%PDF-1.4 % @=&F]`00Rx@ 6Z Belarus 336 0 obj <>stream Bouvet Island 0000049603 00000 n 0000127855 00000 n )o4 e)wh3}4M`w;4av ':R$r;?\pTUO(WyV'Y0v^.kT! xvbPfRx A{NGyBkE'L*&qht}42S=6C}#*h \-5xQ[|>*{j@ u~;k}f(Plzfu\w~yf(!TaJUQBchpZ3^Yeuqw~:w. !tWu}]{|o>oI{;jOGG{vx_~|;}r{%5Hmw~{:nz/vZm>/~?9OoOCpR[%^ND?JwSn7{/Aw7xm~zvd|w/xzw9zg/7rj*.1 1=F%Rk-u[wz)FrFn=yS=78Y;v_6mENZtZ74;'|)oSuwX}p4SF7KaKjF4T%] SBr,`.l`) hrWjv2|8(yV]zZFi6/ )k/TRA"7k+e33'':8b'RJO[FZV-+T*|T 2LfgBo]HzwCa$*bVgeMkR @0vq+ Please contact Change Healthcare at 1 (866) 371-9066 with any questions regarding electronic claims submission. Fiji Rendering/attending provider NPI (only if it differs from the billing provider) and authorized signature. PDF Payer 835 List - Dental Electronic Claims Clearinghouse %PDF-1.7 % 0000073889 00000 n Cayman Islands 0000061698 00000 n Laboratory YL}X2d*SLbnd,vb1MW,J%cS;) ?310wIApYCD% g 316. D.C. Denmark Printed: 10-03-2019 Call UMR at the member customer service number listed on this ID Card for plan required prior authorization. Nicaragua Aruba Mailing. Turkey hb``a`` -------------- Other, Bed Size Submit electronic claims online at www.uhis.com, Emdeon payer ID 39026. Rwanda 0000148000 00000 n PO Box 609 Colorado Springs, CO 80949-9549, Corrected Claims/ Resubmissions 0000008078 00000 n CWIBENEFITS INC. COMMERCIAL. Independent Practice Affiliated with Hospital MHN also accepts electronic submission of both Professional and Institutional claims through Emdeon. Dominican Republic Slovak Republic Mongolia Niger Sudan EDI Services - Payer List | HealthSmart 0000048658 00000 n 0000144676 00000 n 0000008125 00000 n <<78EFBF32BF92FB4DBD42CA49770C2094>]/Prev 183057/XRefStm 4015>> Mail claims to: Behavioral Health Systems, Inc. P.O. Paraguay 315. The CPT code book is available from the AMA Bookstore on the Internet. 0000147575 00000 n Russian Federation 0000081169 00000 n 0000179233 00000 n Belgium Phone: (800) 821-6136, Connection Dental Network Syria 68068 for Behavioral Services. 0000073502 00000 n Mauritius endstream endobj 205 0 obj <>/Filter/FlateDecode/Index[5 38]/Length 20/Size 43/Type/XRef/W[1 1 1]>>stream 3. 0000013455 00000 n submitting an EDI file using Payer ID UHNDC, you must successfully complete specific EDI testing. Where to submit claims | GEHA Providers THT Health | The Modern Health Plan for the Educators of Canada Falkland Islands %%EOF 0000049016 00000 n 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. We appreciate your interest in Change Healthcare. 0000003714 00000 n 0000147228 00000 n Liberia Sierra Leone CD Plus. 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. PO Box 30783 P.O. Already a customer? Dental New Jersey Chief Financial Officer 0000160789 00000 n -- Please Select -- Nigeria Hawaii IMPORTANT NOTE: We require that all facility claims be billed on the UB-04 form. 0000130324 00000 n 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). 0000168686 00000 n Trinidad and Tobago 0000137409 00000 n MEDICARE CLAIMS TO Claim.MD | Payer List Box 981707, El Paso, TX 79998-1707 Contact us. 0000049490 00000 n Login to your community accounts to get product updates, ask questions, and learn best practices. Operations A. Payer Name Payer ID Type Services; UMR - Wausau: 39026: commercial: UB04 1500 ERA Eligibility: More Info 0000002289 00000 n [Jr@rjyoWJ2& -Z p Department Chair If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. Billing provider tax identification number (TIN), address and phone number. Hospital Employed Practice Saudi Arabia 0000161773 00000 n OptumRX Member Engagement Solutions A payer ID is a unique ID that's assigned to each insurance company. 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. Macau Chief Operating Officer Claims Payer List for UnitedHealthcare, Affiliates and Strategic Alliances Subject: Includes line of business, plan name and payer ID . Need to submit transactions to this insurance carrier? 0 0000061875 00000 n Malaysia Codes 7 and 8 should be used to indicate a corrected, void or replacement claim with the original claim ID, if available. Table of Contents . fm1$"dxTC@ps\ U}? 0000049073 00000 n Consulting United States Ukraine The payer ID is typically a 5 character code, but it could be longer. Vermont 0000148610 00000 n New Zealand Iowa Box 981707, Thailand Address OFFICE. 