India A. 0000010920 00000 n Service line date required for outpatient procedures. Taiwan 0000087708 00000 n EDI Submitter: 44054 Rendering/attending provider NPI (only if it differs from the billing provider) and authorized signature. 0000140914 00000 n Guam Malawi Puerto Rico EDI Submitter: 44054 Department Chair Slime Party - Because Slime is Fun for Adults, Too! Liechtenstein Freedom Life Insurance Company of America Payer ID: 62324; Electronic Services Available (EDI) Professional/1500 Claims: YES: Institutional/UB Claims: YES: Secondary Claims: YES: Need to submit transactions to this insurance carrier? 0000159788 00000 n 0 CD Discount. Norway 0000159195 00000 n 0000146494 00000 n Northwest Territories 2021-2022 Annual Report. hbbbd`b``l $ u Learn more about the data we collect or request your data be removed, Choosing Who Can See My Confidential Medical Information, Copyright 2023 Managed Health Network, LLC. Ecuador Box 30783, Salt Lake City, UT 84130-0783 Hh2lW` kd+*~(s*#Oo6XvF#rQUUi1@Hk3Y-2` 0000157961 00000 n Salt Lake City, UT 84130, WellMed Claims address 0000001043 00000 n FLORIDA UBC HEALTH FUND If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. hbbd```b``"fHL NA$>d4 9`v Reunion Salt Lake City, UT 84130-0783 De + 0000146835 00000 n CPT is a numeric coding system maintained by the AMA. Please note: The networks listed below should be used for claims based on services performed in 2020. DOS on/after 1/1/2015 need to be sent through UMR Wausau Payer ID 39026. Imaging Center PO BOX 29045 Hot Springs, AR 71903, Denial Code CO 4 The procedure code is inconsistent with the modifier used or a required modifier is missing, Denial Code CO 18 Duplicate Claim or Service, Denial Code CO 16 Claim or Service Lacks Information which is needed for adjudication, Denial Code CO 22 This care may be covered by another payer per coordination of benefits, Denial Code CO 24 Charges are covered under a capitation agreement or managed care plan, Denial Code CO 29 The time limit for filing has expired, Denial Code CO 50 These are non covered services because this is not deemed medical necessity by the payer, Denial Code CO 97 The benefit for this service is Included, Denial Code CO 109 Claim or Service not covered by this payer or contractor, United Healthcare Customer Service Phone Numbers, Cigna Claims address and Customer Service Phone Number, Insurances claim mailing address and Customer Service Phone Numbers, Healthfirst customer service phone number, claim and appeal address, United Healthcare Claims Address with Payer ID List, Aetna Claims Address for Mailing and Insurance Phone Numbers for provider and Member, Medicare Claims address-When and How to file for reimbursement, List of Worker Compensation Insurance with Claim mailing address, List of Auto Insurances with Claim mailing address, Insurance Claims address and Phone Number, Insurance with Alphabet A Claims address and Phone Number, Insurance with Alphabet B Claims address and Phone Number, Insurance with Alphabet C Claims address and Phone Number, Insurance with Alphabet D Claims address and Phone Number, Insurance with Alphabet E Claims address and Phone Number, Insurance with Alphabet F Claims address and Phone Number, Insurance with Alphabet G Claims address and Phone Number, Insurance with Alphabet H Claims address and Phone Number, Insurance with Alphabet I Claims address and Phone Number, Insurance with Alphabet J Claims address and Phone Number, Insurance with Alphabet K Claims address and Phone Number, Insurance with Alphabet L Claims address and Phone Number, Insurance with Alphabet M Claims address and Phone Number, Insurance with Alphabet N Claims address and Phone Number, Insurance with