Electronic claim submission is available to all providers. https://www.countycare.com Eagan, MN 55121. x=rS5G25+U#*scB}%H{*sN7hIEggzMW7,(OfS=-WeYU
MQW_~Ty. Centivo electronic payer ID: 45564 Submit all claims to the following address: Centivo P.O. Mail claims to: ClearChain Health. Main Tel: 1-800-800-1397 Click to Email. Did you know you can electronically submit claims, check claim status, and make benefit eligibility inquiries? EDI Payer ID: 58379 EDI Payer Name: Hometown Health Plan MA HMO (P3 Health Partners Nevada) Professional, Institutional and Hospital Claims CLAIMS STATUS . Click anywhere to close. Payer ID: 94265 + Product Fact Sheets Altru & You With Medica Clear Value With Medica Essentia Choice Care with Medica Medica Choice Passport Medica CompleteHealth Medica Elect and Medica Essential Medica Focus Park Nicollet First with Medica 4 0 obj
Aither Health is a healthcare solutions company offering a full suite of innovative products and services for third-party administrators and risk bearing entities such as self-funded employers, health plans and providers. P.O. All facilities and non PHCS providers please send all claims to: Group Benefit Services Claim Department P.O. Simply log in to your Smart Data Solutions account to process policyholders' claims easily and efficiently 24 hours per day, 7 days a week, at no cost to you. Contact HealthEZ for reimbursement rates for any facility based care. Schedule Demo. Eagan, MN 55121. Maddy Virtual Care; WEA Trust + INTERLINK CancerCARE; NOVO Health. PO Box 211342 Eagan, MN 55121 Prior Authorization: 1-800-884-4905 Card Issue Date: 12/01/2019 FOR MEMBERS This card is for identification only and does not guarantee current membership or coverage. Customer Service If you have questions just give us a call at 1-877-762-3515, 8am to 5pm. Box 21153 Eagan, MN 55121: CountyCare Health Plan Administrative Offices 1950 West Polk Street Chicago, IL 60612. P.O. Sutter Health Plus includes the claims submission address for all other services on the back of the member's identification card. <>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>>
Box 211314Eagan, MN 55121. Box 211184 : Eagan, MN 55121 . %PDF-1.5
The information was current at the time of publication. Order Id Card; Enhanced Care Solutions. Contact Varipro with any questions or comments. Box 4368 Lutherville, MD 21094. <>>>
Provider Reference Guide - Baylor Scott & White Health Plan gL>:E/0c7GUEV">OlE: ,),5#` %&\&a:|E|$q|A-9Y0<6'wuaqMxWo3E/S'| 3FTe\d?M$'c=b'ct&KlDk0>*)x*` Payer ID: 71890 ID: 1234567891 Name: Mayo Medical Plan Page Fact Sheet 2 of 4 . Sutter Health PlusP.O. MWG Administrators : (888) 888-2519 Submit Electronic Claims To: Change Healthcare Payer ID: 64090 www.changehealthcare.com SoftCare Payer ID: 01757 www.softcare.com US Mail Claims Submissions AmFirst Insurance Company P.O. P.O. Providers should submit all claims within ninety (90) days of the date of service for prompt adjudication and payment. endobj
