To allow for more efficient processing of claims, we ask for your cooperation with the following:
- When submitting claims use the correct and complete member number.
- Submit claims in a timely manner.
- CCHP does not accept faxed claims. Claims should be sent electronically or by paper. Providers are encouraged to submit claims electronically.
- CCHP asks providers to allow 45 days to pass from the date of submission before calling to check the status of claims.
- Review rejection reports. Correct and resubmit rejected claims.
- Claims must include the correct billing and rendering NPI and taxonomy. If the information submitted on the claim is different than what is registered with ForwardHealth, your claim will reject
A correct and complete member number must be submitted on the claim. Using the correct member number on the claim helps ensure correct and timely claim payment.
Important items to remember when submitting claims:
- Submit claims electronically or type claims. Handwritten claims may be returned
- Claims with eraser marks or whiteout corrections may be returned.
- Only clean claims containing all required information will be processed within the required time limits. Rejected claims that have missing or incorrect information may not be resubmitted. A new claim form must be generated for resubmission.
- Use proper place-of-service codes
- Use modifier code “25” when it’s necessary to indicate that the member’s condition required a significant, separately identifiable evaluation and management service above and beyond the other procedure or service performed on the same date by the same provider.
- Bill anesthesia claims with the correct codes from the American Society of Anesthesiologists with appropriate anesthesia modifiers and time units, if applicable.
- Submit only one payee address per tax identification number.
- If a claim is submitted with an error, the provider must submit a new claim. Claims must be submitted within the timely filing requirements or the claim will be denied
- Services for the same patient with the same date of service may not be unbundled. For example, an office visit, a lab work-up, and a venipuncture by the same provider on the same day must be billed on the same claim.
- Submit all provider appeals within the time frame outlined in your Provider Network Agreement.