Alphabet O Claims address and Phone Number, Insurance with Alphabet P Claims address and Phone Number, Insurance with Alphabet Q and R Claims address and Phone Number, Insurance with Alphabet S Claims address and Phone Number, Insurance with Alphabet T Claims address and Phone Number, Insurance with Alphabet U Claims address and Phone Number, Insurance with Alphabet V Claims address and Phone Number, Insurance with Alphabet W to Z Claims address and Phone Number, Medical Billing Terminology of United States of America, What is Explanation of Benefits of Health Insurance in Medical Billing. Chief Compliance Officer -- Please Select -- Cardiology Kenya 0000005075 00000 n Patient Access Laos Zimbabwe, State/Location Martinique 800.821.6136. Other health insurance information and other payer payment, if applicable. COMMERCIAL. Availity is working with the payer to resolve this issue as quickly as possible. China OptumRX Vice President All medical claims should be mailed to the addresses listed below for each network. How to use this page To ensure accurate submission of your claims, answer these three questions: What plan is it? Alaska Dental Plans. 0000022641 00000 n 0000009289 00000 n Other, Bed Size Japan Patient or subscriber medical release signature/authorization. Paper Claims . MHN collects some private data about site visitors. Pharmacy 0000158331 00000 n Non-Participating Payor. -- Please Select -- Turks/Caicos Isls. !tWu}]{|o>oI{;jOGG{vx_~|;}r{%5Hmw~{:nz/vZm>/~?9OoOCpR[%^ND?JwSn7{/Aw7xm~zvd|w/xzw9zg/7rj*.1 1=F%Rk-u[wz)FrFn=yS=78Y;v_6mENZtZ74;'|)oSuwX}p4SF7KaKjF4T%] SBr,`.l`) hrWjv2|8(yV]zZFi6/ )k/TRA"7k+e33'':8b'RJO[FZV-+T*|T 2LfgBo]HzwCa$*bVgeMkR @0vq+ Payer IDs are used to route EDI transactions to the appropriate payer. Algeria South Africa US Minor Outlying Is. South Dakota 0000004418 00000 n Virgin Islands (British) Germany C-Level Laboratory Together, we are accelerating the journey toward improved lives and healthier communities. 0000049603 00000 n Medical Record Retrieval & Clinical Review Login to your community accounts to get product updates, ask questions, and learn best practices. Enrollment 0000088002 00000 n PO Box 30783 Administrator Need to submit transactions to this insurance carrier? The CPT code book is available from the AMA Bookstore on the Internet. American Samoa All medical claims should be submitted electronically using the network EDI numbers as listed below for each network. New Jersey Virgin Islands Protect Yourself This Holiday Season with Health Tips, Indoor Activities for Kids That Dont Include Screen Time, No Excuses: How to Accomplish Your Goals In the New Year, Need More Vitamin D? Lithuania Call to verify network status and you'll be ready to accept all three in no time! Saint Kitts and Nevis 0000081169 00000 n . 0000087773 00000 n All dental claims should be submitted to EDI: 44054. P.O. No additional support tickets are needed at this time. 0000097318 00000 n To support a better user experience on our website, we've combined our frequently asked questions to one section (e.g., claims, provider portal, EAP center of excellence, general, etc.). 0000022830 00000 n Mozambique 0000035375 00000 n Direct Care Broker or Supplier Contracts: Accredo, AeroCare, Apria, Bayada, BioScrip, Byram, CardioNet, Coram, DJ Orthopedics, DynaSplint, Edgepark, First Call Pharmacy, Hoveround, InfuSystem, Insulet, Interim, KCI, Liberator/Bard Care, Lincare/American Home Patient, Hanger, Optum Women's and Children's Health, Maxim, McKesson, The Med Group, Medtronic, National Seating and Mobility, NE Express, NuFactor, Option Care, Orthofix, Respirtech, Rotech, 180 Medical, Exception: Providers contracted with VGM Homelink submit claims to Homelink: Billing provider National Provider Identifier (NPI). Antarctica 0000007145 00000 n 0000049714 00000 n Laboratory Delaware h[]~L0wHv8vqt~*rH7,3tizC]oIzYNJmkm*U Corrected Claims/ Resubmissions National Drug Code (NDC) for drug claims as required. In order to ensure claims are submitted correctly, providers must use the following Payer IDs: 68069 for Medical Services. Fiji Contact us. 0000003247 00000 n All medical claims should be submitted electronically using the network EDI numbers as listed below for each network. 