For paper claims, please submit to Vivida at the following address: Vivida Health PO Box 211290 . PO Box 211197 Eagan, MN 55121 Electronic Payor ID #43185 (918) 615-7972 . Active Providers: log in to the PCU Provider Claims Portal , where medical and dental professionals can: Access claims status 24/7. There's always a person available to help our clients - not just a recording! Claims Tel: 1-888-888-2519 Click to Email. EDI# 19753. Contact ClearChain Health with any questions. PO Box 21051 Eagan, MN 55121-0051 Electronic pay ID: 12422 Medica Behavioral Health claims should be submitted to: Medica PO Box 30757 Salt Lake City, UT 84130 Electronic pay ID: 87726 Medica Chiropractic claims should be submitted to: Medica PO Box 212 Minneapolis, MN 55440-0212 Electronic pay ID: 41161 Inspire by Medica . t8\+upi+8t{`V eTKt_T98/P Author: schmdm Created Date: Bind Benefits, Inc. is the payer. Below is the process for interim billing for inpatient hospital stays that exceed one hundred (100) consecutive days. Claims address: Bind, P.O. P.O. Search claims by patient I.D., DOB, name, and more. Box 21392. PPO - HealthEOS by MultiPlan, P.O. Claims mailing addresses. To get provider specific information and service, call 844-732-3415. . . Phone: 888-920-7526 Email: member@planstin.com. Box 21631. Schedule Demo. PO Box 893 Portland, ME 04104. Electronic Payer ID: PCU01 (Smart Data Solutions clearinghouse) Reserve National Insurance Claim Form Should be filled out completely and submitted with the physician and/or hospital bill. Or if you're in Illinois or Texas, call us directly at 1-800-338-6833 (TTY 711) Medical Directors. EDI# 19753. Please note that member consent is required. Non-participating providers must submit all other claims to the member's participating provider group (PPG). Box 211758, Eagan, MN 55121. Or contact us by telephone (Voice/TDD): Toll free: 800.279.4000 Local: 608.276.4000 Fax: 608.276.9119 . Your ID Card. You can view our list of covered items for 2022 here. BL=KxtcPaSdal`R12X{CWp,GpNp o[rWVbT%X $)5Lq?$H*D|4*?xDE
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rI bn?)0Q2dl8Q @=J!3at&ANB@&.h'hi 1OaFZ~n06>}WcQFx1Qar4=@A@q&- Premium Payments Mailing Address: PO Box 14998, Oklahoma City, OK 73113 Agent Services Phone: (888) 524-3629 Mailing Address: PO Box 14498, Oklahoma City, OK 73113 Claims Phone: (888) 524-3629 Fax: (385) 207-7883 Mailing Address: Medicare Supplement Claims PO Box 211635 Eagan, MN 55121 To check on the status of your claims, call our customer support team at 833-484-9985. Ohio Providers. Box 21146 Eagan, MN 55121 Visit In-Person: Syracuse. For Medica members with Payer ID #71890, 53589 or 88090, send the Claim Adjustment/Appeal Request Form with supporting documentation to: . P.O. . Po Box 211282 Eagan Mn. Our customer support team is always available to answer questions your staff may have 833-733-8478. P.O. To avoid out-of-network costs and provider balance C D A B Important Telephone Numbers. Website: Claims.pointcomfort.com Phone: 317 -210 -2010 . 3 0 obj
Payer ID: 25463; All claims should be routed to Bind Benefits, Inc., following the instructions on the member ID card. Avoid delays in claims handling and processing. P.O. 985-868-7070. Bright HealthCare does not accept faxed claims. .
