Reminders and Helpful Tips – March 21, 2019

NCCI Compliance:

Our new claims processing system is fully compliant with the National Correct Coding Initiative (NCCI) and you may have noticed some slight coding changes. To ensure quick and accurate claims processing make sure your office staff and third-party billing vendors are using NCCI edits.

NEW Member ID Numbers:

Whether submitting claims electronically (preferred method), or by paper, be sure to use the new member ID number for service dates after 1/1/19. New member ID numbers will have a 3- character prefix followed by 12 digits and can be found on the member’s new ID card.

For your information, here are the new ID prefixes.

ID Card Prefix

ZSK
R
ZSC
ZSM
ZSF
QWY (previously ZSH)
YWY (previously ZSP)
ZSD
ZRW (previously ZSA)
ZRW (previously ZSA)
ZRW (previously ZSA)
ZYW (previously ZSP

Call Center Hours:

Please remember our call center is open from 7:00-8:00 a.m. exclusively for provider calls. Call 888-359-6592 to take advantage of this option for reduced on-hold time.

Fax Numbers:

See below for the best place to fax your requests/documents. Faxing more than 75 pages? Give us a call at 888-666-5188 so we can discuss other options.

Document Destination

Fax Numbers

What should get sent here?

Authorizations

307-432-2917

  • Pre-authorization request
  • Initial inpatient hospital authorization
  • Pharmacy authorizations
Concurrent Review

307-432-2756

  • Updates and records for current inpatient hospital stay
Appeals

307-432-2942

  • All pre and post service appeals
  • Claim Adjustment forms and records
Medical Records

307-635-9366

  • Requested medical records
  • Records for denied claims and authorizations

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