ELIGIBILITY & CLAIMS

Claim Submissions Revisions
For PCP/Specialists, Ancillary Providers, Hospitals, and Non-Participating Providers.
There are 4 major revisions for Providers:
  • Members are now assigned to a single provider rather than a group.

  • When filling out UB-92 and HCFA-1500 claim forms, 2 lines of information have changed.
  • Your Provider ID number has changed.
  • Claims for Medicare and Medicaid must now be mailed to separate addresses. (Only Senior Partners claims for dates of service prior to August 1, 2007, when our ownership of the plans ceased, should be submitted to Health Partners.)
  • Please remember… Claims MUST be filled in properly or they will be rejected and returned to you for re-submission with the proper information.
For Physician Budget Providers
There are 3 major revisions for Providers:
  • Members are now assigned to a single provider rather than a group
  • When filling out UB-92 and HCFA-1500 claim forms, 2 lines of information have changed.
  • Your Provider ID number has changed.
  • Please remember… Claims MUST be filled in properly or they will be rejected and returned to you for re-submission with the proper information.
 
215-991-4350 • Provider Helpline • 1-888-991-9023
 
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