1095 tax forms now available Medical members can access your 1095 tax form by, You are using a browser we no longer support. Chief Information Officer Belize Billing provider tax identification number (TIN), address and phone number. All dental claims should be submitted to EDI: 44054 If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. CD Plus. Louisiana 0000147228 00000 n Five Ways to Ease Back to School Stress for Kids, Avoid Mindless Eating with these Five Tips, Five Easy Ways to Establish Proper Handwashing Behaviors, WildFire Resource Guide & Hurricane Resource Guide, Tips on How to Communicate with Children During COVID-19 Pandemic, Five Ways Relationships Are Good for Your Health, Diabetes Awareness Month: Tips for Preventing and Recognizing Signs of Diabetes, Eating for Your Sight: Five Foods for Healthy Eyes. 376 0 obj <> endobj Bosnia and Herzegovina Optum receives 837I (institutional claims) and 837P (professional claims) and routes them to UMR. If you have claims for GEHA FEHB members and Medicare is the primary plan, GEHA participates in CMS Coordination of Benefits Agreement (COBA) Program and will receive claims and the Medicare primary benefit information electronically from the Coordination of Benefits Contractor (COBC). Philippines Pitcairn Kiribati United Kingdom Please find frequently asked questions on the Provider FAQs tab or click, OHS Driving Under the Influence (DUI) Program, Understanding Your Out-of-Network Benefits, You Too Can be a Hero by Wearing a Face Mask, Fireworks Safety: Dont Let a Good Time Blow Up in Your Face. Accommodation code is submitted in Value Code field with qualifier 24, if applicable. Dental Network Solutions Pennsylvania In addition, submitting electronically reduces postage and other paper related expenses and supports improvement to your overall . Please Use Payor ID# 63100. 0000006920 00000 n Kentucky Mali Box 1860, Waterloo, IA 60704. Wisconsin 0000158654 00000 n Seychelles Coordination of benefits (COB): When we are the secondary payer; the provider must submit the claim and a copy of the explanation of medical benefits/explanation of benefits (EOMB/EOB) from the primary carrier to Health Net for payment consideration. Sample GEHA Member ID Card . Rwanda Payer Payer ID: 39026 United Health Shared Services (on back of card) Payer ID: 39026 . Radiology Mississippi 0000080992 00000 n Burkina Faso Patient name, Member identification (ID) number, address, sex, and date of birth must be included. -- Please Select -- California Eye Care - New Century Health . $UZZNl)Q,nB=&X"HZic2lc[J"*yDO3.o8T*feoXRz`4U !x*w$Jn(*Pmfk[wv$(=MKi3T|}G)WoKP 2Jl*N|Jd-EIAM}+>@rATf@MWX&3O5S-kLB)[MA=Ln5-IWEdVZTQ Palestinian Territory, Occupied Saskatchewan Dental and Medicare primary Mail to GEHA, Direct Care Broker or Supplier Contracts Sweden Military Pacific 2. 0000004177 00000 n z8aD>:wr?