Transcription of 5. Billing and Payment - Kaiser Permanente
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5. Billing and Payment - Kaiser Permanente
5. Billing and Payment It is your responsibility to submit itemized claims for Services provided to Members in a complete and timely manner in accordance with your Agreement, this Provider manual and applicable law. For Self-Funded products, KPIC utilizes a TPA to process claims. The TPA s claim processing operation is supported by a set of policies and procedures which directs the appropriate handling and reimbursement of claims received. The Member's Plan Sponsor is responsible for Payment of claims in accordance with your Agreement. Please note that this Provider manual does not address submission of claims under the HMO. product. Whom to Contact with Questions If you have any questions relating to the submission of claims for services to Members for processing, please contact Self-Funded Customer Service at (800) 663-1771. Methods of Claims Submission Claims may be submitted by mail or electronically. Whether submitting claims on paper or electronically, only the UB-04 form will be accepted for facility services Billing and only the CMS-1500 form, which will accommodate reporting of the individual (Type 1) NPI, will be accepted for professional services Billing .
NCAL KPIC Self-Funded Program Provider Manual 2018 33 Section 5: Billing and Payment 5. Billing and Payment It is your responsibility to submit itemized claims for Services provided to Members in a
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