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Posted by 1406 on Monday - December 9, 2019

HealthChoice encourages ambulatory surgery centers to bill facility charges on a form UB-04 or through 835i electronic claims. However, HealthChoice will accept facility charges when billed on a CMS 1500 form as outlined below.

When an ASC bills both the professional and ambulatory surgery center charges on a CMS 1500 form, it can be difficult to distinguish between the two.

Posted by 1406 on Monday - December 9, 2019

Effective Jan. 1, 2020, HealthChoice requires providers to indicate on the claim the name of the drug being administered, even if reimbursement is not being requested for the drug. HealthChoice will not pay for the administration charge unless the drug being administered is covered and medically necessary.

For questions about this change, contact the medical and dental claims administrator toll-free at 800-323-4314.

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Posted by 1406 on Thursday - November 14, 2019

Remember that HealthChoice covers routine vaccinations, including the vaccine and its administration, for adults and children according to the to the Centers of Disease Control and Prevention guidelines under the medical or pharmacy benefits.

Posted by 1406 on Friday - September 20, 2019

If you receive a refund request from HealthChoice, please include a copy of the overpayment letter along with the refund check. If you have identified the overpayment and are returning funds, please include the patient name, HealthChoice member ID number, transaction ID number and date of service.

Please send all refund checks to the following address:

HealthChoice
P.O. Box 34006
Little Rock, AR 72203

Posted by 1406 on Tuesday - April 23, 2019

Back in the fall, the fax number for the certification administrator has changed to toll-free 855-532-6780. This new fax number is only for the certification administrator and not for the HealthChoice Health Care Management Unit.

Posted by 1406 on Tuesday - January 22, 2019

If you do not already receive electronic remittance advices from your clearinghouse, you must register for HealthChoice Connect at www.healthchoiceconnect.com to receive them from HealthChoice.

Posted by 1406 on Tuesday - January 22, 2019

Your patients with HealthChoice primary coverage may be able to get certain imaging, cardiology or surgical procedures covered at 100 percent if they utilize a HealthChoice Select provider.

HealthChoice Select is a program designed to reduce the costs of certain services by contracting with select medical facilities to provide these services with no out-of-pocket costs to members.

Posted by 1406 on Tuesday - January 22, 2019

When the provider who renders the service is different from the billing provider, the rendering provider information, including the individual provider’s NPI number, must be included on the claim. The rendering provider’s name and individual NPI number will help ensure that the claims administrator selects the correct network or non-network provider and applies benefits accordingly.

Posted by 1406 on Tuesday - December 4, 2018

EGID heard your concerns regarding transmitting faxed information to our Health Care Management Unit. We involved not only the local and long-distance carrier, but also the hardware manufacturer and our internal IT team to find a solution. This collaboration led EGID to procure new fax lines to be more compatible with the fax protocols in use today. Over the next several months, we will phase out the old numbers.

Posted by 1406 on Wednesday - October 24, 2018

HealthChoice is offering a new and unique benefit for all HealthChoice members. The focus of the program is to strengthen the relationship between a member and their physician. If there is no provider associated with a member, care management encourages the member to find the right primary care provider and assists the member in scheduling and keeping those appointments. The philosophy is that if that relationship is strong, the member will have better health outcomes.

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