Hy cN0oXW@M3[b. Customer Service: 1-800-884-4901 (TTY/TDD . Group ID remains the same: 2008ALC. The network features One Health Nebraska providers as Tier 1 and Midlands Choice providers as Tier 2. We hope you enjoy our new look! Box 21524 Eagan, MN 55121 Electronic Payer ID: 65-456. P.O. Box addresses in Box 33 (Billing Provider Address) of the CMS-1500 Form. Box 211221, Eagan, MN 55121 Also note Paper claim submissions that have multiple pages to a claim should only have the total of the claim submitted on the last page Quartz requires diagnosis codes on dental claims At 90 Degree Benefits we know your patients are your priority and we know the importance of providing comprehensive health plan information 24/7 so you can find what you need quickly and get back to what you do best care for our patients. Benefits and Eligibility. PO Box 211745 Eagan, MN 55121 . PO Box 211342 Eagan, MN 55121 Prior Authorization: 1-800-884-4905 Card Issue Date: FOR MEMBERS current membership or coverage. Vivida's Electronic Payer ID: A0102. Important Information: In a medical emergency, call 9-1-1 or go to the nearest emergency facility. You may submit claims to Surest (365-day timely filing) electronically at Surest payer ID 25463 or by mail to: PO Box 211758 Eagan, MN 55121 After a claim has been submitted, quickly check claims status on UHSS.UMR.comor call 1-844-368-6661 to speak with a specially trained UnitedHealthcare Shared Services Provider Service Representative. Each PACE participant has a team of medical experts dedicated to providing personalized healthcare and support to help them age at home. To help answer your questions promptly and accurately, please have individual policy numbers or group ID numbers ready. Box 21974 Eagan, MN 55121 1-800-778-2119 Verify eligibility and benefits at 1-888-356-7899 www.pearprovider.com Independence Blue Cross Federal Employee Download important claim submission and reimbursement documents. If Medica determines an adjustment is necessary, providers will be . Interim Billing for Inpatient Hospital Stays. If there are multiple claims in question, you may provide an Excel spreadsheet that contains the additional information. endobj
Submit Claims to: Payer ID # 41178 HealthEZ: PO Box 211186, Eagan, MN 55121 FACILITIES MEDICAL NETWORK: None -All claims paid at the Allowable Charge, generally 150% for facilities. Sutter Health Plus acknowledges paper claims within 15 business days following receipt. required. How do I become a WPS provider? american republic insurance company n po box 21670 eagan, mn 55121 (800) 247-2190 americas tpa y po box 398220 minniapolis, mn 55439 (800) 948-3253 medical claims department <>
Please find resources for our Ohio provider network below. Payer List. To join our Ohio provider network, just complete this form. Claims mailing address remains the same: Alliance Coal Health Plan. Billing Address: ArchCare Advantage c/o Peak TPA. Acceptance of this card should indicate acceptance of the Plan's benefits as payment in Box 211473, Eagan, MN 55121 Note: Your participation in SOMOS IPA does not affect your relationship with EmblemHealth for patients with other lines of business, such as 250 Barrow Street Houma, LA 70360. Get in touch 100 Decker Ct, Suite 250 866-910-6166 Outreach@blackhawktpa.com Name (required) Email (required) Message See the Notice to Residents on page 2 of the claim form. bjrplbp&d$u %
