NY Manual
SHP Manual

SHP Provider Manual
3.2 Coordination of Services | 3.2a Sample Service Plan Letter (Page 2)

3.2 a Sample Service Plan Letter (Page 1)

 

                                                                                                           

   

<<Date>> 

 

 

<<First Name>><<Last Name>>

<<Address 1>> <<Address 2>>

<<City>>, <<State>> <<Zip>>  

 

                                                                                                                                           Member:  <<MEM NAME>>

                                                                                                                                           Member ID#: <<MEM ID>>

 

RE: Service Plan 

Dear <<First Name>><<Last Name>>: 

This is to inform you that Senior Health Partners has approved the services listed below. 

This represents your Service Plan for your approved services for the period of XX/XX/XXXX to YY/YY/YYYY 

If you have any additional questions, please contact your Care Management Team at<< (212) 324-2600>><<Monday – Friday 9:00 a.m. to 5:00 p.m. >>.

 

Sincerely,   

 

cc: provider/facility/PCP/member