UnitedHealthcare Shared Services Patient name, Member identification (ID) number, address, sex, and date of birth must be included. If you do have electronic claim submission capabilities, please submit claims electronically. Syria Clinical Interoperability Solutions Box 14621 Get help with Change Healthcare products, find resources such as enrollment forms and payer lists, and quicklly resolve common issues. Payer ID: 39026 Sending claims electronically eliminates the need for paper forms and allows for faster and more accurate submission of data. 0000003247 00000 n Nicaragua HUMANA INC. Arcadian Management Services Inc Other ID's: 61104, L0200, 72127, 62072, 61120, 62073, 73288, 95885. The payer ID is typically a 5 character code, but it could be longer. Current functionality may be reduced and some features may not work properly. 0000080665 00000 n Andorra Costa Rica Pennsylvania 0000153297 00000 n 0000007354 00000 n Your online resource for healthcare regulations and standards. Box 1860, Waterloo, IA 60704. Member Engagement Enrollment Portal Guide. P.O. Nevada Admission type code for inpatient claims. Czech Republic Admitting diagnosis required for inpatient claims. Egypt Cambodia 0000049016 00000 n (Payer ID valid only for claims with a billing submission address of PO Box 1128, Eau Claire, WI 54702-1128) . 0000103693 00000 n Congo, The Dem. 0000179233 00000 n CF0101 08-08 %PDF-1.6 % 43 164 Contact your . 0000008030 00000 n Dental and Medicare primary Mail to GEHA, UnitedHealthcare Choice Plus (all 50 states) New Jersey 0000061377 00000 n 13337. De + 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. 0000125869 00000 n Korea (North) 0000103806 00000 n 299 0 obj <> endobj Michigan 0000118735 00000 n EDI Payer ID 39026 Box 30783, Finland El Salvador Chief Medical Information Officer 0000087379 00000 n Bahrain Quebec -- Please Select -- Radiology Mozambique Analyst/Administrator Peru 0000160789 00000 n Emergency Medicine 0000006954 00000 n Albania 0000010081 00000 n Codes 7 and 8 should be used to indicate a corrected, void or replacement claim with the original claim ID, if available. [Jr@rjyoWJ2& -Z p Vice President Additional fields may be required, depending on the type of claim, line of business and/or state regulatory submission guidelines. Vermont 0000134302 00000 n Need access to the UnitedHealthcare Provider Portal? Phone: (800) 821-6136, Connection Dental Network Viet Nam Iraq 0000073826 00000 n California Health & Wellness. Please note: The networks listed below should be used for claims based on services performed in 2020. 0000162048 00000 n Sweden Project Management On the UnitedHealthcare Payer List, medical Payer IDs refer to professional and institutional claim submissions. Comoros Salt Lake City, UT 84130-0783 0000049255 00000 n The CPT code book is available from the AMA Bookstore on the Internet. 11694 36 Address OFFICE. Revenue Cycle Management Iceland Latvia Saudi Arabia Armenia 0000115087 00000 n 0000003410 00000 n Marshall Islands 0000073502 00000 n A payer ID is a unique ID that's assigned to each insurance company. Bosnia and Herzegovina US Minor Outlying Is. Togo 0000049714 00000 n Laboratory Payer ID: 39026 . 0000144676 00000 n St. Helena Virginia Falkland Islands Brit/Indian Ocean Terr. 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). 0000141277 00000 n If different, then submit both subscriber and patient information. 0000143482 00000 n Training/Education Eagan, MN 55121, Mental Health, Behavioral Health, and Substance Use Disorder Claims rendered by in and/or out-of-network providers: Only for claims where the submit claims to address on the medical ID card is a CoreSource . Other, Country For all other uses, Level I Current Procedural Terminology (CPT-4) codes describe medical procedures and professional services. 0000129651 00000 n %%EOF Find out More. 0000165174 00000 n 0000103728 00000 n Solomon Islands The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), is currently used to code diagnostic information on claims. Information Systems/Technology Find yourproduct support portal. 0000002334 00000 n IMPORTANT NOTE: We require that all facility claims be billed on the UB-04 form. 0000004069 00000 n 315. 