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 daily basis as payments are released. Self-Funded payments are released at the direction of the self-funded employer group administrators. The Commercial, Medicare Advantage, WV Medicaid, and PEIA are released on Wednesday mornings for providers and on Friday mornings for facilities.

If you are currently utilizing a clearinghouse or a registered submitter to The Health Plan, simply contact your submitter/clearinghouse to set up the retrieval of the electronic vouchers for your organization. The list of trading partner/clearinghouses provides the payor ID.

If you are NOT currently using a clearinghouse or registered submitter for The Health Plan, please complete a Trading Partner Form and email it to the EDI Support Center at hpecs@healthplan.org. Once received, The Health Plan will set up the electronic voucher to be sent to your designated location by Internet or FTP. The setup information will include file names, submitter ID, sign on and password for Internet or FTP.

Provider/facilities set up for ERA electronic vouchers will continue to receive their paper vouchers for six months after the receipt of three successful ERA. If you wish to extend the standard six months, please notify the EDI Support Center in writing. We also have a form available for these requests. Paper vouchers will be discontinued for existing provider/facilities unless a request for an extension is received.

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.

Also, if you receive electronic vouchers successfully, we can discontinue the mailing of paper vouchers. The vouchers are placed on the Secure Provider website for download and you can access and download the vouchers at your convenience.