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Network Health

Claims

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To help you get paid quickly and accurately, we have a variety of ways for you to submit a claim and check claim status. So we can properly process your claims, submit all claims within the appropriate time frames. We deny claims we do not receive within the appropriate time frames. We send an explanation of payment (EOP) report with each claim denial and check for payment. We conduct internal and external claims audits to validate accuracy of payment and confirm that claims accurately represent the services our members receive.

For more information, please see our Timely Filing of Claim Submissions and Adjustment Requests Policy, refer to our Provider Manual, or call us at 888-257-1985.


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