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Birmingham, AL 35283-0724. If you do have electronic claim submission capabilities, please submit claims electronically. Bangladesh Wyoming EDI Payer ID 39026 DOS on/after 1/1/2015 need to be sent through UMR Wausau Payer ID 39026. United Healthcare Claims Address: Payer ID: United Healthcare: PO BOX 30555 SALT LAKE CITY, UT 84130-0555P.O. Payer IDs route EDI transactions to the appropriate payer. 0000153536 00000 n Original submission is indicated with a 1 in claim frequency box or resubmission code (box 22). North Dakota Procurement/Purchasing/Supply South Africa 259. Patient name, Member identification (ID) number, address, sex, and date of birth must be included. Montana Software Vendor Pharmacy Solutions Poland P.O. Sales/Business Development/Marketing Belize PO BOX 1449 GOODLETTSVILLE, TN 37070-1449, Behavioral Health Claims 0000167211 00000 n UnitedHealthcare accepts the following claim types from both participating and non-participating care providers: If you arent submitting claims electronically, or arent using EDI for all available transactions,go to EDI Connectivityfor more information and help getting started, 2023 UnitedHealthcare | All Rights Reserved, EDI 835: Electronic Remittance Advice (ERA), EDI 270/271: Eligibility and Benefit Inquiry and Response, EDI 276/277: Claim Status Inquiry and Response, EDI 278: Authorization and Referral Request, EDI 278I: Prior Authorization and Notification Inquiry, EDI 278N: Hospital Admission Notification, Sign in to the UnitedHealthcare Provider Portal, Health plans, policies, protocols and guides, The UnitedHealthcare Provider Portal resources. -- Please Select -- z8aD>:wr?##:cR29**6$+GZPfz_igKmfB[IIC}(2k%6 RpT-sW1j\7y):X aENYvPo1g+'{1 v;w\9htw-]|6$^AW0pc}ru4O,4*;LcKa1op_e8B+B7~N.iMyB` Claims information Payer ID numbers and addresses for submitting medical and behavioral health claims. EDI Payer ID #39026 Australia 0000147228 00000 n 0000103184 00000 n -------------- 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. startxref Legal/Regulatory/Compliance These may be different when submitting Amerigroup EDIs in Availity. Estonia Value-Based Care Solutions, Solution Type 0000006954 00000 n EDI Submitter: 44054 We make it easier to find the payer information you need with our Easy Search, Real Time, Claims and ERA payer lists. Provider Network Optimization Solutions Greenland *MHN disclaims any warranty for MD On-Lines services and any liability for errors in or omissions from services, information, or materials on the MD On-Line website. An issue has been identified causing a delay in the delivery of UMR Wausau 835 files for checks dated 1/20/22. Risk Adjustment and Quality Solutions Nevada 0000112372 00000 n Georgia Bermuda 0000119628 00000 n Nebraska Israel India Pakistan UMR payer ID 39026, if your clearinghouse is not Optum . P.O. Cardiology 800.821.6136. Salt Lake City, UT 84130, WellMed Claims address P.O. All dental claims should be mailed to GEHA at the appropriate address below: Aetna Signature Administrators (Alaska, Arizona, California, Connecticut, Georgia, Kentucky, Maine, Massachusetts, Michigan, Nevada, New Hampshire, New Jersey, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Washington) View our network today to connect with a payer or partner for all available transactions. 0000032040 00000 n %PDF-1.6 % Ontario Aruba submitting an EDI file using Payer ID UHNDC, you must successfully complete specific EDI testing. Vendor Relationships Australia Mongolia National Drug Code (NDC) for drug claims as required. CD Plus. P.O. Niger Coordination of benefits (COB): When we are the secondary payer; the provider must submit the claim and a copy of the explanation of medical benefits/explanation of benefits (EOMB/EOB) from the primary carrier to Health Net for payment consideration. 0000087773 00000 n What type of plan is it? Paper Claims . 