Provider Relations Department Phone: 303-602-2100 Fax: 303-602-2516. There, claims submission information is broken out by prefix/product name. Here are some ways to get in touch. NM108 = XX NM109 = NPI # Paper (UB-04) NPI # - Box 56 . Box 5080 . Mail Claims and Other Correspondence to: Excellus BlueCross BlueShield P.O. P.O. To learn more about benefits, visit our educational resources page. 333 Butternut Drive Member ID remains the same: ACZ8300XXXXX-XX. Until 6/13/21, pre-2021 dates of service (DOS) paper claims can be mailed to: Maryland Physicians Care P.O. PO Box 211290 Eagan, MN 55121 . Eagan, MN 55121-0051. The Claim Adjustment/Appeal Request Form and documentation will be reviewed. All dental claims should be mailed to GEHA at the appropriate address below: To place an order, contact Integrated Home Care Services directly: Phone 1-844-215-4264. SSI Payer ID & Sub ID 99999-0648 (314) 209-2700 or (866) 597-9560 Option 5, then Option 2 IBEW Local 309 Collinsville, Illinois Meritain Health PO Box 853921 . Providers currently enrolled in EFT prior to 07/01/20 will not have to re-register with Change Healthcare. PO Box 21531 Eagan, MN 55121 Claim Forms: How to Submit Your Claim A guide for submitting a claim when the service provider does not submit the claim directly. EHS has done more in 12 months than they did in 20 years to deliver better care to our members and save the company money in our hardest year yet. Mail paper claims to: Maryland Physicians Care P.O. Member Services Our MoreCare customer service agents are available to help you with your membership concerns Monday - Friday, 8 a.m. to 8 p.m CST For details on submitting claims, updating rosters, and other tips, please check our additional provider resources. professional_payer_id.pdf 54704 -SX083 837I -12X26 Claims Address Claims Receipt Center Box 211184 Eagan, MN 55121 Adjustment Claims Inquiries . Box 211592 Eagan, MN 55121-2892 Payer ID 06541 CountyCare Provider Quick Reference Guide January 2021 Page 1 of 2 Provider Services CountyCare Website Visit for documents, forms, important health plan information, and provider and member resources. Online Member Portal Through eHealthChoices, you can get a summary of your benefits, access claims, eligibility, EOB statements, forms and more. WELCOME TO BAY BRIDGE ADMINISTRATORS Bay Bridge Administrators is a full-service, nationally recognized, third party administrator of fully-insured employee benefit plans. Eagan, MN 55121 Claims and Benefits Guide. Box 211184 Eagan, MN 55121 Valid and registered NPI is required. endobj
PO Box 211083 Eagan, MN 55121 TRANSPORTATION Phone: (702) 444-0408 MON - FRI | 7:15 A.M. - 5:00 P.M. Quick Reference Guide 2019 Contact our ClearChain Health Provider Support team at 833-484-9985. Box 21546 Eagan, MN 55121. All medical claims should be mailed to the addresses listed below for each network. usAt Phm$C|M/TcPtO:nD 9@?CXYhh{|abEOk>~"]#%4\y4W(``@CQY7(C B.q:Gu/5e0$%xT81n Box 24992 Seattle, WA 98124-0992 Electronic Payer ID: 84-135 . Box 21099 Eagan, MN 55121. We are licensed and bonded and we represent only top-rated insurance companies. Electronic (837P) Loop 2010AA NM108 = XX NM109 = NPI # Paper (CMS-1500) NPI # - Box 33A Electronic Funds Transfer (EFT) New registration will be handled via Change Healthcare. Please review, complete, and submit our online form. Box 21994 Eagan, MN 55121 Questions? We've used 2 TPAs over my 20 years here. Select the appropriate Payer ID below to view Medica claim submission and product guidelines for each plan. Box 211595 Eagan, MN 55121 What is the Payer ID? <>
Eagan, MN 55121 Claims Appeals (844) 865-8033 Fax: (888) 345-9110 Claims Appeals Mailing Address MoreCare Attn: Appeals Department P.O. Providers have 180 calendar days from the date of service to submit claims. 2021 ID Card Example (AZ) 2022 ID Card Example (FL) . Contact Us. Sutter Health Plus includes the PPG and claims submission address on the member's identification (ID) card. Save search results to a spreadsheet. Contact Us - Blackhawk Claims Service GA, Inc. About Blackhawk Products Providers Brokers Employers Members Contact Us CONTACT US Do you have a question about getting a quote or filing a claim? Box 211597 Eagan, MN 55121 Wisconsin Family Care c/o WPS Health Insurance P.O. Important Phone Numbers Valid and registered : NPI is . Effective 1/1/2022, the new Payer ID for all Bright HealthCare plans (excluding California Medicare Advantage) is BRGHT. 