For our providers
We’re here to help. When you have the right information at your fingertips, you can give your patients the care they deserve. Get all the information and tools you and your staff need to manage your practice and deliver excellent service to patients.
Patient Access Center / Customer Service
The Patient Access Center provides direct phone access to customer service representatives knowledgeable in the areas of benefit coverage, claims processing, provider referrals, prescription refills to test results, inquiries about billing and insurance, and the scheduling and cancelation of doctors’ appointments.
Hours of Operation
Monday–Friday: 8:00 am–6:00 pm
Quality and Network Management
The Quality and Network Management (QNM) Department links Montefiore Medical Center, Montefiore’s independent practice association (IPA) provider networks, and contracted programs and health plans.
For additional information, please access our QNM Webpage, click here.
Epic Tapestry is a module through Epic that integrates provider care by giving access to users to view claims’ status, check member eligibility, and generate and view referrals and authorizations.
We encourage everyone to register for Epic Tapestry. For new user registration, or to access the portal please click here
Utilization Management (UM), Referrals and Authorizations
- Durable Medical Equipment (DME) Guidelines
- Injectable Drug Vendor List and Process
- Medical Management Utilization Review Criteria
- IPA Referral Directory
- IPA Vendor Referral Directory
- Precertification Guidelines for Emblem
- Precertification Guidelines for Oscar
- OSCAR MA Preauthorization List
- Prior Authorization Form
- QNXT Remit Reasons to HIPAA Remit Reason Codes Mapping (EOB Explanation Codes)
- Time Frames for Urgent and Nonurgent Utilization Review Guidelines
- NCQA Attestation
- Decision Support Criteria
Regional Health Information Organizations
All participating and newly credentialed providers in the IPA are required to join a regional health information organization (RHIO), which are data hubs that electronically collect and help exchange healthcare information. For more information on joining a RHIO click here