December 2019 – Claims corner newsletter

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In this issue:

  • Medi/Medi Claim Submissions
  • Newborn Claims/Eligibility
  • Prop 56 Supplemental Payments
  • PDR vs CORR
  • Mailing Address

PAPER CLAIMS  Effective October 1, 2019 all paper claim submissions should be mailed to the following address:

PO BOX 211395
Eagan, MN 55121-2195

Provider Portal—DRE

The Provider Portal will allow providers and their administrative staff to have online access to claims status, submit PDR & Correspondence along with monitoring status and be able to validate member eligibility. Please go to our website www.hpsj.com and download the DRE Confidentiality Statement to get the process started today.

PROP 56

Be on the look out! As DHCS continues to approve additional supplemental payments, HPSJ will be sending out new Provider Alerts!

Coordination of Benefits (COBA)

(reference provider alert 02/21/18)
*Reminder*
Any claims submitted to Medicare on or after January 01, 2018 will be received by HPSJ via an electronic submission from CMS/Medicare. Please do not submit paper claim with EOB as it will be considered a duplicate claim and possibly delay processing and payment.

Newborn Claims/Eligibility
Physician services for the care of the newborn are covered under the mothers benefit for the month of birth and the month following delivery. However, the newborn will have their own HPSJ Member ID number. The delivering facility must contact HPSJ with the baby face sheet so newborn can be set up in the system. The newborn ID number can be located through the provider portal when looking up the mother’s information. All claims for the newborn must be billed with the newborn ID number to receive payment.

Reference Provider Alerts at www.hpsj.com/alerts/
 Provider Dispute Resolution (PDR) Submission
 Correspondence
 Corrected Claim Submission

Posted on December 18th, 2019 and last modified on December 18th, 2019.

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