0000127723 00000 n We use the National Uniform Billing Committee (NUBC) Official UB-04 Data Specifications Manual as the standard source for codes and code descriptions to be entered in the various form locators (FL). All medical claims should be submitted electronically using the network EDI numbers as listed below for each network. Iraq hb``Xo:1Gl$ 4"c0ax`L^ H^;wxlO8.dVa,Pe8h6?RJ% kS; qTgaU`p*`b`a::*CX^C(($!!,719w !IC!1KO#k*X~b^1lH-fxfg=39X9bB;Y\"Y2lXZfLpFQYeR2#`*\(6 _4 (Claims for payer address of Rockford, IL ONLY.) Cte d'Ivoire Djibouti Claims: EDI # 39026, UMR, PO Box 30541, Salt Lake City, UT 84130-0541 Vision Claims: Spectera Vision, PO Box 30978, Salt Lake City, UT 84130 This card must be presented each time services are requested. Printed: 10-03-2019 Call UMR at the member customer service number listed on this ID Card for plan required prior authorization. Cuba Luxembourg Single Page Claims: Claims without attachments are the simplest to file electronically. Heard/McDonald Isls. Universal product number (UPN) codes as required. Martinique Payer IDs are used to route EDI transactions to the appropriate payer. Illinois hbbd```b``:"-T0w"1 #Xed;fd0DGHm RLHee`bd`d M" Hge 0 BA= United States Adding insurance payers and selecting the correct payer ID Kazakhstan 3. Dental Plans. Greece h1 04f\G` z0=i2\x!!!!!!!CCC. 0000146494 00000 n When "a" is the alpha character shown on the state license (A, C, G), "0" is the filler zero and "nnnnn" are the five numeric characters in the state license number. Electronic Submission to United Healthcare In case of electronic submission, you will need UHC payer ID i.e. Vendor Relationships 0000145948 00000 n Senior Vice President 316. Consumer Payments & Communications 0000062099 00000 n If you do have electronic claim submission capabilities, please submit claims electronically. Independent Practice Not Affiliated with Hospital UHC Provider Services Phone: (844) 586-7309 Laboratory For physicians, the state license number should be entered as a seven-digit number "A0nnnnn." Serbia and Montenegro hb```e``Z"@(pzX`rSV%omFcs (E33v`9P3PesFk3Ag`v8RpW00'=@ ' Bravo Health - Cigna Healthspring. DOS on/after 1/1/15 need to be sent through UMR Wausau Payer ID 39026. 0000147653 00000 n Connecticut View our network today to connect with a payer or partner for all available transactions. Gabon 0000008125 00000 n Delaware 0000073889 00000 n 0000005887 00000 n 0000148268 00000 n PO Box 609 Colorado Springs, CO 80949-9549, Corrected Claims/ Resubmissions Lexington, KY 40512-4621. Mailing. ]m4hq51l^XNFsZb jB"l! GEHA FEHB Medical -- Please Select -- If your practice management system uses Emdeon as its clearinghouse, you can submit claims using MHN's payer ID: To find out if your practice management software uses Emdeon's clearinghouse, check with your vendor. 0000008030 00000 n Algeria submitting an EDI file using Payer ID UHNDC, you must successfully complete specific EDI testing. Please contact Change Healthcare at 1 (866) 371-9066 with any questions regarding electronic claims submission. Mozambique EDI Payer ID: 50701 American Samoa Manager Payment Accuracy Solutions South Carolina Paxlovid - Pharmacist Prescribed List. Access the Assurance EDI, Clearance EDI, and ConnectCenter payer information here. Israel 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. * The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), is currently used to code diagnostic information on claims. 0000019237 00000 n Where to Submit Claims | GEHA 0000049490 00000 n If you have any questions about payer ID numbers, please contact Harvard Pilgrim Health Care's Electronic Data Interchange (EDI) team at . Care Management/Population Health 0000036268 00000 n Wallis/Futuna Isls. UnitedHealthcare Shared Services This ID is used to submit claims electronically through our system. startxref 0000097318 00000 n EHR Implementation/Management Sweden PDF Clearance EDI Eligibility Payer List - Change Healthcare Please Select 0000162376 00000 n Mayotte 0000123934 00000 n For more information about Emdeon services, call (877) GO-WebMD (469-3263) or visit: Consolidated Billing: All charges for the patient stay should be included on the same bill, this includes therapy/treatment and ancillary services. Salt Lake City, UT 84130-0783 Chief Compliance Officer Find out More. Germany 0000004418 00000 n CD Discount. Bolivia Tokelau St. Helena 0000162699 00000 n Sri Lanka Learn More Change Healthcare Attachment Payer List Box 14621 Unsure, Company Type United Health Care, Optum, United Behavioral Health - What's The Deal? If your clearinghouse is not Optum, and you wish to receive an 835 electronic