- #IL BCBS TIMELY FILING LIMT CODE#
- #IL BCBS TIMELY FILING LIMT PLUS#
- #IL BCBS TIMELY FILING LIMT PROFESSIONAL#
Has a corresponding referral, if required Is received timely by U of U Health Plans Clean ClaimsĪ clean claim is any claim submitted by a Provider that: Box 45180 Salt Lake City, Utah 84145-0180Ĭlaims shall be processed and remittance advices sent to the provider in accordance with the timeliness provisions set forth in the providers participating provider agreement. If you need to submit a paper claim, please submit paper claims to the following address: University of Utah Health Plans P.O. University of Utah Health Plans prefers you to submit claims electronically. Supporting Documentation including operative reports, emergency room reports, medical records supporting diagnosis when requested, etc.Įxplanation of Benefits from Primary Payer (if applicable).
#IL BCBS TIMELY FILING LIMT CODE#
Procedure codes (CPT) or Revenue codes identifying services on claim (CPT codes should be obtained from the CPT Code Handbook for the year corresponding to the date of service).īilled Charges for each service on claim.
Medical Diagnosis ICD-10 Code(s) (Codes should be obtained from the Medical Diagnosis Code Handbook for the year corresponding to the date of service. Other Insurance Information (if applicable and known). Provider’s Practice and Billing Addresses. Identification Number of Patient/Subscriber. All necessary information for correct processing of the claim should be included on or attached to the claim form, including:
#IL BCBS TIMELY FILING LIMT PROFESSIONAL#
Providers should submit claims on standard forms (CMS 1500 for professional services and UB04 for facility services), or the appropriate 837 HIPAA compliant transaction EDI file within timely filing requirements. PCP providers are required to return member calls within two (2) hours of being contacted or have a mechanism in place to direct members to the appropriate after-hours care.īilling & Claims Payment Claims Submission Requirements The use of in-office recordings must state the operating hours of the office, whom to contact if after hours, and direct the member to call 911 if it is an emergency. U of U Health Plans requires all providers to have backup coverage during off-hours or scheduled days out of the office and to have telephone coverage 24 hours per day, 7 days per week. Once in the exam room, the member should not wait longer than 15 minutes before seeing the provider. Office Wait Timesįor scheduled appointments with PCPs and Specialists, members should not wait longer than 45 minutes before being taken back to an exam room. The provider’s telephone system shall be adequate enough to handle the volume of calls coming into the office. Providers are required to have implemented an appropriate scheduling system that allows for adequate allotments of time for different appointment types and allows for adequate slots reserved for urgent/acute care. Non-urgent, but in need of medical attentionĪ PCP is defined as a generalist in any of the following areas: We welcome your comments and suggestions on how we can better serve you and your staff. For us, this is more than insurance, this is personal. Our goal is not to just operate at industry standards, but to exceed them in every possible way. Grand Valley Preferred is a commercial plan that we offer to employer groups in Grand Junction, Colorado and the surrounding areas.Īs a member of the University Health Care team, we hold ourselves to the highest standards in the services we provide to our members and to the providers who care for our members. Healthy Preferred is a commercial plan that we offer to employer groups, primarily along the Wasatch Front, for their employees. Healthy Premier is a commercial plan that we offer to employer groups and individuals throughout the state of Utah and surrounding intermountain areas. In subsequent years we became the claims administrator for the other University and State projects – UNI HOME, as well the University’s behavioral health benefits.
#IL BCBS TIMELY FILING LIMT PLUS#
Effective July 1, 2016, University Health Care Plus is administered by Regence BlueCross BlueShield of Utah in a joint venture between Cambia and the University of Utah. University Health Care Plus (UHCP) is a self-funded health plan for the employees of the University of Utah and their dependents. In 1999, the University Health Care Plus plan was added. Since our inception, we have grown our Healthy U membership, and have added several lines of business. Our initial enrollment was approximately 3,000 members. U of U Health Plans was organized in 1998 with the formation of Healthy U (a Medicaid Managed Care Plan) as a managed care entity to handle the administrative functions of Healthy U. We value and honor the distinctive connection that you share with our members. Welcome to the University of Utah Health Plans (U of U Health Plans). University of Utah Health Plans – An Introduction
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