Electronic Claim Filing Information

Below is information on submitting electronic claims to the Healthy Start Program (HSP). We encourage your to start submitting electronically to reduce paperwork and expedite claim processing time. To submit HSP claims electronically you will need to provide the following information:

• National Provider Identifier (NPI) provider number
• UniCare's Electronic Payor Number is 80314.

EDI Vendors Available:
UniCare accepts electronic claims through the following clearing house vendors:

For Physicians

For Hospitals

For more information about how to begin submitting electronic claims for HSP, please contact UniCare toll free at 1-877-210-4083. Or e-mail UniCare at ediunicare@wellpoint.com.

For questions about your provider number, status of claims, or for other Plan-related questions, please contact Customer Service at 1-888-488-9161.

EDI (Electronic Data Exchange)
EDI is quickly becoming the state of the art process for everyday business transactions in the health care industry. Many health care organizations, including health care partners, payers, vendors and fiscal intermediaries have found EDI to be a fast, inexpensive and safe method of automating business processes.

Benefits of Utilizing EDI

• Eliminates inefficiencies associated with the processing of paper claims
• Accelerates payments-claims are processed in days rather than weeks
• Results in cleaner claims with front-end editing
• Reduces administrative costs when compared to paper claims
• No charge for service

FREE WEB CLAIMS SUBMISSION

The Healthy Start Program offers web based transactions at no cost, as a courtesy to our providers. Go to www.unicare.com , then select provider, then select your state, then select “Submit HIPAA Transactions.”

Working with EDI Clearinghouses

Many health care partners choose to work with EDI clearinghouses for their electronic claims submissions and other EDI transactions. The clearinghouse has connectivity to multiple payers. They use their connections for routing a multitude of transactions back and forth between health care partners and payers, and they automatically format the data into a standard format required by that payer. They also take care of the testing for the provider and setting up communications. The EDI clearinghouse becomes a health care partner’s daily liaison for the processing of health care transactions.

The Healthy Start Program works with many different clearinghouses. A list of contracted clearinghouses can be found at:

http://www2.unicare.com/providers/edi/index.asp
The lists are available in a downloadable format.

To learn more about the Healthy Start Program EDI and how to get your office connected, contact EDI Services Department at: (877) 210-4083