Billing & Payment Information

Total Physicians, Hospitals & Others
PAYER ID: 38201


THC preferred clearinghouses: Emdeon, Ingenix, Netwerkes


Claim Address: Total Health Care Inc, Michigan

P.O. Box 21486

Eagan, MN 55121-0486


EFT EFT Enrollment Authorization Form


EOP/Remittance Advice: Available online ONLY.

Registration Form for first time users


Filing Limit: 365 days from date of service. Appeals and

resubmission of unclean claims must be received

within 180 days from the original denial date


Billing Guidelines THC follows Medicaid billing guidelines for all lines

of business. CMS edits apply according to

Medicaid rules.


Claims Status: Claims Status From


Paper Claims: Paper claims must be standardized to meet

imaging specifications as follows:

Insurance Refund Request Insurance Refund Request Form



  • 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 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: