Submitting Documentation for Electronic Claims

The Health Plan may require additional doucmentation in order to adjudicate your claims. To assist with the submission of required documentation such as an operative report for multiple surgical procedures, office notes, if the diagnosis does not support the level of service billed, etc. The Health Plan has a dedicated fax line to submit the required documentation, the fax number is 740.695.7882.

To assure the required documentation is routed correctly, you myst accurately complete the "Health Plan Fax Cover Sheet" in its entirety. Failure to complete the fax cover sheet may result in your claim (s) being denied. A separate fax cover sheet is required for each document faxed. You must fax all required documentation within 24 hours of your electronic claims transmission.

Obtain a copy of the Fax Cover Sheet.