file, your clearinghouse has to enroll at Optum. Madagascar Georgia 13337. General Management TRICARE EAST ALL CLAIM OFFICE ADDRESSES: VAPCC E: TRIWEST HEALTHCARE ALLIANCE ALL CLAIM OFFICE ADDRESSES: 39026 E: UMR . Wisconsin Eagan, MN 55121, Mental Health, Behavioral Health, and Substance Use Disorder Claims rendered by in and/or out-of-network providers: GEHA-ASA Physician Only for claims where the submit claims to address on the medical ID card is a CoreSource . United Healthcare Claims Address with Payer ID List Identify those dropping to paper in your system and convert them to an EDI 837 transaction by applying the appropriate Payer ID . Payer Information. Puerto Rico 0000035375 00000 n Inpatient institutional claims must include admit date and hour and discharge hour (where appropriate), as well as any Present on Admission (POA) indicators, if applicable. Blue Shield of Iowa. 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. 0000129651 00000 n Department Chair Paper Submission to United Healthcare In case of claims paper submission to United Healthcare, you will need UHC claims mailing address. Solomon Islands Faroe Islands When billing for more than one attending provider, indicate each UPIN on the appropriate detail line. 0000008078 00000 n Lithuania On the UnitedHealthcare Payer List, medical Payer IDs refer to professional and institutional claim submissions. Claims submitted late may be . Dental is listed separately, if applicable. CD Discount. Canada D.C. Vice President The EDI 837 Health Care Claim transaction is the electronic transaction for claims submissions. 0000008173 00000 n 0000158331 00000 n Other, Country Please note: Do not use Payer ID 421406317. How to use this page To ensure accurate submission of your claims, answer these three questions: What plan is it? Hospital Employed Practice Where to Submit Claims | GEHA Radiology All medical claims should be submitted electronically using the network EDI numbers as listed below for each network. 0000127276 00000 n Get help with Change Healthcare products, find resources such as enrollment forms and payer lists, and quicklly resolve common issues. Cambodia Falkland Islands Chief Executive Officer Trust 200+, Practice Specialty Belgium Teachers Health Trust 2950 E. Rochelle Avenue Las Vegas, NV 89121 . Argentina Hh2lW` kd+*~(s*#Oo6XvF#rQUUi1@Hk3Y-2` P.O. To submit paper claims, please mail your form to: MHN Claims Other, Job Level El Salvador 0000018618 00000 n A Submit paper claims to the address on the back of the member ID card. Member Engagement P.O. 11729 0 obj <>stream Chief Operating Officer Services A complete claim is a claim, or portion of a claim that is submitted on a complete format adopted by the National Uniform Billing Committee and which includes attachments and supplemental information or documentation that provide reasonably relevant information or information necessary to determine payer liability. In order to ensure claims are submitted correctly, providers must use the following Payer IDs: 68069 for Medical Services. trailer PDF Reference Guide for Payer ID Numbers - Harvard Pilgrim Health Care IMPORTANT NOTE: We require that all facility claims be billed on the UB-04 form. Emergency Medicine No additional support tickets are needed at this time. Note: If you use a clearinghouse, billing service or vendor, please work with them directly to determine payer ID. endstream endobj startxref Spain Patient Access Panama New York Contact your clearinghouse if current Payer IDs aren't on their payer list. Medical claims rendered by in and/or out-of-network providers: Aetna Signature Administrators (If the subscriber lives in any of the following states: Alaska, Arizona, Colorado, Connecticut, Georgia, Kentucky, Maine, Massachusetts, Michigan, Nevada, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont, Washington) $UZZNl)Q,nB=&X"HZic2lc[J"*yDO3.o8T*feoXRz`4U !x*w$Jn(*Pmfk[wv$(=MKi3T|}G)WoKP 2Jl*N|Jd-EIAM}+>@rATf@MWX&3O5S-kLB)[MA=Ln5-IWEdVZTQ Access product updates and information, ask questions, learn about best practices & benchmarks, and connect with experts & peers. Healthcare Consulting Services Trinidad and Tobago 0000022641 00000 n 0000174831 00000 n -- Please Select -- 0000005075 00000 n Boost Your Intake with These Tips, Five Ways to Get Something Positive Out of Dealing with Your Emotions, Five Health Benefits of Smiling and Laughing, Five Simple Stretching Exercises to Improve Total Body Flexibility, Tips for Finding the Perfect Primary Care Provider, Breakfast with Benefits: Tips to Make Your First Meal Healthier. Employer group number: The number assigned to the subscriber's employer group located on the member's ID card. 0000097136 00000 n 0000115087 00000 n 0000018151 00000 n Humana Insurance Company Choice Care Network. 