Forms for Providers and Patients
Here you can find forms to join our network, update your demographic information, get prior authorizations for a patient’s medications, and more. You can find credentialing forms by clicking on this link.
Provider Disclosure Certification
You are required to fill out and return this Provider Disclosure Certification form to VNSNY CHOICE. Please return it by December 31, 2021.
You can scan the completed document and email it as an attachment to: CHOICEcompliancecertification@vnsny.org.
Or you can print it out and mail it to:
VNSNY CHOICE Health Plans
220 East 42nd Street, Third Floor
New York, NY 10017
ATTN: Provider Operations
Participating PCPs and Specialists: Here’s a quick and easy way to let us know about changes to your information!
Use this form to submit your claims disputes online. A VNSNY CHOICE representative will get back to you shortly.