0000006920 00000 n Laboratory Billing provider National Provider Identifier (NPI). $UZZNl)Q,nB=&X"HZic2lc[J"*yDO3.o8T*feoXRz`4U !x*w$Jn(*Pmfk[wv$(=MKi3T|}G)WoKP 2Jl*N|Jd-EIAM}+>@rATf@MWX&3O5S-kLB)[MA=Ln5-IWEdVZTQ Office Manager Nebraska Canada Mass General Brigham plans have instructions specific to them. endstream endobj 66 0 obj <. Alaska Physician CWIBENEFITS INC. COMMERCIAL. )o4 e)wh3}4M`w;4av ':R$r;?\pTUO(WyV'Y0v^.kT! xvbPfRx A{NGyBkE'L*&qht}42S=6C}#*h \-5xQ[|>*{j@ u~;k}f(Plzfu\w~yf(!TaJUQBchpZ3^Yeuqw~:w. Jordan Antigua and Barbuda Box 21542 Oklahoma These may be different when submitting Amerigroup EDIs in Availity. Algeria Box 30783, Salt Lake City, UT 84130-0783 Somalia 0000011777 00000 n Box 21542, Eagan, MN 55121 Arizona Taiwan Payer Information. All medical claims should be submitted electronically using the network EDI numbers as listed below for each network. P.O. Argentina Medical Practice Management Other, Solution of Interest BOX 740800 ATLANTA, GA 30374-0800: 87726: . Cocos (Keeling) Islands trailer Austria Phone: (800) 821-6136 endstream endobj 11728 0 obj <>/Filter/FlateDecode/Index[236 11458]/Length 191/Size 11694/Type/XRef/W[1 1 1]>>stream Please contact Change Healthcare at 1 (866) 371-9066 with any questions regarding electronic claims submission. 0000112372 00000 n Doctor 0000022641 00000 n Slovenia UHC Provider ServicesPhone: (877) 343-1887, UnitedHealthcare Select Plus 200+, Practice Specialty Hh2lW` kd+*~(s*#Oo6XvF#rQUUi1@Hk3Y-2` Marianas 0000081203 00000 n Claims Payer List for UnitedHealthcare, Affiliates and Strategic Alliances Subject: Includes line of business, plan name and payer ID . 257. Executive 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 Billing provider tax identification number (TIN), address and phone number. A Submit paper claims to the address on the back of the member ID card. Guatemala Spain Mail claims to: Behavioral Health Systems, Inc. P.O. 0000123934 00000 n 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 Colombia Niue 0000097136 00000 n EDI Payer ID #39026 0000147653 00000 n Claims & Denials hbbbd`b``l $ u SAGE TECHNOLOGIES Saint Anthony PHO STA01 ST ANTHONY PHO Saint Marys Health Plan Yukon Territory Reunion 0000144715 00000 n Patient or subscriber medical release signature/authorization. 0000004338 00000 n Billing Service 0000166973 00000 n 0000006751 00000 n Payer ID: 39026 Student Insurance Harvard Pilgrim Health Care/ StudentResources . Serbia and Montenegro 0000074376 00000 n 0000115021 00000 n Slovak Republic UnitedHealthcare Shared Services Namibia Lebanon Brazil Claims Payer List for UnitedHealthcare, Affiliates and Strategic Alliances Subject: Includes line of business, plan name and payer ID . 0000123653 00000 n 0000159788 00000 n Payer Name and ID Your payer name is AMERIGROUP, and the payer ID is 26375. Make today the day you stop. P.O. 11729 0 obj <>stream Drug testing Dates of service on and after January 1, 2017: We follow the Centers for Medicare & Medicaid Services (CMS) coding guidelines for reporting drug testingprocedures as outlined in the 2017 CMS Clinical Laboratory Fee Schedule (CLFS) Final Determinations document posted on the CMS website (CMS8). 0000153536 00000 n Ohio Netherlands Software Vendor Kazakhstan If the subscriber is also the patient, only the subscriber data needs to be submitted. Billing/Coding 0000146416 00000 n Rwanda Guam Guinea Correct coding is key to submitting valid claims. }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! Other, Bed Size Manager PO Box 30783 0000007887 00000 n In addition, submitting electronically reduces postage and other paper related expenses and supports improvement to your overall . Kuwait When billing for more than one attending provider, indicate each UPIN on the appropriate detail line. Value-Based Care Solutions, Solution Type Physician Practice Management Paper Claims . BENEFIT PLANNERS, INC. 39026 N N/A PO BOX 690450 SAN ANTONIO TX 78269 French Guiana H[Gi$1~!Xv2X>U! Dental Claims PO Box 609 Colorado Springs, CO 80949-9549. Electronic Interchange Group Professional Commercial Payer List Payer ID Claim Office # Type . Hot Springs, AR 71903, Grievances & Appeals Department For information on submitting claims, visit our updated Where to submit claims webpage. Liberia EDI Submitter #06603 Services Seychelles 4q<={Wm|? Equatorial Guinea Use Healthcare Common Procedure Coding System (HCPCS) Level I and II codes to indicate procedures on all claims, except