Scott & White Health Plan

Claims and Billing

• Introduction
   
• Commitment to Quality
   
• Claims Guidelines and Submission
  • Filing deadline
  • Clean claim
• Paper Claims
  • Completing a paper CMS 1500 Form
  • Completing a paper UB 04 For 
• Electronic claims
  • Submitting claims directly to SWHP electronically
  • Submitting claims thru a clearing house
  • Electronic Data Interchange (EDI) Intake Form
  • Electronic Data Interchange (EDI) Authorization Form
     
• Appeals
  • Provider Appeals
  • Filing Limit Provider Appeals
  • Duplicate and Corrected Provider Claim Appeals
  • Provider Appeal Request Form
     
• Provider Reimbursement
  • Claim Check
  • Modifier Payment Policy
  • Modifier Priority Table
  • Bilateral and Multiple Surgical Procedures Professional Payment Policy
  • Balance Billing
     
• Claim Status Inquiry
  • MyBenefits Provider Module (Provider link/Sign On Request Form)
  • Customer Service Advocates
  • Balance Billing
     
• Coordination of Benefits
  • Coordination Of Benefits Policy
  • Medicare Coordination Of Benefits Guidelines
     
• SeniorCare Policyholders Claims
   
• Third Party Liability
  • Workers Compensation
  • Subrogation
  • Ingenix Accident Report
     
• Account Reconciliation
  • Negative Balance
  • Retractions/recoupments, Returned Checks, and Refund Checks
     
• Statutory Verification/Declination
   
• Locum Tenens Billing
   
• Frequently Asked Questions