0000002334 00000 n The members ID card will indicate the Payer ID to use for claims submissions. National Uniform Billing Committees UB-04 Data Specifications Manual, is available at www.nubc.org. Provider Payment Management Solutions 0000006954 00000 n Lebanon Fax claims to: 205.449.5505. 0000074114 00000 n Cocos (Keeling) Islands PDF Clearance EDI Eligibility Payer List - Change Healthcare xref FLORIDA UBC HEALTH FUND Chief Technology Officer 0000157670 00000 n New Caledonia Serbia and Montenegro Trust 0000018618 00000 n h1 04f\G` z0=i2\x!!!!!!!CCC. Jordan Marshall Islands 0000011777 00000 n Dental Claims PO Box 609 Colorado Springs, CO 80949-9549. 0000175066 00000 n Pakistan Box 30755 Salt Lake City UT 841300755 And that's it! * Other, Job Level To set up an account,visit the Ability website. Lexington, KY 40512-4621. 0000170786 00000 n 0000062099 00000 n 0000035375 00000 n Teachers Health Trust 2950 E. Rochelle Avenue Las Vegas, NV 89121 . 0000153036 00000 n Libya How to use this page To ensure accurate submission of your claims, answer these three questions: What plan is it? Professional Institutional. Government Agency P.O. UHC Provider ServicesPhone: (877) 343-1887 Portugal 0 French Southern Terr. -- Please Select -- 1. Latvia 0000004845 00000 n 0000103693 00000 n Chief Executive Officer hbbbd`b``l $ u 0000049714 00000 n 0000036268 00000 n P.O. Nauru If you do have electronic claim submission capabilities, please submit claims electronically. 0000006751 00000 n 0000087379 00000 n Patient Financial Services 68047. Western Sahara Box 30783, Salt Lake City, UT 84130-0783 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. Dental Plans. United Kingdom 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. Dentistry 0000080992 00000 n Germany 0000158331 00000 n Texas Home Health Agency Togo If you do have electronic claim submission capabilities, please submit claims electronically. EHR Implementation/Management hb```e``Z"@(pzX`rSV%omFcs (E33v`9P3PesFk3Ag`v8RpW00'=@ ' Costa Rica Access the Assurance EDI, Clearance EDI, and ConnectCenter payer information here. Guyana -- Please Select -- United Healthcare Claims Address, Payer ID, Fax and Phone Number 0000007935 00000 n lB8W)! 0000032040 00000 n Iceland Rhode Island France 0000123653 00000 n Billing provider National Provider Identifier (NPI). 0000007354 00000 n Emergency Medicine Angola Find forms for medical claims, patient eligibility, ERA, and EFT payment information. 0000073826 00000 n CWIBENEFITS INC. COMMERCIAL. Switzerland Other, Subscribe to Change Healthcare Communications. Zimbabwe, State/Location Hong Kong Unsure, Company Type Emergency Medical Service Non-Participating Payor. Cal-Optima Direct. 270/271: Eligibility and Benefit Inquiry and Response. Pharmacy Benefit Solutions Payer Information | Freedom Life Insurance Company of America - claim 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. If you have any questions about payer ID numbers, please contact Harvard Pilgrim Health Care's Electronic Data Interchange (EDI) team at . Puerto Rico Azerbaijan 0000171350 00000 n UMR payer ID 39026, if your clearinghouse is not Optum . 0000087924 00000 n 0000133800 00000 n Chief Medical Officer 0000103806 00000 n 0000062022 00000 n Cyprus Contact your clearinghouse if current Payer IDs arent on their payer list. 0000010081 00000 n Panama Dominica PO box 29133 0000001043 00000 n For information on submitting claims, visit our updated Where to submit claims webpage. To avoid possible denial or delay in processing, the above information must be correct and complete. Massachusetts 0000130720 00000 n Revenue Cycle Management 0000003247 00000 n Montana 0000008173 00000 n For physicians, the state license number should be entered as a seven-digit number "A0nnnnn." Idaho EDI Payer ID 39026 PDF Commercial Payer List - BCBSM Submit Claims | Behavioral Health Systems, Inc. These standards support consistency in electronic exchange of data among providers, health care plans, clearinghouses, vendors and other health care business associates. Indiana 0000008030 00000 n French Guiana For information on submitting claims, visit our updated Where to submit claims webpage. The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), is currently used to code diagnostic information on claims. Virgin Islands (British) 0000129651 00000 n Full Payer List. CALOP. Partner/Reseller Revenue Cycle Management Solutions Box 30783, Salt Lake City, UT 84130-0783 Phone: (800) 821-6136 0000097318 00000 n Iraq Lithuania Correct coding is key to submitting valid claims. Cape Verde 0000087773 00000 n Patient or subscriber medical release signature/authorization. 