Up tab at the top of the page and complete the form. Once you've completed the form, a representative from WNYHealtheNet will contact you to set up your account within 5 business days. You can also request a personal orientation session.

The following information is available on the site:

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.

Member ID Card: click here to view larger member id card.