Health Homes HIPAA Billing

Health Homes HIPAA Billing Enrollement Guidelines (EmblemHealth)

Health Homes HIPAA Billing Enrollement provides receiving direct deposits to your bank account(s) with electronic remittance advice (ERA) through electronic funds transfers (EFT). The registration process is simple, secure, and takes just moments to complete:

  1. Step 1: Have available a recent EmblemHealth Explanation of Benefits (EOB) and, either a voided check, or a letter from your bank listing the account name, account number, account type and bank routing number for each of your practice’s bank accounts used to receive electronic payments.
  2. Step 2: Go to PNC Remittance Advantage at https://rad.pnc.com.
  3. Step 3: Select the “Register for Portal and Online Payment Services” link on the upper left side of your screen.
  4. Step 4: Register for the website with your email address, your practice’s tax identification number, and your Provider ID, found on your EmblemHealth EOB.
  5. Step 5: For larger practices, add all of your practice’s payees and organize them according to bank account, location, personnel, or whatever is appropriate for your practice.
  6. Step 6: Enter your bank account information and upload a scanned image of your voided check or bank letter.
  7. Step 7: Associate each payee group with a bank account, and then submit your enrollment form online.
  8. Step 8: Allow two weeks to validate the bank account information before receiving electronic payments and remittance advices.
  • The UB-04 may be used when applicable and in accordance with plan-specific guidance. If you must use a paper claim, the UB-04 is the correct type of claim form. Please do not use UB-92 or CMS1500 forms.
  • The bill type for the UB-04 will be 34x.
  • Services performed on the same date of service and/or same hour should be billed on the same claim.

EmblemHealth uses the Medicaid CIN (Client Identification Number) as the member ID number for its Medicaid and HARP members. This is what you should use as the unique identifier. Be sure to bill the units as appropriate for each type of service. National Provider Identifier (NPI) must be used on every claim. According to the NYS Department of Health, NPI will be used to identify Case Management Agencies (CMAs). Supplemental guidance will be issued to accompany the taxonomy grid in Attachment A.

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