0000153536 00000 n 0000004338 00000 n Box 1860, Waterloo, IA 60704. Quebec Eagan, MN 55121, Mental Health, Behavioral Health, and Substance Use Disorder Claims rendered by in and/or out-of-network providers: Kiribati Engagement & Experience Armenia 0000007354 00000 n Nebraska %PDF-1.6 % Kenya 68068 for Behavioral Services. 316. Moldova Cte d'Ivoire Dominican Republic Tonga SAGE TECHNOLOGIES Saint Anthony PHO STA01 ST ANTHONY PHO Saint Marys Health Plan Provider Payment Management Solutions 0000097318 00000 n United Healthcare Claims Address: Payer ID: United Healthcare: PO BOX 30555 SALT LAKE CITY, UT 84130-0555P.O. Paraguay 0000001766 00000 n Antigua and Barbuda Clinical Interoperability Solutions Table of Contents . 0000127855 00000 n San Marino Pakistan %PDF-1.4 % If you do have electronic claim submission capabilities, please submit claims electronically. 0000161773 00000 n 0000147306 00000 n 0000160789 00000 n Please note: The networks listed below should be used for claims based on services performed in 2020. submitting an EDI file using Payer ID UHNDC, you must successfully complete specific EDI testing. Claims Payer List for UnitedHealthcare, Affiliates and Strategic Alliances Subject: Includes line of business, plan name and payer ID . Please contact Change Healthcare at 1 (866) 371-9066 with any questions regarding electronic claims submission. Sudan UMR formerly UMR Wausau GEHA in Alabama Other ID's: 31107, 33108, 74214, 74223, 75196, 75243, 95266, 87726, UMR01, 37237, UMRWV, 52132 Need to . Korea (South) 0 All Rights Reserved, Attention providers! IMPORTANT NOTE: We require that all facility claims be billed on the UB-04 form. 0000004845 00000 n New York About. * All medical claims should be submitted electronically using the network EDI numbers as listed below for each network. Marshall Islands Box 981707, Single Page Claims: Claims without attachments are the simplest to file electronically. Administrative/Human Resources 0000002334 00000 n Billing provider National Provider Identifier (NPI). Yemen Lesotho 0000148000 00000 n 0000162376 00000 n N. Mariana Isls. 0000161430 00000 n Argentina Delaware Holiday Season Healthy Eating Yes, it Can be Done! PO Box 400066 Payer Name Change Healthcare Payer ID Payer-assigned Payer ID Connectivity Type Available Authorization Required 1199SEIU Family of Funds 1199NB 1199N1 13162 Both Portal A & I Benefit Plan AIBPL1 93044 Portal AARP 36273 X12 No Absolute Total Care CNTENE 68069 X12 No Service line date required for outpatient procedures. Palau endstream endobj 11728 0 obj <>/Filter/FlateDecode/Index[236 11458]/Length 191/Size 11694/Type/XRef/W[1 1 1]>>stream 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). Title: MN010-W120, PO Box 1459 Kansas hbbbd`b``l $ u Box 30755 Salt Lake City UT 841300755 And that's it! A Claims must be received within 90 days from the service date. Contact your . 0000049073 00000 n Medical Auditing 0000005887 00000 n -- Please Select -- xref Technology . 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. Australia Heard/McDonald Isls. ^l,W~!u8XO7VZa}XhDt$Xq)5 %",g|0 *@&DX LZ2U[bfWPA New Brunswick Steps to getting contracted plus plan information, Phone numbers and links for connecting with us, List of contracted, high-quality independent lab providers, Update, verify and attest to your practice's demographic data, Provider search for doctors, clinics and facilities, plus dental and behavioral health, Policies for most plan types, plus protocols, guidelines and credentialing information, Specifically for Commercial and Medicare Advantage (MA) products, Pharmacy resources, tools, and references, Updates and getting started with our range of tools and programs, Reports and programs for operational efficiency and member support, Resources and support to prepare for and deliver care by telehealth, Tools, references and guides for supporting your practice, Log in for our suite of tools to assist you in caring for your patients. 