Everything You Need.
All in One Place

Download Our Provider Orientation Guide

Welcome to your Elm & Oak IPA resource hub—where up-to-date tools, referrals, care coordination info, and important updates are just a click away.

Download Our Provider Orientation Guide

What We Provide

Our care managers serve as a single point of contact for members, offering:

One-on-one support to schedule appointments and follow treatment plans

Help navigating benefits and community services

Coordination among providers, behavioral health, and social service partners

Submit a Referral

Tools to Help You Deliver Better Care

Stay organized and informed with quick access to quality programs, forms, training, and more.

Access the latest enrollment forms, care coordination documents, and compliance information.

Credentialing FAQ Tip Sheet

A quick reference guide answering common questions about provider credentialing with Molina Healthcare of New York.

Download Credentialing FAQ Tip Sheet

HIV Attestation Form

Submit this form annually to attest that you are an HIV-experienced provider.

Download HIV Attestation Form

Non-Credentialed Practitioner Application

Use this form to enroll providers who do not require credentialing, such as nurse practitioners, physician assistants, CRNAs, registered dieticians, emergency room physicians, pathologists, anesthesiologists, and hospitalists.

Download Non-Credentialed Practitioner Application

Ownership Disclosure Form

Use this form to disclose ownership and financial interest of the group or facility.

Ownership Disclosure Form

PCP Change Form

Use this form to add or remove a patient from your roster.

Download PCP Change Form

Practitioner Enrollment Application

Use this form to enroll brand new practitioners with the health plan, such as medical doctors, audiologists, diabetic educators, podiatrists, midwives, chiropractors, occupational therapists, optometrists, oral surgeons, osteopathic doctors, physical therapists, speech pathologists, and pain management physicians.

Download Practitioner Enrollment Application

Provider Demographic Change Form

Use this form for updates to an existing group, facility, or individual practitioner, such as name changes, TIN changes, additional locations, terminations, remit changes, and sponsoring MD changes.

Download Provider Demographic Change Form

Provider Employee Attestation Form

Submit this form annually to certify that employees and other provider personnel are not excluded or otherwise prohibited from participating in any state or federal healthcare program.

Download Provider Employee Attestation Form

Provider Orientation Guide

A quick reference guide to Elm & Oak Health (formerly Monroe Plan for Medical Care), our IPA, and our partnership with Molina Healthcare of New York, including key programs, services, procedures, and helpful links.

Download Provider Orientation Guide

Quick Provider Fact Sheet

Frequently asked questions and guides to the various forms linked here.

Download Quick Provider Fact Sheet

Roster Template

Use this form when removing, adding, or updating provider information to your group’s practice roster.

Download Roster Template

Professional Community Fee Schedule

Use this to view posted professional fee schedule

Professional Fee Schedule

Fee Schedule Explained

The Monroe Plan for Medical Care and YourCare IPA (dba Elm & Oak Health) Fee Schedule outlines the professional fee schedule.

Fee Schedule Explained

Fee Schedule At A Glance

The Fee Schedule at a Glance highlights how services are reimbursed under the Monroe Plan and YourCare IPA (dba Elm & Oak Health)

Fee Schedule At A Glance

Newsletters

View all Newsletters

Bulletins

Molina Provider Exclusion Monitoring Attestation

Molina Healthcare of New York, Inc. is required to confirm our network providers have procedures in place to identify and determine the exclusion status of your managing employees through routine checks of Federal databases.

Download

Access and Availability Reminders

Your roster submission helps ensure that Elm & Oak and Molina Health Plan of NY have the latest information on all affiliated providers.

Download

Annual Cultural Competency Training and Attestation

Training modules and resources are available to enhance cultural competency when serving diverse patient populations.

Download
View all Bulletins

Webinars & Trainings

On-demand and live educational events to keep your practice aligned with industry changes.

Stay Compliant with NYS Health Equity Regulations

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Need Help?

Our Provider Relations team is here to support you. Whether you need technical help, have questions about a claim, or want to talk through care coordination—we’re ready to assist.

Contact Us