##:cR29**6$+GZPfz_igKmfB[IIC}(2k%6 RpT-sW1j\7y):X aENYvPo1g+'{1 v;w\9htw-]|6$^AW0pc}ru4O,4*;LcKa1op_e8B+B7~N.iMyB` UHC Provider ServicesPhone: (877) 343-1887 0000097136 00000 n Heard/McDonald Isls. CD Discount. Costa Rica * 0000000016 00000 n Lesotho Find out More. Maine 258. Diagnosis codes, revenue codes, CPT, HCPCS, modifiers, or HIPPS codes that are current and active for the date of service. CD Plus. 0000040339 00000 n Manitoba Singapore All dental claims should be mailed to GEHA at the appropriate address below: Direct Care Broker or Supplier Contracts EDI Submitter: 44054 P.O. 0000146026 00000 n National Uniform Billing Committees UB-04 Data Specifications Manual, is available at www.nubc.org. UnitedHealthcare Shared Services 0000028199 00000 n CF0101 08-08 52192. Germany 1-199 Primary diagnosis code and all additional diagnosis codes (up to 24 for institutional) with the proper ICD indicator (only ICD 10 codes are applicable for claims with dates of service on and after October 1, 2015). Original submission is indicated with a 1 in claim frequency box or resubmission code (box 22). Additional fields may be required, depending on the type of claim, line of business and/or state regulatory submission guidelines. Project Management Box 21542 Pharmacy Solutions 0000097202 00000 n HIPAA has national standards for health care EDI transaction and code sets. General Management Qatar Physician Including the correct 5-digit payer ID helps avoid having your claim rejected due to listing an incorrect payer. Please contact Change Healthcare at 1 (866) 371-9066 with any questions regarding electronic claims submission. -- Please Select -- Barbados Procurement/Purchasing/Supply Healthcare Consulting Services Cocos (Keeling) Islands 0000125869 00000 n Bouvet Island Printed: 10-03-2019 Call UMR at the member customer service number listed on this ID Card for plan required prior authorization. Michigan CALOP. Argentina Timor-Leste Djibouti Phone: (800) 821-6136, UnitedHealthcare Choice Plus (If the subscriber lives in any of the following states: Alabama, Arkansas, Delaware, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maryland, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Mexico, North Carolina, North Dakota, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington DC, West Virginia, Wisconsin and Wyoming) Independent Practice Affiliated with Hospital 0 TRICARE EAST ALL CLAIM OFFICE ADDRESSES: VAPCC E: TRIWEST HEALTHCARE ALLIANCE ALL CLAIM OFFICE ADDRESSES: 39026 E: UMR . %%EOF Croatia To ensure claims are as accurate as possible, use current valid diagnosis, procedure codes, and modifier codes and code them to the highest level of specificity (maximum number of digits) available. ^l,W~!u8XO7VZa}XhDt$Xq)5 %",g|0 *@&DX LZ2U[bfWPA 39026 52180 Unicare Life & Health Insurance Company 80314 35198 34638 . 404 0 obj <>stream 0000014575 00000 n 0000004183 00000 n Paraguay Only for claims where the submit claims to address on the medical ID card is a CoreSource . All dental claims should be submitted to EDI: 44054. Botswana Nicaragua %%EOF 257. Non-Participating Payor. Tajikistan Massachusetts Tuvalu EDI Payer ID 39026 Micronesia Senior Vice President lB8W)! Moldova Healthcare Information Exchange hb```b``c`e``)`b@ !?0 -# Home Health Agency Macau 68068 for Behavioral Services. Legal/Regulatory/Compliance endstream endobj startxref 0000103511 00000 n 299 0 obj <> endobj Guam Salt Lake City, UT 84130-0783 Dominican Republic Independent Practice Not Affiliated with Hospital Oman 0000007982 00000 n Dental is listed separately, if applicable. 0000008173 00000 n -------------- 0000061377 00000 n Niue 0000074037 00000 n Use the Change Healthcare product support portals to submit support requests and find answers to your questions. Congo, The Dem. 0000003714 00000 n Suriname Administrative/Human Resources Indonesia 392 0 obj <>/Filter/FlateDecode/ID[<2B6FDBD48D83564DAD4FC2DD51BA67C7>]/Index[376 30]/Info 375 0 R/Length 96/Prev 321559/Root 377 0 R/Size 406/Type/XRef/W[1 3 1]>>stream Cayman Islands New York Salt Lake City, UT 84130-0783. Single Page Claims: Claims without attachments are the simplest to file electronically. Turkey Teachers Health Trust 2950 E. Rochelle Avenue Las Vegas, NV 89121 . 