Billing and Claims

Billing Reference Sheets and Claims Submission and Guidelines
The guidelines associated with the billing reference sheets and claims submissions.

Coverage Decisions and Appeals
Various documents and information associated with coverage decisions and appeals.

Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) Authorization Agreement Instructions
Instructions on how to complete the EFT / ERA agreement and setup.

EDI Transaction Overview and EFT Set Up
An overview of EDI transactions and the set up of EFT.

Requests for Remittance Advice
Advice for participating providers who have EFT setup.

Provider Reconsideration Form 
Use this form to request Reconsideration of a Denied Pre-authorization.

Provider Refund Form