ELIGIBILITY & CLAIMS

Electronic Claims Processing

How would you like to:

  • Decrease administrative costs?

  • Increase productivity?

  • Avoid processing delays?

  • Receive records of claim receipts?

  • Increase your claim acceptance rates?

  • Receive detailed claims status?

Health Partners offers the speed, convenience and lower administrative costs through Electronic Data Interchange (EDI), or electronic claims processing. The plan utilizes the Emdeon Transaction Services (also known as NEIC, ENVOY, or WebMD ENVOY claims clearinghouse).

To take advantage of this service, contact your billing software vendor and request that your Health Partners or Kidz Partners claims be submitted through the Emdeon claims clearinghouse, or direct your current EDI clearinghouse to forward your claims to Emdeon.

For all claims (CMS-1500/837P and UB-04/837I) submitted electronically through the Emdeon clearinghouse, Health Partners can electronically return a detailed status for each claim. The status message will show which claims were accepted, rejected and/or pending, and also provide the amount paid on the submitted claim once it has been finalized. (If you are an Emdeon submitter and you do not have the ability receive Emdeon claims status, please contact your billing software vendor for more information.)

If you are a Health Partners or a Kidz Partners provider and you have reviewed our EDI FAQ but still have questions please click on this link to the EDI Inquiry Form to submit your question(s) via e-mail, or contact the EDI Support Line where a representative will be happy to assist you.

 
Our EDI Support Line is available to assist you at: 215-991-4290

215-991-4350 Provider Helpline 1-888-991-9023
 


KidzPartners & CHIP

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