57080. Quebec Liberia 0000014575 00000 n Training/Education French Southern Terr. COMMERCIAL. Iceland The payer ID is typically a 5 character code, but it could be longer. P.O. Kiribati Get help with Change Healthcare products, find resources such as enrollment forms and payer lists, and quicklly resolve common issues. 0000153297 00000 n Claim Type Address Commercial (HMO, POS, PPO) - in CT, MA, ME, NH, RI and VT Medicare Enhance (including ancillary and DME claims) Medicare Supplement . Imaging Center Swaziland Clinical Decision Support Solutions To enroll, contact UMR 835 File Enrollment at Optum, 866 -367 . A complete claim is a claim, or portion of a claim that is submitted on a complete format adopted by the National Uniform Billing Committee and which includes attachments and supplemental information or documentation that provide reasonably relevant information or information necessary to determine payer liability. 0000049255 00000 n 376 0 obj <> endobj Anesthesia 0 Please note that ours also contains former brand and plan names, as well as comments that may help you choose the correct Payer ID. Revenue Performance Advisor Payer List We make it easier to find the payer information you need with our Easy Search, Real Time, Claims and ERA payer lists. endstream endobj startxref 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. Italy San Antonio, TX 78229, Part B RX Claims Address: 0000141716 00000 n GEHA-ASA 0000073889 00000 n Nurse/Nursing Executive Congo, The Dem. In order to ensure claims are submitted correctly, providers must use the following Payer IDs: 68069 for Medical Services. Palau Government Agency 0 Palestinian Territory, Occupied Box 830724. 0000005346 00000 n Turkmenistan Antarctica Phone: (800) 793-9335, UnitedHealthcare Choice Plus (Florida and Texas) Cayman Islands Tennessee UHC Provider ServicesPhone: (877) 343-1887, UnitedHealthcare Choice Plus (all 50 states) Contact your clearinghouse if current Payer IDs arent on their payer list. P.O. 0000002289 00000 n EDI Payor #39026 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). Liechtenstein Northwest Territories Germany 0000148610 00000 n 0000049490 00000 n 0000159788 00000 n It's never too late to quit smoking. California Health & Wellness. <<78EFBF32BF92FB4DBD42CA49770C2094>]/Prev 183057/XRefStm 4015>> CWIBENEFITS INC. COMMERCIAL. 0000008030 00000 n 65 0 obj <> endobj Malta Information Systems/Technology 39026 52180 Unicare Life & Health Insurance Company 80314 35198 34638 . 0000129651 00000 n Please contact Change Healthcare at 1 (866) 371-9066 with any questions regarding electronic claims submission. General Management Kazakhstan N. Mariana Isls. Micronesia 0000144715 00000 n 0000162048 00000 n 0000123653 00000 n Dental is listed separately, if applicable. Project Management 0000010920 00000 n Seychelles Hong Kong 0000174831 00000 n Box 21542, Eagan, MN 55121 0000148000 00000 n Colorado Box 30783, 0000115424 00000 n 0000009289 00000 n Your Role in Behavioral Health and Wellness, Helping Your Child Cope with Mental Illness, Friendships: Enrich your life and improve your health, Why You're So Anxious About Going Back to the Office, How to Engage at Virtual and Hybrid Events, How Mental Health Impacts You in the WorkPlace, Have a Happy and Stress-free Thanksgiving, November is National Family Caregivers Month, Protecting Yourself and Others: Five Medication Safety Tips, Someone I Know has a Substance Use Disorder, Keys to Happiness: Five Things Continually Happy People Do, The Benefits of Helping Others: Improve Your Health Through Good Deeds, Putting Your Emotions in Check: Five Ways to Get Something Positive Out of Dealing with Your Emotions, Getting Along: Tips for Succeeding in a Diverse Workplace, Five Tips to Promote Employee Health and Drive Productivity, Guidelines for Providers: Responding to a Layoff, Providers Guide to Job Performance Referrals, Working with Law Enforcement Clients and Families, Additional Information about Physician Settlement, Transparency in Coverage Machine Readable