Billing & Claims Submission
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Guidelines are available to help you with reimbursement for specific services. See reimbursement guidelines.
Take Advantage of Your Provider Portal to Check Claims & Eligibility
Our customer service representatives can check eligibility and quote benefits, however, you will find our Provider Connect portal will save you time and be more convenient. The portal also allows you to view your claim status, submit prior authorization requests and check prior authorization status.
Submit Claims Electronically or by Mail
Use Proper Format for Electronic Corrected Claims
A corrected claim is any claim that has a change to a claim previously processed (e.g., changes or corrections to charges, procedure or diagnostic codes, dates of service, added lines, etc.). Electronically submitted claim corrections should be submitted in the following format:
1. In the 2300 Loop, the CLM segment (claim information), CLM05-3 (claim frequency type code) must indicate “7” – REPLACEMENT (replacement of prior claim).
2. In the 2300 Loop, a REF*F8 segment needs to follow the CLM segment (claim information) and must include the prior claim number issued by Samaritan Health Plans or IHN-CCO for the claim being corrected. Samaritan Health Plans and IHN-CCO claim numbers consist of 11 to 12 numeric characters and can be found on your electronic remittance advice (EDI 835), paper remittance advice or in the Provider Connect portal.
3. Any original claim lines that are removed and not resubmitted on the replacement claim will automatically be removed during reprocessing and the previously paid amount will be auto recouped from the next payment issued.
Receive Payment More Quickly
Samaritan Health Plans encourages you to file your claims electronically as a way to lower administrative expenses, receive payments more quickly, reduce paper use and expedite billing error corrections. We offer five options for electronic claims submission, also known as EDI:
Trizetto Provider Solutions
PhysicianSupport@cognizant.com
800-969-3666 — Customer Service
Payer IDs: SAMAD (Samaritan Advantage), SAMCP (Samaritan Choice), INCHN (InterCommunity Health Network CCO), SAM00 (Samaritan Employer Group)
CHC1
changehealthcare.com
800-527-8133, option 2
Payer IDs: 2122 (Professional) and 5952 (Institutional)
Change Healthcare
changehealthcare.com
866-371-9066
Payer ID: CP001 (All plans)
Payer Connection
payerconnection.com
503-820-3803
Payer IDs: SA01 (Samaritan Advantage), SCP (Samaritan Choice), IHN (InterCommunity Health Network CCO), SAM00 (Samaritan Employer Group)
Office Ally
officeally.com
360-975-7000, option 1 — Customer Service
Payer IDs: SAMHP (All plans)
We Accept Paper Claims
Submit paper claims via mail to these addresses:
InterCommunity Health Network CCO
PO Box 887
Corvallis, OR 97339
Samaritan Choice Plans
PO Box 336
Corvallis, OR 97339
Samaritan Health Plans
Employer Group PPO plans:
PO Box 887
Corvallis, OR 97339
Medicare Advantage plans:
PO Box 1510
Corvallis, OR 97339
Paper Claim Processing Tips
For claims that must be submitted on paper there are some simple things that providers can do to speed up processing and payment:
- Use only standard red and white CMS 1500 (HCFA) and 1450 (UB) forms.
- Submit only claim forms that are typed or printed.
- Print with dark font (i.e. do not print claims when toner/ink is low).
- Correctly align text in the form boxes and do not allow text to lap over lines.
- All claims and attachments should be printed single sided. Do not duplex print, even on primary EOBs or attachments.
- Send full page attachments only.
- Do not staple claims or attachments together.
- Mark multipage claims with either a page number (i.e. page 2 of 3) or a “continued”.
- Ensure that each secondary claim has the primary EOB submitted with it.
- Do not write or stamp over top of the body of the claim form.
CMS 1450 and 1500 Form Requirements
Need help filling out the CMS 1450 or 1500 Form? Use the following guides to find out what each field is for and which are always required.
Customer Service Can Help
Our customer service team can:
- Refer you to additional resources.
- Provide technical support for our provider portal, Provider Connect.
- Accept grievances and concerns.
- Connect you to claims resources.
Hours: Mon. – Fri., 8 a.m. to 8 p.m. PT
In Corvallis, call: 541-768-5207
Toll-free: 1-888-435-2396