MLTC Member Materials and Forms
The list below includes links to a variety of materials for VNS Health MLTC members. You can get a printed copy of any member materials by calling 1-888-867-6555 (TTY: 711), Monday–Friday, 9 am–5 pm.
Member Handbook InsertNew York Independent Assessor – Initial Assessment Process
Online Provider Search Tool
Find an up-to-date list of in-network providers in your community. The search results are printable.
If you need a directory in a printable format, see the PDF files below.
Download PDF: NYC Metro Area Upstate New York
Forms and Personal Health Materials
CDPAS Recertification – Physician Order Form
MLTC members can have their home care service provided by a consumer directed personal care assistant through Consumer Directed Personal Assistance Services (CDPAS). The physician order form is required during the initial assessment and every 6 months during CDPAS recertification.
Download PDF: Form
Authorization for Release of Health Information Form (DOH 5032)
Authorization for Access to Patient/Member Information Through a Health Information Exchange Organization
Member Rights and Responsibilities Booklet
This booklet includes information on Member Bill of Rights and Responsibilities, Patient Self-Determination Policies, Making Decisions About Your Medical Care, and Planning in Advance for Your Medical Treatment.
MLTC Member Newsletters
See current and past issues of Member Newsletter for health tips and checklists, recipes, and more.