Files. Gibraltar United States Morocco Payer 835 List Payer ID Payer Name 59069 21st Century Health (MedsavUSA)(NJ) 74237 32 Dental (PO Box 9150, Austin, TX) 20413 3P Administrators (Onalaska, WI) 37283 AAG-American Administrative Group (Lubbock, TX) AARP1 AARP Dental Insurance Plan (Mechanicsburg, PA) 52133 ACEC Health Plans (SLC, UT) 61425 ACEC-Healthplan Reunion Box 21542, Eagan, MN 55121 Phone: (800) 821-6136 0000166973 00000 n Hungary Vermont Slime Party - Because Slime is Fun for Adults, Too! D.C. -- Please Select -- Tonga Non-Participating Payor. Box 30783, Salt Lake City, UT 84130-0783 Printed: 10-03-2019 Call UMR at the member customer service number listed on this ID Card for plan required prior authorization. California These standards support consistency in electronic exchange of data among providers, health care plans, clearinghouses, vendors and other health care business associates. Share of cost is submitted in Value Code field with qualifier 23, if applicable. Maldives 0000148346 00000 n 43 0 obj <> endobj 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). All medical claims should be mailed to the addresses listed below for each network. Anguilla For . To avoid possible denial or delay in processing, the above information must be correct and complete. Finance/Accounting Puerto Rico UMR formerly UMR Wausau GEHA in Alabama Other ID's: 31107, 33108, 74214, 74223, 75196, 75243, 95266, 87726, UMR01, 37237, UMRWV, 52132 Need to . 0000062022 00000 n 0000097202 00000 n For physicians, the state license number should be entered as a seven-digit number "A0nnnnn." 316. 0000153036 00000 n 0000023307 00000 n 392 0 obj <>/Filter/FlateDecode/ID[<2B6FDBD48D83564DAD4FC2DD51BA67C7>]/Index[376 30]/Info 375 0 R/Length 96/Prev 321559/Root 377 0 R/Size 406/Type/XRef/W[1 3 1]>>stream Mexico 0000002334 00000 n 0000080665 00000 n Payment Accuracy Solutions Executive Find out More. Togo South Africa Honduras 0000061698 00000 n 0000112488 00000 n Laboratory Yemen All dental claims should be mailed to GEHA at the appropriate address below: If the patient has Medicare primary coverage, mail to GEHA: Guinea 0000019237 00000 n Please Use Payor ID# 63100. 0000158914 00000 n Paraguay Claims: EDI # 39026, UMR, PO Box 30541, Salt Lake City, UT 84130-0541 Vision Claims: Spectera Vision, PO Box 30978, Salt Lake City, UT 84130 This card must be presented each time services are requested. Cyprus 0000048430 00000 n Yukon Territory Additional fields may be required, depending on the type of claim, line of business and/or state regulatory submission guidelines. Payer Name Payer ID Type Services; UMR - Wausau: 39026: commercial: UB04 1500 ERA Eligibility: More Info The members ID card will indicate the Payer ID to use for claims submissions. Please Select }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! trailer 39026 39026: Y N: Commercial UnitedHealthcare: 87726 Y: Y . Billing provider National Provider Identifier (NPI). Peru Note: Payers sometimes use different payer IDs depending on the clearinghouse they're working with. Title: MN010-W120, PO Box 1459 Visit Ability to register today to begin submitting MHN claims for free. Dominica EDI Claims. Uzbekistan Lexington, KY 40512-4621. Chief Operating Officer P.O. Pharmacy Benefit Solutions Niue Syria Missouri New Zealand All medical claims should be submitted electronically using the network EDI numbers as listed below for each network. Chief Medical Officer 0000123934 00000 n Lithuania Barbados 0000161114 00000 n endstream endobj 44 0 obj <>/Metadata 3 0 R/Pages 2 0 R/StructTreeRoot 5 0 R/Type/Catalog/ViewerPreferences<>>> endobj 45 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/Properties<>/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 46 0 obj <> endobj 47 0 obj <> endobj 48 0 obj [/Indexed/DeviceCMYK 30 70 0 R] endobj 49 0 obj [/Indexed/DeviceCMYK 0 71 0 R] endobj 50 0 obj [/Indexed/DeviceCMYK 15 72 0 R] endobj 51 0 obj [/Indexed/DeviceCMYK 45 73 0 R] endobj 52 0 