0000143482 00000 n How to use this page To ensure accurate submission of your claims, answer these three questions: What plan is it? * 0000174831 00000 n Mozambique 0000159195 00000 n Box 981707, El Paso, TX 79998-1707 hbbd```b``"fHL NA$>d4 9`v 0000032040 00000 n Iran Angola CALOP. Ghana PO Box 30997 Operations trailer 0000008173 00000 n 0000175066 00000 n 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 . 0000003714 00000 n Rwanda Zambia -- Please Select -- 0000022830 00000 n Type of Bill - Enter the appropriate three- or four-digit code that indicates the type of bill you are submitting. MHN.com uses cookies. We make it easier to find the payer information you need with our Easy Search, Real Time, Claims and ERA payer lists. Turkmenistan US Minor Outlying Is. Codes 7 and 8 should be used to indicate a corrected, void or replacement claim with the original claim ID, if available. Member Engagement Solutions California Canada Bolivia 0000010081 00000 n Algeria 1-199 0000123934 00000 n American Samoa 0000005592 00000 n -- Please Select -- 0000080992 00000 n 0000170786 00000 n Contact your . 259. Q What are the timely filing requirements? 0000062022 00000 n Nurse/Nursing Executive Chief Medical Information Officer Czech Republic Medical Record Retrieval & Clinical Review Box 30783, Salt Lake City, UT 84130-0783 Saskatchewan * If you have any questions regarding this offer, please call Ability at 800-548-2890. 0000127276 00000 n In addition, submitting electronically reduces postage and other paper related expenses and supports improvement to your overall . 0000007982 00000 n Singapore Hospital Employed Practice San Antonio, TX 78229, Part B RX Claims Address: Tennessee 0000152773 00000 n Taiwan Phone: (800) 821-6136 Enrollment 0000103577 00000 n 0000010920 00000 n Cal-Optima Direct. 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.). Mayotte 0000061988 00000 n 0000008078 00000 n 0000147228 00000 n -- Please Select -- Contact your clearinghouse if current Payer IDs arent on their payer list. Payer Information. P.O. Make today the day you stop. Salt Lake City, UT 84130-0783 3. 0000001043 00000 n 0000146835 00000 n startxref GEHA-ASA Other, Subscribe to Change Healthcare Communications. 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. Payer IDs are used to route EDI transactions to the appropriate payer. -- Other Locations -- Trust EDI Payer ID #39026 Somalia Turkey P.O. Eat Your Way to a Brighter, Whiter Smile! Guinea-Bissau 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). UHC Provider Services Phone: (844) 586-7309. Use Healthcare Common Procedure Coding System (HCPCS) Level I and II codes to indicate procedures on all claims, except for inpatient hospitals. Samoa Box 30783, North Dakota Colombia 0000008125 00000 n %PDF-1.7 % Healthcare Consulting Services Mongolia United Arab Emirates CF0101 08-08 Prince Edward Island Micronesia Box 830724. Only for claims where the submit claims to address on the medical ID card is a CoreSource . If Medicare is the patient's primary plan: -- Please Select -- Payer Connection - Electronic Claims Payer List Name Payer ID ERA Paper* Address City State Zip 6 DEGREES HEALTH INCORPORATED 20446 N N/A A I BENEFIT PLAN ADMIN AIBPA N N/A 1220 SW MORRISON ST 300 PORTLAND OR 97205 . Risk Adjustment and Quality Solutions Indiana Newfoundland and Labrador Payment Accuracy Solutions 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. Enterprise Imaging Solutions Macedonia EHR Implementation/Management Hospital/Health System Medical Network Solutions Alberta Manitoba COMMERCIAL. Access product updates and information, ask questions, learn about best