You're expected to follow Texas Department of Insurance (TDI) requirements, as well as meet our requirements for filing claims. This will take longer to process than electronic claims. If you prefer to file claims the old-fashioned way, we do accept paper claims. The EDI Intake Form is for our Configuration team to enter your provider information into our claims adjudication system.įor more information, visit Availity or call them at 800.282.4548. Non-contracted providers must fill out an EDI Intake Form before filing claims to BSWHP for the first time. Patients' Member Identification Numbers must be complete (and include the two-digit suffix) for a claim to be accepted electronically.You are strongly advised to review your accepted/rejected reports from Availity daily to determine if any claims were rejected by BSWHP.Both UB-04 and CMS 1500 claim forms are accepted electronically.When submitting claims, use the Baylor Scott & White Health Plan Payer Number 88030.You must use your National Provider Identifier (NPI) number when submitting claims through Availity so proper provider identification can be made.Medical software vendors may charge a fee for installation and maintenance of system enhancements that support claims transmissions.Availity also delivers information beyond what is available in standard HIPAA transactions. About AvailityĪvaility offers a secure web portal that is simple to use, integrating with software systems typically found in most physician's offices and hospitals around Texas. You may also submit claims through the HIPAA-compliant Availity Web Portal. By filing electronic claims, you can expect: How to File Electronic Claims Filing claims has never been fasterįaster responses mean everything in the healthcare industry, so let's reduce the time it takes to process your claims. For more information, see procedure-specific payment policies. We reimburse medically necessary surgical services and other procedures. How to submit a UB-04 Claim: Download the guide.How to submit a CMS 1500 Claim: Download the guide. Read the following tutorials to learn how to correctly fill in the required fields. These non-clean claims are considered never received and must be corrected and resubmitted within the BSWHP claims filing deadline for reconsideration.
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