Submit claims electronically to save time and money. We offer your practice five ways to submit electronic claims:
- Network Health Connect
Access Network Health Connect, our enhanced online provider service, to electronically submit HCFA and UB04 claims. Through Network Health Connect, you can also check claim status, view claim details, and much more. For details, please see our Provider Manual.
- Direct submission
You can submit electronic claims files through secure file transfers, as well as through virtual private network (VPN) transmission. Direct claims submission is free and offers you customized reporting and increased control over testing and processing.
- NEHEN (New England Healthcare EDI Network)
NEHEN is a consortium of regional payers and providers who have designed and implemented a secure and innovative electronic-commerce solution for reducing administrative health care costs. For information on how to join NEHEN, please visit www.nehen.net, or call 781-290-1300.
The NEHEN consortium collaborated on a single Web site called NEHENnet to give smaller practices and providers with less IT support access to the most popular and essential transactions for a fixed monthly fee through a single site. For more information, call NEHENnet at 781-290-1290, download a fact sheet at www.nehennet.org, or ask for an invitation to a weekly Webinar at firstname.lastname@example.org.
- Clearinghouse submission
We accept professional and institutional EDI claims via the MD On-Line and Emdeon clearinghouses. Make sure you update the clearinghouse with Network Health’s payer ID number: 04332.
For questions about setup and connectivity to another clearinghouse, or how to appropriately configure
- MD On-Line — For questions about setup and connectivity, please contact MD On-Line or read about the special offer for Network Health providers.
- Emdeon — For questions about setup and connectivity, please contact Emdeon Business Services Support at 800-845-6592.
your clearinghouse’s software, please call your Network Health provider relations representative at 888-257-1985.
We can help you start submitting electronic claims
- First, make sure you have the following information:
Next, call us at 888-257-1985 or e-mail us to get started. For quality assurance purposes, we will ask you to complete our testing procedures. Your provider relations representative will help coordinate the testing and implementation process with our EDI managers.
- National Provider Identifier (NPI) number
- Tax ID number
- Payment address
If we reject an electronic claim
- If we do not accept your claim for a particular EDI submission, you will receive an EDI Reject Report either electronically (if you submitted your claim via direct electronic submission) or by mail.
- Claims that appear on our EDI Reject Report will not appear on your EOP and are not active for processing in our claims system.
- You must correct and resubmit these claims for processing within the timely filing limits, or within 60 days from the date of rejection.
- If you resubmit a claim 90 days or more past the date of service but within 60 days from the date of the EDI Reject Report, please resubmit on paper with a copy of the Network Health EDI Reject Report. We may deny your claim if you do not file within the limits listed above.
For more information
Please see our Provider Manual for details about our electronic capabilities.