practices & benchmarks, and connect with experts & peers. Payer ID: 74227 ; All dental claims should be mailed to GEHA at the appropriate address below: If the patient has Medicare primary coverage, mail to GEHA: Svalbard/Jan Mayen Isls. 0000019237 00000 n 11694 0 obj <> endobj Pennsylvania Payer ID: 39026 Sending claims electronically eliminates the need for paper forms and allows for faster and more accurate submission of data. Saint Lucia Please Select El Paso, TX 79998-1707 EDI Payor #39026 258. Chief Medical Officer South Carolina HIPAA has national standards for health care EDI transaction and code sets. Sample GEHA Member ID Card . Bosnia and Herzegovina 39026 39026: Y N: Commercial UnitedHealthcare: 87726 Y: Y . 0000167211 00000 n 0000159481 00000 n Mexico hb``c``a`e`2AX@u@ 39026 e umr (formerly umr wausau) all claim office addresses 79480 e umr harrington all claim office addresses Correct coding is key to submitting valid claims. Denmark Oklahoma Cyprus 0000040339 00000 n 376 0 obj <> endobj To avoid possible denial or delay in processing, the above information must be correct and complete. EDI Claims. 315. Ireland Box 21542, Eagan, MN 55121 Phone: (800) 821-6136 Brunei Darussalam Kentucky Ontario All medical claims should be submitted electronically using the network EDI numbers as listed below for each network. Latvia BOX 740800 ATLANTA, GA 30374-0800: 87726: . 0000003888 00000 n Imaging Center Antarctica Puerto Rico Spain Guyana Salt Lake City, UT 84130-0783. 11729 0 obj <>stream Slovenia Martinique 0000129961 00000 n 0000004177 00000 n Japan Charges for listed services and total charges for the claim. 0000006954 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. Belize Gibraltar Non-Participating Payor. 0000061698 00000 n C-Level Patient or subscriber medical release signature/authorization. Outpatient claims must include a reason for visit. 0000097202 00000 n Nevada Radiology Address OFFICE. Member Eligibility & Enrollment Solutions Monaco Find, access, and login to your product application portal as a current customer. Claims & Denials Box 21542 Australia Nova Scotia 0000022641 00000 n Executive Get help with Change Healthcare products, find resources such as enrollment forms and payer lists, and quicklly resolve common issues. All dental claims should be mailed to GEHA at the appropriate address below: Aetna Signature Administrators (Alaska, Arizona, California, Connecticut, Georgia, Kentucky, Maine, Massachusetts, Michigan, Nevada, New Hampshire, New Jersey, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Washington) Other, Bed Size 0000157101 00000 n China 0000004015 00000 n Pharmacy Solutions EDI Payer ID 39026 0000146494 00000 n Togo Printed: 10-03-2019 Call UMR at the member customer service number listed on this ID Card for plan required prior authorization. Panama Other health insurance information and other payer payment, if applicable. 2023 Government Employees Health Association, Inc. All rights reserved. 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. All other providers use their state-assigned license number without modifications. Yukon Territory Kyrgyzstan Germany 0000146960 00000 n Manager 0000023754 00000 n MEDICARE CLAIMS TO Visit Ability to register today to begin submitting MHN claims for free. Birmingham, AL 35283-0724. 68047. Ability also has a special offer for MHN practitioners to submit electronically to all payers who accept electronic claims (over 1600 payers). If Medicare is the patient's primary plan: It's never too late to quit smoking. Vendor Relationships Contact your clearinghouse if current Payer IDs aren't on their payer list. 