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NMHC strives to continually increase communications with its providers regarding our new clients and plan design
changes.
If you need to request prior authorization on a medication for a current NMHC member, please download the
appropriate Prior Authorization Request Form and fax the completed
form to the toll free fax number located at the
top of the PA form,
or submit a
Prior Authorization Online Request.
Our Provider Relations FAQ section provides answers to some commonly asked questions regarding
claims adjudication through NMHC. If you have a specific question, or if you would like to request
a contract, please call the NMHC Provider Relations department at (877) 877-3075. The Provider
Relations department is open Monday through Friday from 8:30AM to 5PM ET. You can also
contact us online or write to us at:
NMHC
Attention: Provider Relations
23 British American Boulevard
Latham, New York 12110
For answers to claims questions you may contact our Provider Service call
center and speak with a Customer Care Professional (CCP). You can also
reference our Pharmacy Payer Sheets by clicking a link below:
Our CCPs are specially trained and consistently meet or exceed industry
standards for answering and resolving incoming inquiries. Our first call
resolution is 91% compared to an industry average 85%*. And our call abandon
rate is only 3.54% compared to an industry average of 5%*. CCP performance is
continually monitored to assess accuracy and professionalism.
The Provider Service call center can be reached by calling: (800) 510-8980.
- The hours of call center operation are:
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- Monday through Friday: 8:00 AM - 11:00 PM (ET)
- Saturdays, Sundays and Holidays: 9:00 AM - 7:00 PM (ET)
At NMHC, we strive for service excellence. Please complete our Provider Relations Survey and let
us know how we are doing.
*Industry standards based upon NMHC analysis with over 15 years in the industry
and supported by the ICSA (International Customer Service Association).
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