System configuration updates
This document provides information regarding known claims issues and is updated weekly on Fridays. Please contact Provider Services with any questions or concerns.
Electronic data interchange (EDI) is the electronic exchange of data between a health care provider and a payer. EDI offers a fast, secure way of exchanging information such as eligibility, benefits, and claim status or submission.
View EDI details
You have the right to request an appeal of a claim decision. You may request this appeal on your own behalf or on behalf of a covered member.
Dispute a claim decision
These policies outline the basic terms for reimbursement of services covered under our members’ benefits plans. You’ll also find definitions of terms used in the policies and a disclaimer for their use.
Review reimbursement policies
You can find claims contact information, claim submission guidelines and pharmacy claim instructions in our Medicare and Medicaid provider manuals.
View provider manuals
Claims and billing forms