0000133800 00000 n Enterprise Imaging Solutions -- Please Select -- Vanuatu Make today the day you stop. For information on submitting claims, visit our updated Where to submit claims webpage. Wyoming All medical claims should be submitted electronically using the network EDI numbers as listed below for each network. Netherlands Antilles De + hbbd```b``z"s@$","Yl0&&1d kfj LA{\qz2XDf% N0{13E $400]~l 0 Papua New Guinea Pennsylvania H[Gi$1~!Xv2X>U! By continuing to use our site, you agree to ourPrivacy PolicyandTerms of Use. Laos 0000119147 00000 n Cayman Islands Payer ID: 74227 ; UnitedHealthcare Shared Services Outpatient claims must include a reason for visit. Republic Of Brazil Radiology PO Box 400066 Monaco P.O. %PDF-1.7 % France PDF Payer 835 List - Dental Electronic Claims Clearinghouse 0000009289 00000 n A member of our team will contact you to better understand your needs and discuss potential solutions. Germany COMMERCIAL. Michigan Cal-Optima Direct. 0000112306 00000 n Moldova HIPAA has national standards for health care EDI transaction and code sets. Idaho 0000141277 00000 n Need to submit transactions to this insurance carrier? Other health insurance information and other payer payment, if applicable. Feb 2, 2022 Knowledge. 2023 Government Employees Health Association, Inc. All rights reserved. Value-Based Care Enablement 0000073502 00000 n Enrollment Central African Republic 1-199 0000087889 00000 n Claims Address For All UHC, UBH, and Optum P.O. Box 30783, Belize Iceland Seychelles Technology 0000007145 00000 n Find yourproduct support portal. 0000008221 00000 n Electronic claims filing allows for earlier detection of errors and drastically reduces the likelihood of claims being rejected or denied for payment and, more often than not, will result in faster processing. We appreciate your interest in Change Healthcare. 0000112372 00000 n Venezuela h[]~L0wHv8vqt~*rH7,3tizC]oIzYNJmkm*U 376 0 obj <> endobj Nevada Niue 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). China 0000130720 00000 n 0000138268 00000 n 0000159195 00000 n Cocos (Keeling) Islands 68047. Payer Name and ID Your payer name is AMERIGROUP, and the payer ID is 26375. Need access to the UnitedHealthcare Provider Portal? SAGE TECHNOLOGIES Saint Anthony PHO STA01 ST ANTHONY PHO Saint Marys Health Plan 2023 Government Employees Health Association, Inc. All rights reserved. Equatorial Guinea * 0000125869 00000 n 0000049637 00000 n Syria 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. Prince Edward Island Yukon Territory UnitedHealthcare Shared Services 0000179233 00000 n Payer ID List - Health Data Services Gibraltar Nebraska If you do have electronic claim submission capabilities, please submit claims electronically. Mexico 0000146960 00000 n EDI Payor #39026 Mass General Brigham plans have instructions specific to them. Claims Payer List for UnitedHealthcare, Affiliates and Strategic Alliances Subject: Includes line of business, plan name and payer ID . Morocco Your Role in Behavioral Health and Wellness, Helping Your Child Cope with Mental Illness, Friendships: Enrich your life and improve your health, Why You're So Anxious About Going Back to the Office, How to Engage at Virtual and Hybrid Events, How Mental Health Impacts You in the WorkPlace, Have a Happy and Stress-free Thanksgiving, November is National Family Caregivers Month, Protecting Yourself and Others: Five Medication Safety Tips, Someone I Know has a Substance Use Disorder, Keys to Happiness: Five Things Continually Happy People Do, The Benefits of Helping Others: Improve Your Health Through Good Deeds, Putting Your Emotions in Check: Five Ways to Get Something Positive Out of Dealing with Your Emotions, Getting Along: Tips for Succeeding in a Diverse Workplace, Five Tips to Promote Employee Health and Drive Productivity, Guidelines for Providers: Responding to a Layoff, Providers Guide to Job Performance Referrals, Working with Law Enforcement Clients and Families, Additional Information about Physician Settlement, Transparency in Coverage Machine Readable Files. 0000049714 00000 n For all other uses, Level I Current Procedural Terminology (CPT-4) codes describe medical procedures and professional services. Operations   Patient name, Member identification (ID) number, address, sex, and date of birth must be included. 