Providers

Billing & Payment Information

Total Physicians, Hospitals & Others
PAYER ID: 38201

 

THC preferred clearinghouses: Emdeon, Ingenix, Netwerkes, SDS

 

Claim Address: Total Health Care Inc, Michigan

P.O. Box 21486

Eagan, MN 55121-0486

 

EOP/Remittance Advice: Visit.

https://providerpay.secureconduit.net to obtain EOP/Remittance advice

now available through Ventanex. Claim line detail via THC Portal – see attached manual

 

Filing Limit: Medicaid – 365 days from date of service.

Commercial – 180 days from service date

Appeals and re-submission of unclean claims – 180 days from original denial date

Billing Guidelines THC follows Medicaid billing guidelines for all lines

of business. CMS edits apply according to

Medicaid rules.

 

Claims Manual: Claims Manual

 

Appeal Process Policy

claimsappeal@thcmi.com

313-748-1393

Paper Claims: Paper claims must be standardized to meet

imaging specifications as noted below:

 

Insurance Refund Request Insurance Refund Request Form

 



DO’S

  • Billing Tips & Guidelines
  • Use only the red and white CMS 1500 claim form with pre-printed patch code for all submissions including status claims. No copies or other forms will be accepted.
  • Use only the red and white UB 04 OCR/original claim for all submissions including status claims. No copies or other forms will be accepted.
  • Make certain print type on the claim is a dark and legible print and printed within the correct column/ box. Make certain that no data is on the red dividing line.
  • Eliminate all character symbols, i.e., periods, commas, etc.

DO NOT’S

  • Do NOT cut perforated forms. The claim forms should be separated in a burster or hand separated.
  • Do NOT handwrite on the claims forms. Type all claim information and comments.
  • Do NOT staple claims and attachments.

 

Behavioral Health Claims: Submit claims to Beacon Health Options

Contact Beacon Health Options at 855-377-2416

 

NDC Claims Submit 11 digit National Drug Code (NDC) with

corresponding procedure code.

 

ICD10 ICD10 Introduction

ICD-10 Coding Tips

ICD-10 Provider Compliance Information

 

Visit the CMS website for helpful information, using the links below:

 

http://www.cms.gov/Medicare/Coding/ICD10/index.html

http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/ICD-10_Section.html

https://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10ClinicalConceptsFamilyPractice1.pdf