![]() Please note that we cannot accept claim submissions via fax. If you are unable to bill electronically, you may send paper claims to the following address: NEW CLAIMS MAILING ADDRESS EFFECTIVE AUGUST 1, 2022Īll other correspondence (including refunds) should be addressed to: Please note that claims submitted on paper may have significantly longer processing times. _ Paper Claim Submission: Please submit electronic claims whenever possible! In the meantime, registered users can use the claims status function of our web portal (see details above) to determine if we have received a claim from CMS prior to submitting. To minimize duplicate claim submissions, please allow sufficient processing time (45 days) before submitting your Medicare primary claims to Advanced Health. All claims should cross over, however there will all ways be exceptions. Your remittance from CMS may indicate that the claim has crossed over to Oregon Medicaid (not WOAH or Advanced Health). In March of 2018, CMS began forwarding claims to Advanced Health for dual-eligible members who are enrolled in both plans. The payer ID for professional is DOCSO (all alpha characters) The payer ID for institutional is UOCSO (all alpha characters).įor questions or issues regarding electronic claim submissions, please contact the Advanced Health account representative at Trizetto Provider Solutions:Įmail: _ NEW! CMS Medicare Crossover Claims: We work closely with Trizetto Provider Solutions and their many trading partners for electronic claims submission. _ NEW! Electronic Claim Submission:Īdvanced Health now accepts electronic claims (837P & 837I) for professional and institutional billing for both primary and secondary claims. Please follow the instructions on our Provider Registration form to initiate this process. Additionally, all providers and vendors must be configured in our claims processing system prior to claims submission. Note: To provide services to OHA Fee For Service clients, you must enroll with OHA directly. If you would like Advanced Health to apply on your behalf, please complete this application: Oregon Medicaid ID Application Packet. Please visit the Oregon Health Authority’s provider enrollment website at for additional details. These are State and Federal requirement and cannot be circumvented. Providers must also not be present on the Office of the Inspector General’s (OIG) exclusion list. _ ALERT! Provider Configuration:īefore we can accept any claim, all providers on that claim (billing, rendering, referring, ordering, prescribing, attending, etc.) must first have a valid Oregon Medicaid ID effective on the date of service. ![]() ![]() For additional information, please see the following document: Claim Inquiry Process For all other providers, please complete and submit the following form: Claim Inquiry Form (fillable PDF). Look for the Claim Status button in the menu. Providers with access to our web portal may now check the status of submitted claims securely online. If you have not already registered for portal access, please click the link above and register as soon as possible to avoid any disruption in service.Īdditionally, Effective September 1st 2021, Advanced Health will no longer distribute printed or PDF versions of EOPs (Explanation of Payments).Īdvanced health will deliver this information solely through the new provider portal.Ĩ35s will continue to be available from our clearinghouse (Trizetto), as well as via the new portal. Please note: The new portal will replace the existing provider portal at, which will cease to be accessible. The new provider portal will allow users to verify eligibility and PCP assignment, check claim and authorization status, and offers new features such as the ability to review adjudication details for finalized claims as well as the ability to download “835” Remittances and Explanation of Payments (EOPs) on demand. Frequently Asked Claims Questions and AnswersĪdvanced Health is pleased to announce the roll out of our new provider portal, located at: ![]()
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