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Claims, Billing, and Payments

Claims and Payment Information and Resources

YOUR CLAIMS AND REMITTANCES 

We understand that easy filing and timely payment of claims are a high priority for our providers. Although you may submit paper claims by mail, there are many benefits to submitting claims electronically, such as improved accuracy, reliability, convenience, and expedited payments.

Claims must be received within 90 days of the date or services (or the time frame stipulated in your contract). If we are not the member’s primary insurance, please submit the claim within 90 days of the date on the Explanation of Payment from the primary carrier.

Important Updates: 

  • All Claim Disputes must be submitted through our Provider Claim Dispute Form. Disputes that are not sent through our Provider Claim Dispute Form will not be addressed. If you are unsure whether to submit a Claim Dispute or Claim Appeal, please click “Should I Submit a Claim Dispute or Claim Appeal?” below.
  • Availity is the preferred EDI and Portal vendor for all Health Plans transactions. Please see “How to Submit Electronic Claims” below.

ELECTRONIC PAYMENT FOR PROVIDERS 
It’s easy to further expedite your claims payments by signing up for electronic funds transfer (EFT) payments that are direct deposited into your bank account. You don’t have to wait for our checks to arrive in the mail or manually sort, reconcile, and deposit checks.

You will need to complete both of the following two steps in order to begin receiving EFT payments and remittances:

1. To set up EFT payments, fill out the EFT Request Form.

2. To receive ERA files, enroll with Availity directly.

For more information, please contact a Provider Services Representative at 1-866-783-0222 or e-mail us

Claims Resources

Consult these additional resources for answers to your questions about claim forms, remittances, billing codes, and the transition from ICD-9 codes to ICD-10 codes.

If you have any questions or require further assistance, please fill out our Contact Us form or call Provider Services at 1-866-783-0222, Monday – Friday, 8 am ‐ 5 pm.