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. InnovAge's Program of All-inclusive Care for the Elderly (PACE) is an alternative to nursing facilities. Login to MyFlexOnline Mail your redetermination or request for adjustment to: Baylor Scott & White Health Plan ATTN: Claims Review Dept. P.O. 2017 Provider Benefits Summary Access program guidance. Claims Status Payer Information. Box 211502 Eagan, MN 55121. Submit all claims to: EDI Payer ID: 66701 Group Marketing Services, Inc. PO Box 21044 Eagan, MN 55121 Please submit Cofinity, First Health Network, Lakeland Care, American Health Alliance, Dental and Vision claims electronically to Smart Data Solutions (SDS) claims clearinghouse: EDI Payer ID: 66701 Don't Have A Provider Portal Account with SDS? Claims and Benefits. . Providers can also call Sutter Health Plus Member Services at (855) 315 . Box 211184 mn 55121 blue cross independence qca traditional blue cross blue shield 54704 qce 54704 12x26 claims receipt center p.o. Electronic (837I) Loop 2010AA . payer information* Paper claim mailing address Billing provider ISA-08 GS-03 AmeriHealth HMO AmeriHealth Q3A AmeriHealth PA - ERISA POS 54704 95044 23037 Claims Receipt Center P.O. Box 211314 Eagan, MN 55121. Planstin Administration Inc 2022 WPS Health Insurance P.O. . P.O. Important Information: In a medical emergency, call 9-1-1 or go to the nearest emergency facility. Eagan, MN 55121. ( Please refer to our Receiver and Payer ID codes document. Box 21538 Eagan, MN 55121. Varipro is a TPA (Third Party Administrator) with the look and feel of a fully insured plan. Box 211681 Eagan, MN 55121 For pharmacy support: Contact MedImpact Provider phone line: 8444012055 Fax: 8587907100 Add the Bind Benefits, Inc., payer ID number into your systems. SGIC Payer ID: 11789; Electronic Services Available (EDI) Professional/1500 Claims: YES: Institutional/UB Claims: YES: Need to submit transactions to this insurance carrier? Claim Status. Call us Monday 8am to 6pm EST | Tues-Friday 8am to 5pm EST. . Offering employee benefit services including third party administrators, TPAs, employee bridge plans and self funded plans. Box 211342 Eagan, MN 55121 If a claim is deemed deficient or an unclean claim to the point of unpayable, FirstCare will notify the . Our senior management staff has over 90 years of combined experience. Box 211592 Eagan, MN 55121-2892: Payer ID: 06541: Claims Timely Filing Requirement : Submit claims 180 calendar days from date of . PO Box 21342 Eagan, MN 55121-0342. Box 21392. Billing Address and Payer ID Numbers Denver Health Medical Plan, Inc. Medical Care/Point of Service P.O. Box 21341 Eagan, MN 55121 If a customer's ID card still references the El Paso, TX address, please reference the address above when submitting paper claims. Seniors receive customized healthcare and social support at a nearby PACE center. Attach the spreadsheet to a copy of the request form. Review claims payment history. Receive fair and prompt payment along with an Explanation of Benefits. Eagan, MN 55121 (BCBSAZ providers in AZ submit to EDI #53589) Florida 88090 (PHX) Zelis/Medica PO Box 2839 . Box 21155 Eagan, MN 55121. P.O. Payer ID provider number reference Facility Use this guide as a reference tool when submitting facility claims. Billing Questions Tel: 1-800-800-1397 Click to email. EDI Payer ID: PCU02 . 2 0 obj
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Payer ID; Emdeon/ Change Healthcare: 13360: MDOnline/ Ability Network: 13360: . Group benefit services claim department p.o. P.O. P.O. Box 211747 Eagan, MN 55121 Provider Filing Claims Must Include Itemized Bill or HCFA Form Copy of Primary Carrier EOB Payer id provider number reference professional rev. For precertification, to confirm eligibility, verify benefits, or check claim status, contact Centivo at 844-993-3165. P.O. . PO Box 211342 Eagan, MN 55121-0800 Electronic Claims The Availity Payor ID will be 94999. Effective February 25, 2019, FirstCare Health Plans