Claims and payment

Learn how to identify our members' coverage, easily submit claims and receive payment for services and supplies.

Identifying members

Easily identify the kind of coverage our members have.

Claims submission

Learn more about billing and how to submit claims to use for payment.

Receiving payment

We know it is essential for you to receive payment promptly. Learn more about our payment and dispute (appeals) processes.

Coding toolkit

View our clinical edits and model claims editing or learn more about global periods, maximum allowed units for procedure codes, unlisted codes and NCCI bypass modifiers.

Electronic transactions

Electronic transactions include sending and receiving information electronically between trading partners – clients and vendors. Learn more about electronic funds transfer (EFT), electronic remittance advice (ERA) and electronic claim attachments, or contact EDI Support for assistance.