Service Determination Requests

Service Determination Requests

As a participating provider of CenterLight Healthcare and an integral part of maintaining the care of our Participants, your patients, we feel it is important to establish a close, collaborative partnership. Together, we can share beneficial health information about your patients—our participants. We can then have the potential to identify concerns earlier and improve patient experience and health outcomes.

Our goal is to ensure that you are always kept informed of relevant information that will assist you in caring for your patients. We would like to share a new regulation that affects the care delivery of our Participants, Service Determination Requests (SDR). We have created a brief guide to what an SDR is, how to identify one, and how they can be communicated to CLHC. We encourage you to review this guide and to become familiar with the SDR process. We appreciate your taking the time to review this important information.

After you review this guide, please complete the Service Determination Request Training Attestation confirming you have reviewed the material. Only one attestation form needs to be completed for your organization. If you have multiple providers under one Tax Identification Number (TIN), please complete one attestation for the TIN. and a member of our team will be happy to assist you.

Should you have any questions, please reach out to ProviderRelationsRequest@centerlight.org and a member of our team will be happy to assist you.

CenterLight Healthcare has an approved PACE contract with the Centers for Medicare and Medicaid Services (CMS) and NY State Department of Health (NYSDOH). Enrollment in CenterLight Healthcare PACE depends on renewal of its contract with CMS and NYSDOH. Participants may be fully and personally liable for the cost of unauthorized or out-of-PACE program agreement services. Upon enrollment, the PACE program will be the participant’s sole service provider. Participants will have access to all services needed as identified by the Interdisciplinary Team, but not to a specific provider of these services. Please contact us for more information.

H3329 CLPACEWebsite Approved MMDDYYYY
Pending CMS and DOH Approval

Last Updated on September 5, 2024