UHA Claim Submission

UHA Claim Submission Requirements For Trading Partners UHA Claim Submission must be processed using the codes required in the National Implementation Guides and the HIPAA rules. Each transmission to UHA should have a unique Interchange Control Number (ISA13). UHA will use this number to determine if it is a duplicate file. b. Submitters are required to submit Read More →

Claims Processing

Claims Processing Cycle (UHA Providers) Claims Processing Cycle via EDI provides a quicker turnaround time on provider claims since it will eliminate the need for UHA to manually process the majority of the claims. However, the length of time required to process a claim depends on many variables in addition to the medium on which they are Read More →

Electronic Claims Attachments

Electronic Claims Attachments: Supplemental Medical Documents Electronic Claims Attachments are supplemental documents providing additional medical information to the claims processor that cannot be accommodated within the claim format. Common attachments are Certificates of Medical Necessity (CMNs), discharge summaries and operative reports. They are sent to the Durable Medical Equipment Medicare Administrative Contractor (DME MAC) and/or A/B MAC with Read More →

270/271 Eligibility Inquiry & Response

Metro Plus Health Plan EDI Claims Submission Notes Metro Plus Health Plan EDI Claims should be submited to Beacon Health Strategies either through electronic data interchange (EDI) connection to Beacon or via Beacon’s eServices web application. Metro Plus Health Plan EDI Claims can be submitted directly by a provider, or through a billing intermediary. EDI: Read More →

HAP Midwest Health Plan’s Claims

HAP Midwest Health Plan’s Claims And Electronic Data Interchange Program HAP Midwest Health Plan’s Claims Department endeavors to assure prompt and accurate claim and encounter review, processing, adjudication and payment. This is accomplished through the development of claims processing systems, pre-payment and post-payment audits, policies, and procedures that are consistently and appropriately applied. HAP Midwest Read More →