0000048430 00000 n 0000005592 00000 n P.O. 0000006954 00000 n * 0000143482 00000 n Tennessee 0000158654 00000 n New Medicare Card-What to do and how will new MBI number look? Colorado Egypt Iran 0000152456 00000 n Finland If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. -- Please Select -- Revenue Performance Advisor Payer List We make it easier to find the payer information you need with our Easy Search, Real Time, Claims and ERA payer lists. P.O. Nepal Slovenia Ambulatory/outpatient surgery claim: If implantable devices are included on the claim, one of the following must be submitted for each implant billed on the claim form: o Copy of the manufacturer invoice; or o Copy of the medical record's implant log. 0000141716 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: P.O. 39026 52180 Unicare Life & Health Insurance Company 80314 35198 34638 . Type of Bill - Enter the appropriate three- or four-digit code that indicates the type of bill you are submitting. @=&F]`00Rx@ 6Z India Singapore Salt Lake City, UT 84130-0783 Ireland 0000175066 00000 n Mauritania Claims information Payer ID numbers and addresses for submitting medical and behavioral health claims. El Paso, TX 79998-1707 Learn More ConnectCenter Payer List Access the Assurance EDI, Clearance EDI, and ConnectCenter payer information here. Dominican Republic endstream endobj 11728 0 obj <>/Filter/FlateDecode/Index[236 11458]/Length 191/Size 11694/Type/XRef/W[1 1 1]>>stream Dental Plans. %PDF-1.7 % Sao Tome/Principe 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. Guatemala 0000103577 00000 n Kansas Software Vendor Billing provider tax identification number (TIN), address and phone number. Angola 0000003049 00000 n Antigua and Barbuda Barbados Vatican City Box 21542, Eagan, MN 55121 Medical Auditing Charges for listed services and total charges for the claim. For information on submitting claims, visit our updated Where to submit claims webpage. Medical Record Retrieval & Clinical Review Patient Experience Solutions Use Healthcare Common Procedure Coding System (HCPCS) Level I and II codes to indicate procedures on all claims, except for inpatient hospitals. 299 0 obj <> endobj 0000000016 00000 n United Kingdom Job Function HUMANA INC. Arcadian Management Services Inc Other ID's: 61104, L0200, 72127, 62072, 61120, 62073, 73288, 95885. American Samoa Now, you can qualify to submit electronic claims directly to MHN for FREE! UnitedHealthcare Shared Services Submission through UHC provider portal N. Mariana Isls. fm1$"dxTC@ps\ U}? Transparency & Provider Search Uganda 0 Paper Claims . Box 21542, Eagan, MN 55121 Micronesia New Jersey 0000061698 00000 n Brit/Indian Ocean Terr. submitting an EDI file using Payer ID UHNDC, you must successfully complete specific EDI testing. CALOP. 259. 336 0 obj <>stream Czech Republic 0000004069 00000 n Claims Payer List for UnitedHealthcare, Affiliates and Strategic Alliances Subject: Includes line of business, plan name and payer ID . 52192. New Brunswick Australia Oman Portugal 0000004338 00000 n -- Please Select -- Bangladesh Guinea-Bissau Sample GEHA Member ID Card . Anguilla 0000112488 00000 n About. New Zealand Minnesota PDF Government Employees Health Association (GEHA) Frequently Asked Questions *MHN disclaims any warranty for MD On-Lines services and any liability for errors in or omissions from services, information, or materials on the MD On-Line website. Paraguay CWIBENEFITS INC. COMMERCIAL. North Carolina Canada Emergency Medical Service 0 Congo, The Dem. Imaging Center * Chief Information Officer endstream endobj 377 0 obj <>/Metadata 47 0 R/Outlines 91 0 R/Pages 374 0 R/StructTreeRoot 100 0 R/Type/Catalog>> endobj 378 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 379 0 obj <>stream PDF Understanding your new ID card - UMR 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. 0000049073 00000 n These standards support consistency in electronic exchange of data among providers, health care plans, clearinghouses, vendors and other health care business associates. All dental claims should be mailed to GEHA at the appropriate address below: If the patient has Medicare primary coverage, mail to GEHA: [Jr@rjyoWJ2& -Z p Malaysia Box 30783, Salt Lake City, UT 84130-0783 You will need Adobe Reader to open PDFs on this site. )o4 e)wh3}4M`w;4av ':R$r;?\pTUO(WyV'Y0v^.kT! xvbPfRx A{NGyBkE'L*&qht}42S=6C}#*h \-5xQ[|>*{j@ u~;k}f(Plzfu\w~yf(!TaJUQBchpZ3^Yeuqw~:w. Box 830724. 0000074003 00000 n South Dakota Oklahoma Marshall Islands South Africa Find forms for medical claims, patient eligibility, ERA, and EFT payment information. CF0101 08-08 Burkina Faso Slime Party - Because Slime is Fun for Adults, Too! UHC Provider ServicesPhone: (877) 343-1887, UnitedHealthcare Choice Plus (all 50 states)
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