Learn
more about |
Description
of information |
| Appeals |
Learn how to appeal the processing of a claim due to a billing/coding edit dispute, or a medical necessity or investigational service denial. |
Benefit Coordination |
Learn about coordination of benefits, overpayment recovery and other party liability. |
| Coding Toolkit |
Find out how our claim system uses customized editing rules and Medicare’s National Correct Coding Initiative (NCCI) to create clinical edits and how this impacts your reimbursement. |
| Dental Billing |
Learn about dental claims submission requirements and predeterminations. |
| Electronic Transactions |
Learn how to submit claims electronically and become familiar with other valuable electronic transactions such as eligibility and benefits, claim status and pre-authorization inquiries. |
| Forms |
Access forms that you may need to submit claims. |
| ICD-10 |
Learn about ICD-10 timeframes, requirements and available resources. |
| Message Codes |
View voucher message codes. |
| Modifiers |
Learn about our modifier reimbursement policies and how they impact your reimbursement. |
| Office Staff Job Tools |
View a list of resources available to you and your staff. |
| Other Billing Information |
Locate billing information not found elsewhere. |
| Provider Center |
Use this online tool to view the status of submitted claims, claim vouchers, member benefits and eligibility and more. |
| Submitting Claims |
Learn about UB-04, CMS 1500 and ADA J-400 claims submission requirements including corrected claims, timely claims filing and submitting supporting documentation. |
