Provider Network

AdvantageCare Physicians

AdvantageCare Physicians (ACPNY) is an integral part of your provider network and offers you and your family convenient primary and specialty care, and related services, at 30+ locations across the New York metro area. To learn more about ACPNY, visit acpny.com.

Want to Find a Local ACPNY Provider?

The "star" icon in our Find Care tool tells you that the provider is part of ACPNY. Start by visiting the Find Care section below made specifically for City of New York plan members.

Provider Coverage: In- and Out-of-Network

If you want out-of-network coverage while keeping in-network copays low, choose the GHI CBP plan.

With our robust network of quality doctors, you can get care from many of the region’s leading doctors, medical professionals, and facilities (including hospitals and urgent care centers).

With the GHI CBP plan, you never need a referral to see in-network doctors. And along with in-network doctors, you can get covered care from any doctor you choose, offering you the widest possible choice.

Covered services from out-of-network doctors do, however, have deductibles and coinsurance. Payment for services provided by out-of-network providers is made directly to you under the NYC Non-Participating Provider Schedule of Allowable Charges (Schedule). The reimbursement rates in the Schedule are not related to usual and customary rates or to what the provider may charge. They are set at a fixed amount based on GHI’s 1983 reimbursement rates. Most of the reimbursement rates have not increased since that time and will likely be less (in many instances, substantially less) than the fee charged by the out-of-network doctor or facility. You will be responsible for any difference between their fee and the amount of the reimbursement. Therefore, you may have a substantial out-of-pocket expense.

If you intend to use an out-of-network doctor or facility, you can get an estimate of the costs before you visit. EmblemHealth has a new self-service, treatment cost calculator in the member portal, myEmblemHealth. The service estimates out-of-pocket costs, or what you may pay for certain items and services. Members can save a PDF copy of the information they view in the online tool on the website or member portal. Members can also contact EmblemHealth Customer Service if they have trouble using the tool, or if they would like a paper copy mailed to them. Please note that this is just an estimate at the time you use the tool. Actual cost may vary based on actual services received and any changes to rates that may happen after the estimate. The best way to use your GHI CBP plan and save on out-of-pocket costs is to see a doctor within the network. Your out-of-pocket costs are lowest — in most cases, just a copay — when you see doctors within our network.

The Right Care, Right in Your Neighborhood

For convenient in-network primary and specialty care right in your neighborhood, look no further than AdvantageCare Physicians (ACPNY). Whether you’re feeling sick, managing an ongoing health issue, or just need a regular check-up, ACPNY’s “whole you” approach has your total care picture in mind.

30-plus Locations—You’ll find ACPNY medical offices throughout the New York metro area: Manhattan, Queens, Brooklyn Staten Island, Long Island, and in the Bronx with our affiliate, BronxDocs. Most offices offer co-located lab, radiology, and other related medical services. Any many are right next door to an EmblemHealth Neighborhood Care. For added convenience ACPNY also offers same-day/next-day appointments.

A Range of Care for You and Your Family

Care offered at ACPNY includes: Primary Care • Pediatrics • Behavioral Health • Cardiology • Endocrinology • Gastroenterology • Nutrition • OB/GYN • Ophthalmology • Optometry • Podiatry • Rheumatology • And more. Most offices also offer on-site lab and radiology services.

Your Own Care team — As an ACPNY patient, you’ll have a dedicated Primary Care Provider, supported by a team of care professionals to help you get the right care at the right time, including virtual visits.

Digital Access — With your myACPNY patient portal account, you can make appointments, request prescription refills and lab results, and more. And your medical records are available to your provider no matter which of our offices you visit.

Services for City of New York Employees

As a City of New York employee with a GHI or HIP plan, you have an exclusive, dedicated Gold Service Line, 646-680-3000. At this number, you can review the ACPNY network to get more information, schedule appointments, and be connected with EmblemHealth to answer any questions about your plan.

With ACPNY, you and your family will benefit from:

  • 30-plus convenient locations across the New York metro area
  • A broad range of primary and specialty care, and related services
  • Team-based care that helps you access the right care at the right time
  • Convenient on-site access to lab and radiology services, and more
  • The myACPNY patient portal that allows you to make appointments, request prescription refills, view lab results, and give any ACPNY medical office immediate access to your medical history and records.

To learn more about the AdvantageCare Physicians difference, call the dedicated City of New York Employee Gold Service Line at 646-680-3000 or visit acpny.com.

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Plans Underwritten by HIP


 

Plans Underwritten by GHI