Blue medicare timely filing full#

Login credentials for EZ-Net are required. Use EZ-Net, HCPs secure web-based data exchange application, to view the status of an existing claim previously submitted to HCP. Where HCP is the secondary payor under Coordination of Benefits, the time period shall commence once the primary payor has paid or denied the claim. The timely filing for Medicaid, Medicare, and Commercial claims is: within 120 days of the date of service. Providers who do not hold a HCP direct contract (are not HCP DIRECT providers) should submit claims for HCP members to Empire by following instructions from Empire. Highlighted areas can become fully obscured during the scanning process. All paper documents are scanned using light-sensitive equipment.

Do not use colored highlighters on your claim forms.

Failure to submit the most specific ICD-10 code(s) may result in rejection of your claim. The Centers for Medicare and Medicaid Services (CMS) requires that ICD-10 codes be submitted at the highest level of specificity.Always include your Tax ID Number and NPI (National Provider Identification) number.Any missing or omitted information may lead to a delay in processing or rejection of your claim. Be sure to properly complete your claim form.Helpful Tips for Successful Paper Claim Submission Retain copies of your EDI transmission acceptance reports as evidence of transmission.Īll paper claims must be submitted on a properly completed CMS 1500 or UB04 claim form and faxed to (516) 515-8870.Mismatched patient information may result in the rejection of your claim. Verify that the Member’s first and last names, health plan ID, and date of birth match eligibility records.

Blue medicare timely filing full#

Submit EDI claims with the Provider’s full and proper name and National Provider Identifier (NPI) number.Helpful Tips for Successful EDI Transmission HCP’s Payer ID number with Availity is 11328.

For assistance, contact Availity at (800) 282-4548 To Submit HCP Direct Claims: In order to submit claims via EDI through Availity to HCP, you must first Log In or Register as necessary with the Availity Essentials Portal at. In addition, it provides you with a record of your claim upload. This process streamlines your claims, improves response time, and enhances correction capabilities. HCP’s preferred method of claims submission is electronic through Availity. Providers who are contracted directly with HCP (HCP DIRECT providers) should submit claims to HCP. Back of ID card: The HCP Provider Services telephone number for Authorizations, (844) 638-0404, is listed on the right of the back of the ID card.Front of the ID card: “HealthCare Partners, IPA” is listed below the PCP’s name in the middle-right of the front of the member’s ID card.There are two areas of the member’s ID card that will verify if a member is managed by HCP How do I determine if an Empire Medicare Advantage member is managed by HCP? HCP manages care for Empire Medicare Advantage patients and is responsible for claims payment to providers who are directly contracted with HCP (HCP DIRECT providers).