obj [/Indexed/DeviceCMYK 1 74 0 R] endobj 53 0 obj [/Indexed/DeviceCMYK 30 75 0 R] endobj 54 0 obj [/Indexed/DeviceCMYK 45 76 0 R] endobj 55 0 obj <>stream El Paso, TX 79998-1707 0000143443 00000 n To ensure claims are as accurate as possible, use current valid diagnosis, procedure codes, and modifier codes and code them to the highest level of specificity (maximum number of digits) available. Dental Network Solutions P.O. 0000141277 00000 n 0000004123 00000 n Cuba 0000004183 00000 n Virginia Cambodia Independent Practice Not Affiliated with Hospital Netherlands Dental CD Plus. Billing Service trailer Ohio Lebanon Home Health Agency Saudi Arabia Hospital Employed Practice %PDF-1.4 % Clinical Interoperability Solutions Member Engagement Solutions 0000008424 00000 n 0000103511 00000 n Idaho Cal-Optima Direct. Payer Board Member/Director/Trustee Box 30783, 0000118735 00000 n West Virginia Japan 0000005592 00000 n If your provider has questions regarding this process, they may contact Envoy/Web MD or call the UMR EDI unit at 1-800-826-9781. Submit CMS-1500 and UB04 Claims Electronically. 0000138352 00000 n Employer group number: The number assigned to the subscriber's employer group located on the member's ID card. Ethiopia Republic Of 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. [Jr@rjyoWJ2& -Z p 0000000016 00000 n 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). Phone: (800) 821-6136, Connection Dental Network American Samoa Chief Quality Officer SAGE TECHNOLOGIES Saint Anthony PHO STA01 ST ANTHONY PHO Saint Marys Health Plan All dental claims should be submitted to EDI: 44054 If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. For a more optimal geha.com experience, please click. Guadeloupe Other, Solution of Interest !C8>}t}W>qWW_{_wOo~_}yJf. 0000146151 00000 n The Provider Services # is 1-877-658-0305. . Kuwait Hh2lW` kd+*~(s*#Oo6XvF#rQUUi1@Hk3Y-2` Denmark All Rights Reserved, Attention providers! Optum receives 837I (institutional claims) and 837P (professional claims) and routes them to UMR. Viet Nam UnitedHealthcare Shared Services Canada Cte d'Ivoire Phone: (800) 821-6136, UnitedHealthcare Choice Plus (If the subscriber lives in any of the following states: Alabama, Arkansas, Delaware, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maryland, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Mexico, North Carolina, North Dakota, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington DC, West Virginia, Wisconsin and Wyoming) Feb 2, 2022 Knowledge. 0000146835 00000 n Libya Brazil Billing provider National Provider Identifier (NPI). If Medicare is the patient's primary plan: endstream endobj 300 0 obj <. Unsure, Company Type UHC Provider Services Phone: (844) 586-7309. UPIN or state license number: Six-digit universal provider identification number (UPIN) or state license number of all attending providers. 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? Payer ID: 39026 United Health Shared Services (on back of card) Payer ID: 39026 . 1. Eagan, MN 55121, Mental Health, Behavioral Health, and Substance Use Disorder Claims rendered by in and/or out-of-network providers: 0000002850 00000 n 0000074114 00000 n Medical Practice Management Medical claims rendered by in and/or out-of-network providers: Aetna Signature Administrators (If the subscriber lives in any of the following states: Alaska, Arizona, Colorado, Connecticut, Georgia, Kentucky, Maine, Massachusetts, Michigan, Nevada, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont, Washington) Teachers Health Trust 2950 E. Rochelle Avenue Las Vegas, NV 89121. The type of bill code used must correspond to the facility, Medicare certification and state license held by the billing entity. Contact your . Ability also has a special offer for MHN practitioners to submit electronically to all payers who accept electronic claims (over 1600 payers). CD Discount. Cape Verde Professional Institutional. Universal product number (UPN) codes as required. Albania Alberta Billing/Coding Norway 0000012577 00000 n By continuing to use our site, you agree to ourPrivacy PolicyandTerms of Use. Dental Claims PO Box 609 Colorado Springs, CO 80949-9549. If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. Enrollment Argentina UnitedHealthcare Shared Services 0000036268 00000 n Teachers Health Trust 2950 E. Rochelle Avenue Las Vegas, NV 89121 . 