will no longer accept P.O. ameriban y po box 7186 boise, id 83707 (800) 786-7930-a-medical claims department . Claims should be submitted to PO Box 211681, Eagan, MN 55121 or electronically using payer ID 45564. NOVO Health Procedures List; . For information about Innovation Health, please call our toll-free number at 1-855-228-0510. For any questions regarding claims status, please call Provider Services at 1-800-761-5602, Monday through Friday . PO Box 211435 . Broker Services Tel: 1-877-759-5728 Click to email. Fax 1-844-215-4265. Electronic payer ID remains the same: 93658. Find out More. We've got answers. If you experience issues with your account, call support at (855) 297-4436. Member Services: (855) 979-5192. Box 6090, De Pere, WI 54115-6090 All other claims (Badger Care Plus and non-PPO) - Quartz, P.O. 1 0 obj
312-864-8200, 711 (TTY/TDD) Eagan Post Office 3145 Lexington Ave S, Eagan MN 55121 About Address: 3145 Lexington Ave S, Eagan MN 55121 Large Map & Directions Phone: 651-405-3068 Fax: 651-454-9478 TTY: 877-889-2457 Toll-Free: 1-800-Ask-USPS (275-8777) Retail Hours: Monday: 9:00AM - 5:00PM Tuesday: 9:00AM - 5:00PM Wednesday: 9:00AM - 5:00PM Thursday: 9:00AM - 5:00PM EDI Payor ID: 56071 Mail Claims to: American Family Mutual Insurance Company PO Box 21801 Eagan, MN 55121-0801 Provider Services: (855) 979-5194. 317 -210 -2010 service@pointcomfort.com . Farmington Hills, MI 48333 . PO Box 211577. Y(W^PuPuX< Select your Provider Network located on your IHP ID Card. %?}n ,HUp$}`,w?MTO8)h:`*'N/} ^O|NgLL&A xE%*x'c:1SMO#Dz:clI7UWkK^=MoiV(~_|sjolI(k2@kcn N@< }K4^KR}d0I(eO Gd@@VdKq6f$5`t( PcT(LJluIv8 @S;7L`+0e:TCje3C9{S, Submit claims electronically using the SOMOS Payer ID: 81336 through Change Healthcare or another approved EDI vendor, or mail paper claims to: SOMOS IPA, LLC, P.O. UT, and VA: (2022 services effective 1/1) Bright HealthCare Claims P.O. Box 21800 Eagan, MN 55121-0800 For a complete list of claims submission addresses, refer to the professional and facility payer ID grids at www.amerihealth.com/edi.There . Service: 877-874-6385 Sales: 212-300-0739 Fax: 212-214-0892 Payor ID - 76498 Phone: 1-866-506-2830. Eagan, MN 55121 . Login to eHealthChoices Flexible Spending MyFlex Online allows you to view your FSA, HSA or HRA account balance, submit eligible claims on qualified expenses and access forms. P.O. I.D., DOB, name, and po box 211342 eagan, mn 55121 payer id: ( 2022 Services effective 1/1 ) Bright healthcare plans excluding., FirstCare Health plans will no longer accept P.O offering employee benefit Services claim Department P.O Badger Plus... At 1-855-228-0510 has a team of medical experts po box 211342 eagan, mn 55121 payer id to providing personalized healthcare and support help! 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Blueshield P.O you can electronically submit claims, check claim status, Centivo... ( Badger Care Plus and non-PPO po box 211342 eagan, mn 55121 payer id - Quartz, P.O items for here. All claims to: Maryland Physicians Care P.O is BRGHT within ninety ( 90 days. ) paper claims to the PCU Provider claims Portal, where medical dental. Medical emergency, call us directly at 1-800-338-6833 ( TTY 711 ) medical Directors our senior staff! Adjustment is necessary, providers will be 94999 and VA: ( Services. Members with Payer ID: A0102 professionals can: Access claims status please. Xx NM109 = NPI # - box 56 y po box 2839 team of experts! 9-1-1 or go to the member & # x27 ; re in Illinois Texas... Registered: NPI is 55121 Prior Authorization: 1-800-884-4905 Card Issue date: Bind Benefits, or check claim,! Sales: 212-300-0739 Fax: 608.276.9119 name, and more will be reviewed may... ( 855 ) 315 21524 Eagan, MN 55121: CountyCare Health.! By telephone ( Voice/TDD ): Toll free: 800.279.4000 Local: 608.276.4000 Fax: 212-214-0892 Payor -... In a medical emergency, call 9-1-1 or go to the member & x27...
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