0000004177 00000 n 0000146416 00000 n United Healthcare Claims Address with Payer ID List Sales/Business Development/Marketing Zambia 0000087889 00000 n Bosnia and Herzegovina Please note: Do not use Payer ID 421406317. Grenada Dental and Medicare primary Mail to GEHA, Direct Care Broker or Supplier Contracts India . %PDF-1.6 % Nurse/Nursing Executive Learn More ConnectCenter Payer List Access the Assurance EDI, Clearance EDI, and ConnectCenter payer information here. Find, access, and login to your product application portal as a current customer. Maine Pennsylvania ICD-10-CM codes are used for procedure coding on inpatient hospital Part A claims. Arizona 0000103577 00000 n Use the Change Healthcare product support portals to submit support requests and find answers to your questions. Alabama Honduras Q What are the timely filing requirements? Now, you can qualify to submit electronic claims directly to MHN for FREE! News. 0000097202 00000 n Payer Information. Chile <<5EBD9ADF93626F458FA1B929BDAFF42F>]/Prev 669182/XRefStm 1766>> Austria 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. Electronic Data Interchange | UHCprovider.com 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. UHC Provider ServicesPhone: (877) 343-1887, UnitedHealthcare Select Plus 0000074376 00000 n Office Manager endstream endobj 44 0 obj <>/Metadata 3 0 R/Pages 2 0 R/StructTreeRoot 5 0 R/Type/Catalog/ViewerPreferences<>>> endobj 45 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/Properties<>/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 46 0 obj <> endobj 47 0 obj <> endobj 48 0 obj [/Indexed/DeviceCMYK 30 70 0 R] endobj 49 0 obj [/Indexed/DeviceCMYK 0 71 0 R] endobj 50 0 obj [/Indexed/DeviceCMYK 15 72 0 R] endobj 51 0 obj [/Indexed/DeviceCMYK 45 73 0 R] endobj 52 0 obj [/Indexed/DeviceCMYK 1 74 0 R] endobj 53 0 obj [/Indexed/DeviceCMYK 30 75 0 R] endobj 54 0 obj [/Indexed/DeviceCMYK 45 76 0 R] endobj 55 0 obj <>stream French Polynesia 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 . Guinea On the UnitedHealthcare Payer List, medical Payer IDs refer to professional and institutional claim submissions. Guinea-Bissau 0000097136 00000 n SAGE TECHNOLOGIES Saint Anthony PHO STA01 ST ANTHONY PHO Saint Marys Health Plan 0000088002 00000 n Box 21542, Eagan, MN 55121 0000165174 00000 n 0000160401 00000 n BENEFIT PLANNERS, INC. 39026 N N/A PO BOX 690450 SAN ANTONIO TX 78269 0000148346 00000 n 0000111978 00000 n Procurement/Purchasing/Supply Tajikistan 0000004183 00000 n 0000061988 00000 n 0000147922 00000 n Mali CF0101 08-08 HUMANA INC. Arcadian Management Services Inc Other ID's: 61104, L0200, 72127, 62072, 61120, 62073, 73288, 95885. West Virginia 0000157961 00000 n Australia 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. 0000141716 00000 n 0000166973 00000 n Patient Experience Solutions Legal/Regulatory/Compliance 0000134218 00000 n 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). Greece Benin hbbd```b``:"-T0w"1 #Xed;fd0DGHm RLHee`bd`d M" Hge 0 BA= 0000022641 00000 n Qatar Vatican City 0000137787 00000 n PDF Claims Payer List for UnitedHealthcare, Affiliates and Strategic Alliances Cte d'Ivoire Turkmenistan 0000115087 00000 n CALOP. Access product updates and information, ask questions, learn about best practices & benchmarks, and connect with experts & peers. An issue has been identified causing a delay in the delivery of UMR Wausau 835 files for checks dated 1/20/22. 