Providers
Billing & Payment Information
Total Physicians, Hospitals & Others
PAYER ID: | 38201
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THC preferred clearinghouses: | Emdeon, Ingenix, Netwerkes, SDS
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Claim Address: | Total Health Care Inc, Michigan
P.O. Box 21486 Eagan, MN 55121-0486
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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
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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.
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Claims Manual: | Claims Manual
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Appeal Process | Policy
claimsappeal@thcmi.com 313-748-1393 |
Paper Claims: | Paper claims must be standardized to meet
imaging specifications as noted below:
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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
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NDC Claims | Submit 11 digit National Drug Code (NDC) with
corresponding procedure code.
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ICD10 | ICD10 Introduction |
Visit the CMS website for helpful information, using the links below:
http://www.cms.gov/Medicare/Coding/ICD10/index.html
https://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10ClinicalConceptsFamilyPractice1.pdf