If we need additional information to complete the processing of your Claim, the notice of delay will state the additional information needed, and you (or your provider) will have 45 days to submit the additional information. We will notify you again within 45 days if additional time is needed. If we need additional time to process your Claim, we will explain the reason in a notice of delay that we will send you within 30 days after receiving your Claim. If Providence denies your claim, the EOB will contain an explanation of the denial. We will send an Explanation of Benefits (or EOB, see below) to you that will explain how your Claim was processed. Alternatively, you may send the information by fax to 50.Ĭlean claims will be processed within 30 days of receipt of your Claim.Mail your claim and supporting document(s) to the address below:.Attach a copy of receipt, provider invoice that includes the provider tax ID number, CPT codes, dates of service, ICD-10 codes (diagnosis codes), billed and paid amount with your proof of payment.Payment will be made to the Policyholder or, if deceased, to the Policyholder’s estate, unless payment to other parties is authorized in writing. See your Contract for details and exceptions. If your Provider bills you directly, and you pay for Services covered by your plan, we will reimburse you if you send us your claims information in writing. Payments for most Services are made directly to Providers. Usually, Providers file claims with us on your behalf. A claim is a request to an insurance company for payment of health care services.
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