Claims status inquiries by third-party billing

April 4, 2022

Effective Feb 17, 2022, third-party billing agencies are no longer able to obtain basic claim status details from the call center and must use the express claims function in IVR. Basic claim status includes claim status, processed and paid date, billed and allowed amounts, amount paid and more.

  • Say "provider" at the prompt and then press 2
  • Say "claim status" or “claims” when prompted
  • Enter provider tax ID # or NPI, and patient claim details (DOS, patient DOB and/or SSN, sponsor ID, etc.) when prompted

Providers can still obtain basic claim status through provider self-service. Any basic status inquiries sent via secure message or chat, fax or mail will also be directed back to self-service.

Any claims issues or questions NOT related to basic claim status will be performed via the call center as normal.

See Basic claim status inquiries for more information.