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Answers & Questions from the Claims Department Q: Can I fax in my claims? A: YES, at this time we are accepting faxed claim forms, you may fax them to 719-538-1433, 24 hours a day, seven days a week. Q: How many days do I have to file my claim? A: You are allowed 60 days from the service date to be considered within the timely filing guidelines. Q: How soon will I receive my payment: A: Payment for services is contingent on a valid authorization and a current CCAR on file. We have averaged 99% of clean claims paid within 14 days. Q: What is the preferred claim form? A: We prefer the HCFA 1500 claim form, but we also accept the Colorado 1500. Both forms are in the Provider Manual. Please see Section 14 for "picture ready" claim forms that can be copied, and the instructions for completion. Q: If my claim is denied for "No CCAR", how long do I have to submit the CCAR for payment? A: You have 30 days to submit the CCAR and have your claims automatically reconsidered.* All reconsidered claims are 30 days from denial. Q: How often do you pay your claims? A: We are continually processing your claims, every Wednesday and Friday we post the claims for payment. The checks are printed and mailed the consecutive Thursday and Monday. Q: Why is there always a "WA" hold on every claim, when I send in a CCAR? A: We use the code WA (Be sure to Complete CCAR forms) to remind the providers to always stay current on the CCAR requirements. Each and every claim has this reminder. Q: Do I have to have a valid authorization in place if you are not the primary payor? A: Yes, CHN will coordinate coverage only if a valid authorization is in place. Remember, Medicaid does not automatically pay secondary copayments, coinsurance or deductibles. If the primary carrier’s benefit is the same or more than our allowed, Medicaid will not make an additional payment. You are not required to file a zero payment claim. Q: I have recently started billing for this provider. What was the last date of service considered and how many sessions are left on the authorization? A: Please call our Member/Provider Services to obtain this information. You can call 1-800-804-5008, Access to Care Line. Q: I do not agree with the payment decision, what can I do? A: You always have the right to appeal a claims decision. You can call our Member/Provider Services for clarification, if you still feel the denial is in error, you must appeal in writing within 30 days of the denial. Please refer to section 5 of your Provider Manual, titled Claims Appeals Process.
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