WTC HEALTH PROGRAM NATIONWIDE PROVIDER NETWORK
Responders and Survivors in the World Trade Center (WTC) Health Program Nationwide Provider Network (NPN) have access to care related to their certified conditions, initial health evaluation, annual monitoring examinations (when applicable), and diagnostic testing.
Not sure when the NPN needs to make an appointment for your WTC-related care or when you can make one on your own? The guidance below is for members in the NPN looking to schedule new or ongoing appointments with a WTC Health Program provider.
First appointment with a provider?
It is extra important that the NPN schedule initial appointments. This makes sure that all bills are properly sent to the NPN, and you do not receive a bill. Scheduling your own initial care may cause you to be billed for services instead of the NPN.
As always, if you need to contact the NPN with questions on how to schedule an appointment, please call NPN Member Services at 1-800-416-2898 (Mon – Fri, 8am to 8pm ET).
Initial Health Evaluations (IHE) for Newly Enrolled Responders and Survivors
Who makes the appointment?
The NPN.
The NPN will contact you after enrollment to help you schedule your Initial Health Evaluation (IHE) and any additional care you may need. For newly enrolled Responders, the IHE is the same as your first monitoring exam.
Annual Monitoring Examinations (AME) for Responders and Certified-Eligible Survivors.
Who makes the appointment?
The NPN.
The NPN will contact you directly to schedule these appointments. You may also call the NPN for assistance.
Please do not attempt to schedule your own AME, even if you are seeing a provider you have previously seen. The NPN must ensure the provider is prepared to provide any testing you need, and that they send the NPN copies of the results afterwards. The results are used to identify any diagnostic testing or certifications you may need.
Members Transferring to the NPN from a Clinical Center of Excellence (CCE)
Who makes the appointment?
The NPN.
The NPN will contact you to transition your care to new in-network providers in your area. Please do not attempt to establish care with a new provider until you have spoken with the NPN.
Why do you have to speak with us? We must make sure that the provider(s) is in network. We may also need to send your medical records to that provider(s) along with important NPN information before you can see that provider.
Members Scheduling Appointments with a New Provider
Who makes the appointment?
The NPN.
If you need to see a new provider for any reason, including a new certification, referral to a specialist, need for additional diagnostics, moving to a new area, or dissatisfaction with a previous provider, please contact the NPN for assistance. The NPN will assist you with locating an in-network provider in your area and scheduling your first appointment.
Members Scheduling Recurring Appointments with a Current Provider
Who makes the appointment?
You do (or the NPN can help).
If you are already seeing an in-network provider for WTC-related care, you may schedule follow up appointments on your own, directly with the provider. If you would like assistance doing this, you may contact the NPN.
Members Who Are Unsure of Provider Status
Who makes the appointment?
Contact the NPN first.
If you are unsure whether your provider is in network or out of network, please contact the NPN for confirmation. If your provider is out of network, our team will assist you to transition your care to an in-network provider. We will also let you know at that point if you can schedule the appointment directly or if we need to do it.
REMEMBER! If you need to contact the NPN for one of the situations above or for other needs, please call NPN Member Services at 1-800-416-2898 (Mon – Fri, 8am to 8pm ET). If you do self-schedule an appointment, please contact the NPN as soon as possible so that we can confirm your provider is in network.