PC Products Input Guide for Claim Status …

1 PC Products Input Guide for Claim Status Transactions emdeon MAX , emdeon Assistant , and emdeon NetDirect . Version PC Products Input Guide for Claim Status Transactions This publication is the proprietary property of emdeon and is furnished solely for use pursuant to a license agreement giving the user the right to use the emdeon product (s) referenced in this document. All uses of this document are subject to the terms of such license agreement. This document may not be used except as permitted by such license agreement or changed, copied, photocopied, reproduced, translated, or reduced to any electronic medium or machine readable form without the prior consent of emdeon . Copyright is held by emdeon Business Services, LLC. emdeon is not liable for any losses or damages that result from the use of this material, including loss of profit or indirect, special, or consequential damages.

2 2018, emdeon Business Services LLC, 3055 Lebanon Pike Suite 1000, Nashville, TN 37214. All Rights Reserved. Printed in the USA. PC Products Input Guide for Claim Status Transactions Table of Contents Table of Contents Overview ---------------------------------------- ---------------------------------------- ------------------------------- 1. About This Guide ---------------------------------------- ---------------------------------------- ------------------ 1. Customer Support ---------------------------------------- ---------------------------------------- ----------------- 1. General Information ---------------------------------------- ---------------------------------------- ------------------- 2. Requests ---------------------------------------- ---------------------------------------- --------------------------- 2.

3 Determine the Transaction Type ---------------------------------------- ------------------------------------- 2. Determine the Search Types ---------------------------------------- ---------------------------------------- - 2. Enter the Search Data ---------------------------------------- ---------------------------------------- -------- 3. Responses ---------------------------------------- ---------------------------------------- ------------------------- 6. Payer-Specific Information ---------------------------------------- ---------------------------------------- ------------ 7. Payer Details ---------------------------------------- ---------------------------------------- ---------------------- 7. AARP ---------------------------------------- ---------------------------------------- ---------------------- 7. Aetna ---------------------------------------- ---------------------------------------- ---------------------- 7.

4 Aetna Administrator Medicare Supplemental ---------------------------------------- ----------------- 7. Aetna Better Health of FL ---------------------------------------- ---------------------------------------- 7. Aetna Better Health PA ---------------------------------------- ---------------------------------------- 7. Aetna Better Health of KY-------------------------------------- ---------------------------------------- -- 7. Aetna Better Health of LA ---------------------------------------- ---------------------------------------- 7. Aetna Better Health of MD ---------------------------------------- --------------------------------------- 8. Aetna Better Health of MO ---------------------------------------- --------------------------------------- 8. Aetna Better Health of VA ---------------------------------------- --------------------------------------- 8.

5 Aetna Better Health of WV ---------------------------------------- --------------------------------------- 8. Aetna Long Term Care ---------------------------------------- ---------------------------------------- --- 8. Aetna Senior Supplemental Insurance ---------------------------------------- -------------------------- 8. Affinity Essentials ---------------------------------------- ---------------------------------------- -------- 8. AGIA Inc ---------------------------------------- ---------------------------------------- ------------------ 8. Alabama Medicaid ---------------------------------------- ---------------------------------------- -------- 8. Allied Benefit Systems, Inc. ---------------------------------------- ------------------------------------- 9. Alternative Insurance Resources, Inc. ---------------------------------------- -------------------------- 9.

6 American Community Mutual ---------------------------------------- ------------------------------------ 9. American Family Insurance Group ---------------------------------------- ------------------------------ 9. American General Life and Accident ---------------------------------------- ----------------------------- 9. American Income Life Insurance Company ---------------------------------------- --------------------- 9. American National Insurance Company ---------------------------------------- ------------------------- 9. American National Life Insurance Company of Texas ---------------------------------------- -------- 10. AmeriHealth Caritas Iowa ---------------------------------------- -------------------------------------- 10. AmeriHealth Caritas Pennsylvania ---------------------------------------- ----------------------------- 10.

7 AmeriHealth Caritas VIP Care Plus ---------------------------------------- ---------------------------- 10. Claim Status ---------------------------------------- ---------------------------------------- ------ 10. AmeriHealth District of Columbia ---------------------------------------- ------------------------------ 10. Ameritas Dental Group ---------------------------------------- ---------------------------------------- - 10. Anthem BlueCross of California------------------------------ ---------------------------------------- -- 10. Avalon Administrative Service ---------------------------------------- --------------------------------- 11. Banner Health Plans ---------------------------------------- ---------------------------------------- ---- 11. Banner University Family Care ---------------------------------------- -------------------------------- 11.

8 BCBS Arkansas ---------------------------------------- ---------------------------------------- --------- 11. BCBS Colorado ---------------------------------------- ---------------------------------------- --------- 11. BCBS Georgia ---------------------------------------- ---------------------------------------- ----------- 11. BCBS Illinois ---------------------------------------- ---------------------------------------- ------------ 11. BCBS Indiana ---------------------------------------- ---------------------------------------- ----------- 12. BCBS Kansas ---------------------------------------- ---------------------------------------- ----------- 12. BCBS Kansas City ---------------------------------------- ---------------------------------------- ------ 12. BCBS LA Medicare Advantage ---------------------------------------- --------------------------------- 12.

9 2018 emdeon Business Services LLC. All rights reserved. Page i PC Products Input Guide for Claim Status Transactions Table of Contents BCBS Massachusetts ---------------------------------------- ---------------------------------------- --- 12. BCBS Mississippi----------------------------- ---------------------------------------- ------------------- 12. BCBS Missouri ---------------------------------------- ---------------------------------------- ---------- 12. BCBS Nebraska ---------------------------------------- ---------------------------------------- --------- 12. BCBS New Mexico ---------------------------------------- ---------------------------------------- ------ 13. BCBS New Jersey (Horizon) ---------------------------------------- ----------------------------------- 13. BCBS Ohio ---------------------------------------- ---------------------------------------- -------------- 13.

10 BCBS Pennsylvania (Highmark) ---------------------------------------- ------------------------------- 13. BCBS South Carolina ---------------------------------------- ---------------------------------------- --- 13. BCBS Tennessee ---------------------------------------- ---------------------------------------- ------- 13. BCBS Texas ---------------------------------------- ---------------------------------------- ------------- 13. BCBS Texas-Medicaid ---------------------------------------- ---------------------------------------- -- 13. BCBS Vermont ---------------------------------------- ---------------------------------------- ---------- 13. BCBS Virginia ---------------------------------------- ---------------------------------------- ----------- 14. Better Health Plans of Tennessee ---------------------------------------- ----------------------------- 14.