How To Submit Claims To MetroPlusHealth

Coverage: New York MetroPlusHealth plans; verify product, provider participation and the current agreement.

MetroPlusHealth claims guidance from the reviewed sources: Electronic claim submission under MetroPlusHealth billing requirements. Confirm the member plan and claim type before using a payer ID or paper address.

At a glance

• MetroPlusHealth describes electronic claims and medical and behavioral-health paper claim forms.

Submission channels

• Electronic claim submission under MetroPlusHealth billing requirements.
• Paper professional and institutional claims using the applicable CMS-1500/HCFA-1500 or UB-04 forms.

Electronic claims payer IDs

• Not clearly published in the researched sources.

Paper claims addresses

• Not clearly published in the researched sources.

Corrected claims and follow-up

• Not clearly published in the researched sources.

• Claims status resource 1

Caveats

• Use the member’s product and current agreement for routing. Portal claim and payment status is not proof of initial claim acceptance. No universal payer ID or paper address is asserted.

Provider resources

• Official behavioral-health claims (official)
• Official policy source (official)
• Official policy source (official)
• Official policy source (official)

Sources

Update notes

Last updated: 2026-10-30.

• Reviewed official claims, behavioral-health claims and October 21, 2026 reference resources. Added the conflicting July 2023 filing notice rather than presenting 90 days as universally reliable.
• Some direct page requests were blocked; official indexed page text was available. Filing needs payer/contract confirmation. No login-only workflow was verified.