Claims
We want to make it as easy as possible for you to conduct business with us. In addition to providing information about how to submit claims and check payments, we offer you tools to find specific information, such as claim status and member coordination of benefits (COB) status.
We accept claims in a variety of formats, including online and paper.
Submit Claims Online – Preferred
Submit claims through our secure, online Provider Portal. You can also track claim payments and more. We offer this service at no cost.
When you submit claims online, you take advantage of:
- Faster claim processing
- Reduced administrative costs
- Reduced probability of errors or missing information
- Faster feedback on claim status
- Minimal staff training or cost
Refer to the Provider Manual for detailed information to submit claims.
We also partner with Availity to offer electronic claim submission and real-time transactions at no charge through the Availity Portal. For details please refer to the Availity Portal Registration Guide.
Get Paid Electronically
We have partnered with ECHO Health, Inc. to deliver provider payments. ECHO offers three payment options:
- Electronic Fund Transfer (EFT) – preferred
- Virtual Card Payment (QuicRemit) – Standard bank and card issuer fees apply*
- Paper Checks
*Payment processing fees are what you pay your bank and credit card processor for use of payment via credit card.
Enrollment Instructions
Enroll with ECHO for payment and choose EFT as your payment preference. Questions? Call ECHO Customer Support at 1-888-834-3511.
Submit Paper Claims – Alternative Option
If you cannot submit all claims electronically, you can also upload paper claims via the Provider Portal. Refer to the Provider Manual for instructions to submit paper claims.
Non-Participating Providers
Submit claims to us using the Non-Participating Provider Profile Form. We are unable to process claims from non-participating providers without this information. Please be sure to attach your W-9 form when you submit this online form.
Claim Overpayment Recovery Requests and Resources
Claim Recovery Refund Check Form
Overpayment Recovery Form – Submit this form to offset overpaid claims against a future payment.
Providers may also submit overpayment recovery requests via the Provider Portal and receive a reference number.
High-Dollar Claims
Submit this Itemized Bill Cover Sheet and itemized statement for high dollar claims.