Reminder to Providers that are contracted with a 3rd party entity for billing or claims support

Providers are expected to grant or authorize adequate levels of access to their respective Billing agent or Clearinghouse. Specifically, when they are assisting with claim submission and reconciliation.

For your convenience please see the following list for access and resources:

• Create an association between the Provider’s Trading Partner Account (TPA) and the 3rd parties TPA. This will provide the entity with access to the claim and payment information 24/7. In addition, It grants the user ability to correct or submit a claim electronically. (Instructions can be found in the Trading Partner Account Registration and Maintenance Guide> Manage Billing Agent Association.)
• Route the 835 file directly to the Clearinghouse or Billing Agent (Instructions can be found in the Trading Partner Account Registration and Maintenance Guide> 835 Routing.)
• Remind the Clearinghouse or Billing Agent of payment cycle changes, which can be found in the Announcements.  
• Provide your 4-digit Security Code to the Clearinghouse, Billing Agent and internal users needing to access the interactive voice recognition system. This is available 24/7 and eliminates hold times to reach a Call Center Professional.
• For our shared efficiency, please ask your Clearinghouse or Billing Agent Representatives to be prepared to provide verifying information when they call.