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 Afghanistan Korea (North) Netherlands Antilles Slovak Republic South Africa 0000130720 00000 n endstream endobj startxref For physicians, the state license number should be entered as a seven-digit number "A0nnnnn." Norfolk Island Haiti Anesthesia PO box 29133 submitting an EDI file using Payer ID UHNDC, you must successfully complete specific EDI testing. For . Albania Find forms for medical claims, patient eligibility, ERA, and EFT payment information. Estonia Minnesota COMMERCIAL. Rendering/attending provider NPI (only if it differs from the billing provider) and authorized signature. 0000103806 00000 n MHN also accepts electronic submission of both Professional and Institutional claims through Emdeon. Full Payer List. Niger If different, then submit both subscriber and patient information. GEHA FEHB Medical Dental is listed separately, if applicable. The members ID card will indicate the Payer ID to use for claims submissions. Emergency Medicine g%g-pf%Zv%? 0000074003 00000 n 0000111978 00000 n Box 30783, Salt Lake City, UT 84130-0783 0000138268 00000 n Mass General Brigham plans have instructions specific to them. Training/Education Submission through UHC provider portal Learn More Change Healthcare Attachment Payer List Gabon Admission type code for inpatient claims. 0000152456 00000 n %PDF-1.6 % Department Chair Salt Lake City, UT 84130-0783 0000002289 00000 n 0000119628 00000 n H[Gi$1~!Xv2X>U! Thailand Billing provider tax identification number (TIN), address and phone number. 0000134218 00000 n St. Helena 0000137409 00000 n 0000028199 00000 n Administrator Luxembourg Chief Executive Officer 0000061761 00000 n Aruba A Submit paper claims to the address on the back of the member ID card. New Mexico Transparency & Provider Search -------------- Director 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 Alaska <<5EBD9ADF93626F458FA1B929BDAFF42F>]/Prev 669182/XRefStm 1766>> CD Plus. 200+, Practice Specialty 0000003538 00000 n Oregon CPT is a numeric coding system maintained by the AMA. 0000049490 00000 n 0000153297 00000 n Netherlands %%EOF Finland Viet Nam Member Engagement hb```b``c`e``)`b@ !?0 -# Lithuania Current functionality may be reduced and some features may not work properly. Contact us. Greenland <<78EFBF32BF92FB4DBD42CA49770C2094>]/Prev 183057/XRefStm 4015>> Chief Financial Officer 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. 57080. 0000012577 00000 n 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. California Health & Wellness. Madagascar India Palau Billing provider tax identification number (TIN), address and phone number. Home Health Agency Alabama Greece Submit CMS-1500 and UB04 Claims Electronically. 0000073502 00000 n 0000144676 00000 n No additional support tickets are needed at this time. 0000000016 00000 n h1 04f\G` z0=i2\x!!!!!!!CCC. Malta Liberia @=&F]`00Rx@ 6Z 0000160095 00000 n 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. National Uniform Billing Committees UB-04 Data Specifications Manual, is available at www.nubc.org. Micronesia * If you have any questions about payer ID numbers, please contact Harvard Pilgrim Health Care's Electronic Data Interchange (EDI) team at . 0000125869 00000 n Qatar Medical Practice Management 0000137787 00000 n 0000115021 00000 n Billing Service Box 21542, Eagan, MN 55121 Maldives UHC Provider ServicesPhone: (877) 343-1887, UnitedHealthcare Select Plus 0000002116 00000 n Paper Submission to United Healthcare In case of claims paper submission to United Healthcare, you will need UHC claims mailing address. Sri Lanka In order to ensure claims are submitted correctly, providers must use the following Payer IDs: 68069 for Medical Services. Guinea Uruguay Care Management/Population Health Clinical Decision Support Solutions If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. Independent Practice Not Affiliated with Hospital Peru ]m4hq51l^XNFsZb jB"l! hb``a`` French Guiana 117 0 obj <>stream 0000146416 00000 n Washington Box 14621 hbbd```b``z"s@$","Yl0&&1d kfj LA{\qz2XDf% N0{13E $400]~l 0 Kazakhstan Idaho Montana }4}`k2o%%iK?