Claims Processing Policies and Guidelines

Bundle: Text

A series of projects have been completed with the goal of reducing the amount of paper providers send to health plans, thereby reducing staff time and speeding payment.

Submitting Corrected Claims

Fields on form can be typed for clarity before printing.

Corrected Claims Cover Sheet (.pdf | 64k | Rev 3.5 | 5/2011)

Corrected Claims Guideline Document (.pdf | 135k | Rev 4.2 | 5/2011)

Submitting Supporting Documentation

Fields on form can be typed for clarity before printing.

Supporting Documentation Cover Sheet (.pdf | 127k | Rev 10.09 | 08/23)

Supporting Documentation Guideline Document (.pdf | 33k | Version 10.8 | 10/07)

Conditions for Splitting Claims

Clarifies the eight most common conditions under which claims are split.

Guideline Document (.pdf | 11.26.13)