Transcription of Provider Billing Manual - Sunshine Health
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Provider Billing Manual - Sunshine Health
Provider Services 1-844-477-8313 2 Table of Contents PROCEDURES FOR claim SUBMISSION .. 4 Claims Filing Deadlines .. 7 claim Requests for Reconsideration, Provider Disputes and Corrected Claims .. 7 claim Payment .. 10 PROCEDURES FOR ELECTRONIC SUBMISSION .. 10 Electronic claim Submission .. 11 Provider Portal Registration .. 11 Electronic Secondary Claims .. 12 Specific Data Record requirements .. 13 Electronic claim Flow Description & Important General Information .. 13 Invalid Electronic claim record Rejections/Denials .. 14 Exclusions .. 14 Electronic Billing Inquiries .. 15 Important Steps to a Successful Submission of EDI Claims .. 16 EFT and ERA .. 16 PROCEDURES FOR ONLINE claim SUBMISSION .. 17 Provider Portal Registration .. 17 PAPER claim SUBMISSION requirements .
claims and to avoid unnecessary rejections and/or denials. Claims will be rejected or denied if not submitted correctly. In general, Sunshine He alth follows CMS (Centers for Medicare & Medicaid Services) billing requirements. For questions regarding billing requirements, contact Sunshine Health Provider Services at 1-844-477-8313.
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