_VSj^*}zQ"&H(mn2&f(*; H~>A" E*$4yf)&wR6;W|- *xh-g.c-;jZ]Ay]ok38USrl/'1+H.IDidO2Cl3r=:Dz44UZIRWWcz~K@ N*=ad]o)C!:g"ZI`\SpN:Y7 9jNu-;B;j5#\Q-W8^4*{w%aT9B;+*cphCLpwvwYW20#:!^i0JLQPh$El9b-&N1+`Xc2 Qnx2P,r0~CYt% WLnYs#YN$_>CCepy"}[ gW6:%] }/>G1{; :n7:dbg,=kdCGJd,>k"f11'Jva-45]/\rw.0;6#~}PaYap?;*=_h&53vCe(fn60\6-h#z-U:E-u=R$LQFm! ICD-10-CM codes are used for procedure coding on inpatient hospital Part A claims. New Medicare Card-What to do and how will new MBI number look? CWIBENEFITS INC. COMMERCIAL. MHN collects some private data about site visitors. Phone: (800) 793-9335, UnitedHealthcare Choice Plus (Florida and Texas) Cocos (Keeling) Islands Iraq 0000049255 00000 n Healthcare Information Exchange Vatican City Military Americas Pharmacy %%EOF 0000008030 00000 n %PDF-1.7 % COMMERCIAL. Wisconsin Employer group number: The number assigned to the subscriber's employer group located on the member's ID card. Jordan Bahrain Sierra Leone Dental and Medicare primary Mail to GEHA, Direct Care Broker or Supplier Contracts Congo, The Dem. Teachers Health Trust 2950 E. Rochelle Avenue Las Vegas, NV 89121 . Puerto Rico Chief Operating Officer Cayman Islands EDI 0000087379 00000 n Payer Name and ID Your payer name is AMERIGROUP, and the payer ID is 26375. Claims Payer List for UnitedHealthcare, Affiliates and Strategic Alliances Subject: Includes line of business, plan name and payer ID . P.O. 2. Turks/Caicos Isls. General Management Myanmar American Samoa Other, Country For information on submitting claims, visit our updated Where to submit claims webpage. Nunavut Professional Institutional. Box 30783, Salt Lake City, UT 84130-0783 0000062099 00000 n Salt Lake City, UT 84130, WellMed Claims address Mail claims to: Behavioral Health Systems, Inc. P.O. Dental Network Solutions trailer Individual Contributor New Caledonia French Polynesia 2-2-22-UMR-WAUSAU-39026-Delayed-ERAs-Checks-Dated-1-20-22. Serbia and Montenegro Your online resource for healthcare regulations and standards. Every day without smoking counts! Claims submitted late may be . United Kingdom endstream endobj 66 0 obj <. Vice President 0000096807 00000 n 13337. If your clearinghouse is not Optum, and you wish to receive an 835 electronic file, your clearinghouse has to enroll at Optum. The Provider Services # is 1-877-658-0305. . Sweden 0000133800 00000 n Cook Islands Together, we are accelerating the journey toward improved lives and healthier communities. Provider Network Optimization Solutions 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. Sales/Business Development/Marketing Chief Information Officer 0000127723 00000 n Tajikistan Namibia Faroe Islands Bangladesh EDI Payer ID #39026 43 0 obj <> endobj Emergency Medical Service Value-Based Care Enablement Claims Address For All UHC, UBH, and Optum P.O. Analyst/Administrator 0000023307 00000 n 57080. 0rT* 0000138352 00000 n Please select 0000003049 00000 n 0000005346 00000 n 0000118735 00000 n 0000088002 00000 n 52192. Florida Payer Name Payer ID Type Services; UMR - Wausau: 39026: commercial: UB04 1500 ERA Eligibility: More Info 0000158654 00000 n 0000007935 00000 n 0000162048 00000 n Box 21542, Eagan, MN 55121 CD Discount. Malaysia -- Please Select -- Virgin Islands 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. Original submission is indicated with a 1 in claim frequency box or resubmission code (box 22). Cardiology 0000048781 00000 n -- Please Select -- Hong Kong Find out More. Chief Quality Officer P.O. endstream endobj 300 0 obj <. 0000147575 00000 n For claims from this year, click Where to Submit Claims from 2021. 0000115424 00000 n

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