for inpatient hospitals. In order to ensure claims are submitted correctly, providers must use the following Payer IDs: 68069 for Medical Services. Iowa Contact us. Protect Yourself This Holiday Season with Health Tips, Indoor Activities for Kids That Dont Include Screen Time, No Excuses: How to Accomplish Your Goals In the New Year, Need More Vitamin D? Madagascar Switzerland 0000007935 00000 n Tennessee All dental claims should be mailed to GEHA at the appropriate address below: If the patient has Medicare primary coverage, mail to GEHA: Louisiana Now, you can qualify to submit electronic claims directly to MHN for FREE! Paper: Homelink, P.O. Box 30783, * If you have any questions regarding this offer, please call Ability at 800-548-2890. 0 0000080992 00000 n Congo 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. 0000061988 00000 n Chief Executive Officer hbbd```b``:"-T0w"1 #Xed;fd0DGHm RLHee`bd`d M" Hge 0 BA= 57080. Hawaii 0 Moldova Turkmenistan It's never too late to quit smoking. endstream endobj startxref South Africa 68047. 0000007145 00000 n Radiology -- Please Select -- Morocco Niger 0000111978 00000 n BMC Health Plan. Virgin Islands (U.S.) Wisconsin 0000137787 00000 n Other, Subscribe to Change Healthcare Communications. Identify those dropping to paper in your system and convert them to an EDI 837 transaction by applying the appropriate Payer ID . Dental Please select Ethiopia 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). Palestinian Territory, Occupied 0000152221 00000 n %PDF-1.7 % All medical claims should be mailed to the addresses listed below for each network. This ID is used to submit claims electronically through our system. Massachusetts 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. Wyoming Mauritius If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. 0000147306 00000 n Oman 117 0 obj <>stream Palau P.O. 0000174831 00000 n Q What are the timely filing requirements? Senior Vice President Professional Institutional. Israel If you have contacted us previously concerning this partnership inquiry, include a list of people within Change Healthcare with whom you have already been in contact. 0000049603 00000 n Including the correct 5-digit payer ID helps avoid having your claim rejected due to listing an incorrect payer. P.O. Turks/Caicos Isls. P.O. 0000004123 00000 n 39026 39026: Y N: Commercial UnitedHealthcare: 87726 Y: Y . 0000003049 00000 n GEHA FEHB Medical 0000119628 00000 n Cape Verde Washington 0 DOS on/after 1/1/15 need to be sent through UMR Wausau Payer ID 39026. EDI Payer ID #39026 0000074037 00000 n Kenya 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 Claims submitted late may be . 0000157961 00000 n 0000162376 00000 n 0000127855 00000 n 39026 39026: Y N: Commercial UnitedHealthcare: 87726 Y: Y . Republic Of Texas Sudan Outpatient claims must include a reason for visit. 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. Prince Edward Island An issue has been identified causing a delay in the delivery of UMR Wausau 835 files for checks dated 1/20/22. hb``a`` Box 981707, El Paso, TX 79998-1707 UHC Provider ServicesPhone: (877) 343-1887, UnitedHealthcare Choice Plus (all 50 states) Learn More Change Healthcare Attachment Payer List Ontario * endstream endobj startxref MEDICARE CLAIMS TO Chief Medical Officer 0000161430 00000 n 0000175066 00000 n . 0000008221 00000 n Uruguay Korea (South) Cal-Optima Direct. 1095 tax forms now available Medical members can access your 1095 tax form by, You are using a browser we no longer support. Mongolia 0000022830 00000 n 0000087889 00000 n (Claims for payer address of Rockford, IL ONLY.) Please note that ours also contains former brand and plan names, as well as comments that may help you choose the correct Payer ID. Operations 57080. Iran Guyana 0000002116 00000 n OptumRX 0000114704 00000 n To enroll, contact UMR 835 File Enrollment at Optum, 866 -367 . %PDF-1.4 % Angola Burundi United Kingdom Ghana French Polynesia Login to your community accounts to get product updates, ask questions, and learn best practices. 0000035375 00000 n Unsure, Company Type 0000158331 00000 n CD Discount. Sao Tome/Principe American Samoa 0 Paraguay 0000062022 00000 n A Claims must be received within 90 days from the service date. UnitedHealthcare Shared Services Guinea-Bissau Singapore g%g-pf%Zv%?
