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Send po box 30537 salt lake city ut 84130 via email, link, or fax. You can also download it, export it or print it out.
How to use or fill out HealthPlan Services (Payor ID # 59143) with our platform
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Click ‘Get Form’ to open the HealthPlan Services claim form in the editor.
Begin by filling out the Employee/Retiree Data section. Enter your name, address, and HealthPlan Services Member ID #, which starts with 'Q9'.
Next, complete the Patient Data section. Provide the patient's name, date of birth, age, and relationship to the employee.
Fill in the Other Insurance Data if applicable. Indicate if the patient is employed and provide details about any other health insurance coverage.
In the Physician or Supplier Information section, enter the provider's billing name, address, phone number, and Tax ID number. Include a description of the diagnosis and services provided.
Complete and sign the Authorizations section to authorize payment directly to your chosen party.
Finally, review all entries for accuracy before mailing or faxing your completed claim form along with itemized bills to HealthPlan Services.
Start using our platform today for free to streamline your claims process!
Fill out HealthPlan Services (Payor ID # 59143) online It's free
Payer IDs for claim submissions Line of businessHEALTH NET PAYER ID CA OR Individual MA HMO, Special Needs Plan (SNP) (does not apply to employer group MA HMO) IFP 680691 more row
What is the payor ID for HealthPartners?
HealthPartners payer ID is 94267 for all Hospital, Medical, Dental, Claim Status and Eligibility transactions.
What is the payer ID for HealthPlan services?
Note: All claims must be filed within one year from date of service. You may mail or fax your completed claim form: MAIL: HealthPlan Services - Payor ID # 59143 P.O. Box 30537 Salt Lake City, UT 84130-0537 FAX: 1-877-779-9873 (please do not include a cover sheet). If you have questions, please call 1-800-216-2166.
What is the payer ID for the health plan?
Electronic Claims Voucher Providers utilizing a clearinghouse or are a registered submitter to The Health Plan, can contact their submitter/clearinghouse to set up the retrieval of the electronic vouchers for their organization. The exclusive EDI gateway for THP is Change Healthcare (CHC), and their payer ID is 95677.
po box 30537 salt lake city utah 84130
HealthPlan Services Provider phone numberHarrington Health provider phone number
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Change Health Care Commercial Par Payer Listing: 8/9/2017
Medicaid claims to this payer ID. This payer ID is for ACS Benefit Services. Inc. ONLY. 2 2A 1 2 A Payer formely known as: Maksin Management Corporation 2 2
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