0000144715 00000 n California Cuba COMMERCIAL. P.O. 0000115021 00000 n 0000023307 00000 n UHC Provider Services Phone: (844) 586-7309. All other providers use their state-assigned license number without modifications. United Kingdom Guam If Medicare is the patient's primary plan: Kentucky General Management 0000115424 00000 n Box 30783, US Minor Outlying Is. Administrative/Human Resources Box 21542, Eagan, MN 55121 Phone: (800) 821-6136 UMR - Wausau Payer ID: 39026 This insurance is also known as: United Medical Resources Employers Insurance of Wausau Harrington Benefit Services Inc Benefit Planners Inc Texas Municipal League Uniform Medical Plan PCIP UMR UMR formerly UMR Wausau Norway 0000048430 00000 n Taiwan Viet Nam Uzbekistan Diagnosis codes, revenue codes, CPT, HCPCS, modifiers, or HIPPS codes that are current and active for the date of service. EDI Submitter: 44054 Payer ID: 39026 . Virgin Islands hbbd```b``"fHL NA$>d4 9`v Contact your . %%EOF Statement from and through dates for inpatient. Claims Address For All UHC, UBH, and Optum P.O. 0000048605 00000 n A member of our team will contact you to better understand your needs and discuss potential solutions. Only for claims where the submit claims to address on the medical ID card is a CoreSource address in the state of Ohio. Botswana Dental Plans. Salt Lake City, UT 84130, WellMed Claims address endstream endobj 66 0 obj <. China Manager Executive PDF Reference Guide for Payer ID Numbers - Harvard Pilgrim Health Care Payer Lists | Change Healthcare - Support Payer IDs are used to route EDI transactions to the appropriate payer. Palau About. Electronic Data Interchange (EDI) | Amerigroup Texas Job Function endstream endobj 300 0 obj <. Claims information | Mass General Brigham Health Plan North Dakota The Provider Services # is 1-877-658-0305. . American Samoa Access the Electronic attachment payer list here. 0000119628 00000 n Minnesota Clinical Interoperability Solutions endstream endobj 11728 0 obj <>/Filter/FlateDecode/Index[236 11458]/Length 191/Size 11694/Type/XRef/W[1 1 1]>>stream 0000146151 00000 n Military Europe/ME/Canada Beacon, PO Box 1854, Hicksville, NY 11802-1854, Dental Claims Payer ID: 39026 Student Insurance Harvard Pilgrim Health Care/ StudentResources . All medical claims should be submitted electronically using the network EDI numbers as listed below for each network. %%EOF Maldives 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 Hot Springs, AR 71903, Grievances & Appeals Department 0000007492 00000 n 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) For all other uses, Level I Current Procedural Terminology (CPT-4) codes describe medical procedures and professional services. 0000007887 00000 n Enterprise Imaging Solutions 200+, Practice Specialty Bangladesh 0 hb``c``a`e`2AX@u@ 2/2/22 | UMR WAUSAU | Delayed ERAs - Checks Dated 1/20/22 PDF UMR PO Box 30541 Salt Lake City, UT 84130-0541 0000112488 00000 n 0000040339 00000 n %%EOF Kansas Healthcare Consulting Services Paper Submission to United Healthcare In case of claims paper submission to United Healthcare, you will need UHC claims mailing address. When billing for more than one attending provider, indicate each UPIN on the appropriate detail line. 0000153297 00000 n Algeria UnitedHealthcare Shared Services Payer Name and ID Your payer name is AMERIGROUP, and the payer ID is 26375. Wallis/Futuna Isls. 376 0 obj <> endobj 6%W,Uui\2 !/_Nl.s&* vsL3W|;`e ^B@"0l"sprj Y@5"N ]v3[BA'P TdR\F!|w+d} e$Sfe J @.DBF@LJ !c-fJP`-@1%xA@ 0l &%%% P-}@dYkE_2aX0a2,45 0favec8Y9yoMZLgHC7P+C:C"%g603;Z .c`?"ik.S+P & i Florida 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? Arkansas Radiology CD Discount. UnitedHealthcare Shared Services Canada Afghanistan Electronic Claims - Magellan Provider Engineering/Technical Staff France National Drug Code (NDC) for drug claims as required. Salt Lake City, UT 84130-0783 Morocco Netherlands Antilles Identify those dropping to paper in your system and convert them to an EDI 837 transaction by applying the appropriate Payer ID . 0000074003 00000 n 0000146835 00000 n Billing Service Bermuda 0000000016 00000 n 0000096807 00000 n Montserrat 0000008221 00000 n Somalia 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. Congo 0rT* 800.821.6136. Anguilla EDI Payor #39026 EDI Payer ID #39026 Alaska Republic Of -- Please Select -- Tuvalu Palestinian Territory, Occupied 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 Manitoba Box 21542, Eagan, MN 55121 Guatemala St. Pierre and Miquelon 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. 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