Provider Payment Policies
The Health Plan recognizes that providers may be experiencing a decrease in revenue due to practice restrictions that have been established in response to the COVID-19 pandemic. We are working hard to improve the turnaround time for claims processing and payment for Commercial, Medicare and Medicaid claims.
During the COVID-19 pandemic, temporary measures were implemented to accelerate provider payments in order to allow for faster access to funding. These temporary measures do not pertain to self-funded groups. Should you require claims assistance, please feel free to contact us at 1.800.624.6961 or contact the practice management consultant assigned to your county.
Electronic Claims Voucher
The Health Plan provides the HIPAA 835 transaction set for electronic vouchers. The electronic vouchers are produced with all lines of business on a specified day according to line of business as payments are released. Self-funded payments are released at the direction of the self-funded employer group administrators.
Providers utilizing a clearinghouse or are a registered submitter to The Health Plan, can contact their submitter/clearinghouse to set up the retrieval of the electronic vouchers for their organization. The list of trading partner/clearinghouses provides the payor ID.
If any THP participating providers are NOT currently using a clearinghouse or are not registered submitter for The Health Plan, please complete a Trading Partner Form and email it to the EDI Support Center at email@example.com. This form can be accessed through MyPlan, the secure provider portal.
If files or reports are missing or requiring status, the clearinghouse or submitter is to contact the EDI Support Center via email with all details to assist in their location. Responses for these emails will be within 24 to 72 business hours in most cases.