![]() ![]() HMO products underwritten by HMO Colorado, Inc. June 2021 Anthem Provider News - KentuckyĪnthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. ![]() Use these helpful tips when filing your claims because Anthem understands that timely payments are as important as timely filing. It is important to note that the member cannot be billed for denied claims that were not filed timely. If your claim denies because it was filed late, Anthem will deny the claim as outlined in your contract with us. The sooner you file the faster your claim is paid.įiling your claim within the timely filing limits can eliminate claim denials. You may also be able to check the claim to verify no adjustments are needed through the Claims Status Listing application located on the Payer Spaces home page. Log onto and use the Claims & Payment tab for the Claims Status tool. It is easy to check your claim online to confirm we’ve received it. From the Patient Registration tab use the Eligibility and Benefits Inquiry tool for a quick and easy search. To check the member’s eligibility or to get a digital copy of the member’s ID card, log onto. To make sure your claim is received on time, double check the member’s insurance information with each visit to your office confirming their primary insurance. Have you confirmed the patient is an Anthem member?Īnother reason claims are delayed is because the claim was filed with Anthem, but it should have been filed with another insurance company first. This gives you the opportunity to correct claims quickly, avoiding delays in filing and running the risk of a claim denial because it wasn’t filed within the timely filing limit. Checking in regularly with your clearinghouse is key to identifying claims errors. When you send claims electronically through a clearinghouse, if errors are identified on the claims, they won’t get submitted for payment. One way to ensure your claim isn’t denied because it wasn’t received within timely filing limits is to follow-up with your clearinghouse on a regular basis. At Anthem Blue Cross and Blue Shield (Anthem), we want your claims to be received on time, so they get paid on time. Refer to the Federal plan brochure for more information.Nationally, 7 percent of all claims are denied because they weren’t filed within the timely filing limits. For HMSA’s Plan for Federal Employees, claims will be accepted until December 31 of the year after the year service was received. Note: Claims must be received within a year from the last day on which services were received. A brief description of the service and/or why the service was needed.A daytime phone number where you can be reached.The name, date of birth, address, and HMSA membership number of the person that received the service or supply.Please include a cover letter with the documents you submit. Information about other health coverage you may have.Where the service was received (for example, an office, outpatient clinic, or hospital).Diagnosis or type of illness or injury.currency at the exchange rate on the date of service. Cost for services that are listed in a foreign currency will be converted to U.S. Date(s) of the injury or start of illness.Provider’s full name, phone number, and address.The provider statement must include all of the information below: We require a provider statement in order to process your claim for services. Please keep the originals for your records, because documents you submit to HMSA won’t be returned to you. Submitting your request for reimbursementĬopies of the provider statement and any supporting documents you send to HMSA should be clear and legible, with your HMSA subscriber number written on each page. Note: For information on Medicare claims, please refer to the articles Senior Connection Plan Certificate or HMSA Akamai Advantage Evidence of Coverage. Submit the claim to HMSA at the appropriate address. ![]() Just send HMSA the statement prepared by your nonparticipating or out-of-state provider and make sure the statement includes all of the information listed below.įor timely claims processing, please submit your claim within a year from the last day on which you received services. If your nonparticipating provider in Hawaii or an out-of-state provider doesn’t file for you, you can submit a claim to us for payment.
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