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ArchCare Advantage (I-SNP) Member Resources

Service Authorization

An organization determination, also known as a service authorization, is our initial decision about whether we will provide the medical care or service a member requests, or pay for a service a member has received. Providers, members or a member’s appointed representative can request a service authorization by contacting the ArchCare Advantage Clinical Services Department. Organizational determinations are made as expeditiously as the member’s health condition requires, but no later than 72 hours after receipt of an expedited request or no later than 14 calendar days for a standard request for services.

Determinations of coverage are made based on Medicare regulations, the ArchCare Advantage Evidence of Coverage, local Medicare carrier policies, internal policies and procedures, and medical criteria.

Part C service authorization requests can be submitted via fax to 1-917-398-1719. Part C service authorization requests can also be submitted by phone by calling Member Services at 1‑800‑373‑3177 (TTY/TDD: 1‑800‑662‑1220), seven days a week, 8 a.m. to 8 p.m., or mail us at ATTN: ArchCare Advantage 205 Lexington Avenue, 8th Floor New York, NY 10016. Please be sure to include all supporting documents with your request.


This page was last updated on Tue, 02/19/2019 – 14:40

ArchCare Advantage HMO SNP is a Coordinated Care Plan with a Medicare contract. Enrollment in ArchCare Advantage depends on contract renewal. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact ArchCare Advantage. This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care. Limitations, copayments and restrictions may apply. Eligible beneficiaries may enroll in our plan at any time of year. You must continue to pay your Medicare Part B premium. Benefits, formulary, pharmacy network, premium and/ or co-payments/co-insurance may change on January 1 of each year.

This information is available for free in other languages. Please contact our customer service number toll-free at 1-800-373-3177, seven days a week, 8 a.m. – 8 p.m. (TTY/TDD: 711). Esta información está disponible gratis en otros idiomas. Por favor llame a nuestro número de servicio al cliente al 800-373-3177, TTY 711, de domingo a sábado, de 8:00 am-8:00 pm.

Discrimination is Against the Law
ArchCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ArchCare does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1 800-373-3177 (TTY: 711).
注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電1 800-373-3177 (TTY: 711)