San Francisco Health Plan EDI Claims: Common Requirements San Francisco Health Plan EDI Claims are processed for the following medical groups: San Francisco Community Clinic Consortium, San Francisco Health Network (previously known as the Community Health Network) and UCSF Medical Group. Any delegated medical group must submit encounter EDI data to San Francisco Health Plan … Read More →
Medical Codes Overview San Francisco Health Plan uses medical codes according to Medi-Cal billing guidelines in addition to Optum coding books application for claim activities. The following procedure medical codes must be used for a claim to be processed: Professional charges – HIPAA compliant HCPCS Level 1 (CPT) & level 2 Inpatient hospital/facility/institutional charges – … Read More →
Tufts Health Plan claim options and useful notes Tufts Health Plan Claim EDI processing helps providers to submit claims electronically – either directly or through a clearinghouse – and receive electronic remittance from Tufts Health Plan. For quicker payment, fewer rejections and ease of processing, providers can send their Tufts Health Plan claim electronically using the following electronic claim options: … Read More →