Payer ID
13265
Payer ID 13265 for MetroPlusHealth professional and institutional claims (now via Availity). (New York)
Timely Filing Limit (TFL)
90 days from date of service or discharge
Appeal Window
Varies — confirm via portal / clearinghouse
Clearinghouse
Availity (primary since 2024; payer ID 13265)
Provider Services
800-303-9626
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
MetroPlusHealth, P.O. Box 219080, Kansas City, MO (verify ZIP/suite on the current claims page)
Provider Portal
https://metroplus.org/providers/
New York City Medicaid/Marketplace/Medicare plan affiliated with NYC Health + Hospitals.
Values vary by plan, region, and contract and can change. Confirm in the payer portal or with your clearinghouse before filing.
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