0000114704 00000 n Jamaica hbbbd`b``l $ u Physician Laos 0000103693 00000 n In addition, submitting electronically reduces postage and other paper related expenses and supports improvement to your overall . For claims from this year, click Where to Submit Claims from 2021. Name Address: City St: 56144 E HEALTHGRAM ALL CLAIM OFFICE ADDRESSES 71063 E HEALTHSCOPE BENEFITS ALL CLAIM OFFICE ADDRESSES . The EDI 837 Health Care Claim transaction is the electronic transaction for claims submissions. 117 0 obj <>stream 0000018151 00000 n Panama Rendering/attending provider NPI (only if it differs from the billing provider) and authorized signature. Faroe Islands 0000022641 00000 n 0000148268 00000 n For all other uses, Level I Current Procedural Terminology (CPT-4) codes describe medical procedures and professional services. South Dakota 0000097353 00000 n We have a long history of helping clients, customers, and partners navigate the changing landscape of healthcare. All institutional claims require the following mandatory items: This is not meant to be a fully inclusive list of claim form elements. If different, then submit both subscriber and patient information. Use the Change Healthcare product support portals to submit support requests and find answers to your questions. Svalbard/Jan Mayen Isls. Saint Lucia Western Sahara Zimbabwe, State/Location Chief Information Officer 0000018618 00000 n Access product updates and information, ask questions, learn about best practices & benchmarks, and connect with experts & peers. EDI Submitter #06603 CALOP. Radiology Single Page Claims: Claims without attachments are the simplest to file electronically. Saint Kitts and Nevis 0000049637 00000 n Macedonia CLAIM.MD Mass General Brigham plans have instructions specific to them. New Caledonia India 0000160401 00000 n Please note: The networks listed below should be used for claims based on services performed in 2020. -- Please Select -- Brazil Emergency Medical Service Cal-Optima Direct. OptumRX %PDF-1.7 % Germany Box 30755 Salt Lake City UT 841300755 And that's it! New Medicare Card-What to do and how will new MBI number look? 270/271: Eligibility and Benefit Inquiry and Response. 0000003049 00000 n PO Box 400066 MHN also accepts electronic submission of both Professional and Institutional claims through Emdeon. 2-2-22-UMR-WAUSAU-39026-Delayed-ERAs-Checks-Dated-1-20-22. Original submission is indicated with a 1 in claim frequency box or resubmission code (box 22). 0000112306 00000 n Slovak Republic 1-199 0000087889 00000 n 0000096807 00000 n Payer Name Change Healthcare Payer ID Payer-assigned Payer ID Connectivity Type Available Authorization Required 1199SEIU Family of Funds 1199NB 1199N1 13162 Both Portal A & I Benefit Plan AIBPL1 93044 Portal AARP 36273 X12 No Absolute Total Care CNTENE 68069 X12 No Sudan %%EOF * If you have any questions regarding this offer, please call Ability at 800-548-2890. 0000049714 00000 n Five Ways to Ease Back to School Stress for Kids, Avoid Mindless Eating with these Five Tips, Five Easy Ways to Establish Proper Handwashing Behaviors, WildFire Resource Guide & Hurricane Resource Guide, Tips on How to Communicate with Children During COVID-19 Pandemic, Five Ways Relationships Are Good for Your Health, Diabetes Awareness Month: Tips for Preventing and Recognizing Signs of Diabetes, Eating for Your Sight: Five Foods for Healthy Eyes. New Brunswick Medical Record Retrieval & Clinical Review 0000140914 00000 n Professional Institutional. Kansas 0000146026 00000 n 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.