0000049016 00000 n 0000103693 00000 n Afghanistan Utah Claims Payer List for UnitedHealthcare, Affiliates and Strategic Alliances Subject: Includes line of business, plan name and payer ID . 0000138352 00000 n We appreciate your interest in Change Healthcare. -- Please Select -- 0 Lexington, KY 40512-4621. Brazil 0000162376 00000 n United States Risk Adjustment and Quality Solutions Dental and Medicare primary Mail to GEHA, UnitedHealthcare Choice Plus (all 50 states) 0000048658 00000 n 322 0 obj <>/Filter/FlateDecode/ID[<304D90465B8F264FB3821BFEF410E30F><42BF6E1904DCEB468D2C308771CC1222>]/Index[299 38]/Info 298 0 R/Length 114/Prev 222343/Root 300 0 R/Size 337/Type/XRef/W[1 3 1]>>stream 0000049637 00000 n Western Sahara India 0000160401 00000 n Do not split bills by type of service or submit separate bills for overlapping dates of service for a component of treatment, including substance abuse toxicology testing. Bravo Health - Cigna Healthspring. Estonia Guadeloupe 0000103184 00000 n If you have any questions about payer ID numbers, please contact Harvard Pilgrim Health Care's Electronic Data Interchange (EDI) team at . If different, then submit both subscriber and patient information. Clinical Interoperability Solutions Name Address: City St: 56144 E HEALTHGRAM ALL CLAIM OFFICE ADDRESSES 71063 E HEALTHSCOPE BENEFITS ALL CLAIM OFFICE ADDRESSES . Missouri Hong Kong Egypt endstream endobj 300 0 obj <. Table of Contents . 0000073502 00000 n Faroe Islands 0000160789 00000 n submitting an EDI file using Payer ID UHNDC, you must successfully complete specific EDI testing. 0000062099 00000 n 0000127276 00000 n CWIBENEFITS INC. COMMERCIAL. New Zealand Quebec Newfoundland and Labrador Marianas All dental claims should be mailed to GEHA at the appropriate address below: If the patient has Medicare primary coverage, mail to GEHA: GEHA-ASA Emergency Medicine P.O. Other United Health Care Billing Considerations Some United Health Care now requires providers to obtain authorization for 60 minute therapy sessions. Senegal Type of Bill - Enter the appropriate three- or four-digit code that indicates the type of bill you are submitting. IMPORTANT NOTE: We require that all facility claims be billed on the UB-04 form. View our network today to connect with a payer or partner for all available transactions. 0000160095 00000 n Nauru British Columbia Electronic Interchange Group Professional Commercial Payer List Payer ID Claim Office # Type . Enterprise Imaging Solutions Partner/Reseller Singapore Claims Address For All UHC, UBH, and Optum P.O. Haiti 0000157101 00000 n Panama 0000004069 00000 n Contact your . Phone: (800) 793-9335, UnitedHealthcare Choice Plus (Florida and Texas) UHC Provider Services Phone: (844) 586-7309. Consulting 43 164 Brazil Palau Payer ID: 39026; Electronic Services Available (EDI) Professional/1500 Claims: YES: Institutional/UB Claims: YES: Eligibility: YES: Prime: Electronic Remittance (ERA) YES: ERA Enrollment Required . 0rT* Korea (North) hb``c``a`e`2AX@u@ All medical claims should be mailed to the addresses listed below for each network. Tunisia Congo 0000023307 00000 n Payer ID: 74227 ; Other, Country [Jr@rjyoWJ2& -Z p Connecticut France 3. If your provider has questions regarding this process, they may contact Envoy/Web MD or call the UMR EDI unit at 1-800-826-9781. New Medicare Card-What to do and how will new MBI number look? startxref 4q<={Wm|? All Rights Reserved, Attention providers!
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