Bold point in the Medical Claim

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Aug 6th, 2022
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Got questions?

Below are some common questions from our customers that may provide you with the answer you're looking for. If you can't find an answer to your question, please don't hesitate to reach out to us.
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Claim detail Date of service. Procedure code. Corresponding diagnosis code. National Drug Code (NDC), if applicable. Attending physicians NPI number. Charge for the service.
Common Re-Submission Codes Include: 6-Corrected. 7-Replacement. 8-Void.
If a claim is not submitted within 60 calendar days, or the requested information is not returned to Health Net within 60 calendar days, the claim will be denied.
You need to file your appeal within 60 calendar days from the date on the coverage determination/organization determination notice (denial letter) you received.
All paper Health Net Invoice forms and supporting information must be submitted to: Email: CalAIMCSinvoicesubmission@centene.com. Address: Health Net Cal AIM Invoice. PO Box 10439. Van Nuys, CA 91410-0439. Fax: (833) 386-1043. Web Portal.
Timely Filing first time claim submission, not later than the sixth month following the month of service. Corrected Claims, Requests for reconsideration or claim disputes must be received within 365 days following the date of payment or the denial of the claim.
We work with the following clearinghouses: Clearinghouse/ Direct SubmitterArizona Complete Healths Payer ID (Medicaid, Medicare and Exchange) First Health 68069 Gatewayedi/Trizetto 68069 Great Expectations 68069 Greenway 6806916 more rows
Six-Month Billing Limit Original (or initial) Medi-Cal claims must be received by the California Medicaid Management Information System (MMIS) Fiscal Intermediary (FI) within six months following the month in which services were rendered. This requirement is referred to as the six-month billing limit.

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