Therefore, For more information about the requirements for extending the time limitation for filing a Medicare claim, please see the CMS I, Enter your email above. Claim Corrections: (866) 518-3253 7:00 am to 4:30 pm CT M-Th. var dteNow = new Date(); Please call us if you do not see your insurance listed, because we are continually adding new health plans. P.O. Box 7861 Non-Discrimination Policy, Copyright © ATTN: Audit Supervisor Madison, WI 53713-1834, WPS GHA Reimbursement.Overpayment. The scope of this license is determined by the AMA, the copyright holder. P.O. 8:00 am to 5:30 pm ET M-F, DDE System Access: (866) 518-3295 All providers and suppliers have a legal obligation to determine the correct primary payer when billing Medicare. Providers should mail their claim, waiver request, and supporting documentation to the attention of the Claims Manager at the appropriate state specific address below. WPS offers a secure way for you to send us any questions you might have, including those related to your health or customer account. Facility Rules for Visitors | BCBS of Out of State Bridgeway Health Advantage CareMore Cigna Champva Coventry Health Care Fresenius Health Partners First Health Great West … (866) 518-3285 Iowa  Current news from CMS and. Claims Department (866) 518-3253 now=new Date(); Contact; Business Units . CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. All rights reserved. 1717 W. Broadway P.O. In 1977 WPS became an independent not-for-profit company, separating from the Medical Society in compliance with state law. As such, the determination that a claim was not filed timely is not subject to appeal. The AMA is a third party beneficiary to this agreement. Box 14260 Iowa  (function($){ What is a clean claim? 7:00am to 5:00 pm CT M-F, Claim Corrections/Reopenings: IN NO EVENT SHALL CMS BE LIABLE FOR DIRECT, INDIRECT, SPECIAL, INCIDENTAL, OR CONSEQUENTIAL DAMAGES ARISING OUT OF THE USE OF SUCH INFORMATION OR MATERIAL. Terms and Conditions | THE ADA EXPRESSLY DISCLAIMS RESPONSIBILITY FOR ANY CONSEQUENCES OR LIABILITY ATTRIBUTABLE TO OR RELATED TO ANY USE, NON-USE, OR INTERPRETATION OF INFORMATION CONTAINED OR NOT CONTAINED IN THIS FILE/PRODUCT. }); High-quality health insurance plans for individuals, families, ... Wisconsin, Michigan, Iowa, and Illinois. Claims Department Close (907) 569-0004 (907) 258-6863 fax. IF YOU DO NOT AGREE WITH ALL TERMS AND CONDITIONS SET FORTH HEREIN, CLICK BELOW ON THE BUTTON LABELED "DO NOT ACCEPT" AND EXIT FROM THIS COMPUTER SCREEN. WPS GHA 7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-Fri Claims Department  WPS GHA 8:00 am to 5:00 pm ET M-F, General Inquiries:  Therefore, do not send your request to WPS GHA using the Redetermination Request Form. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials. ATTN: Audit Supervisor EEO/AA employer. Providers interested in participating must establish a contract with one of the contractors, Health Net Federal or TriWest Healthcare Alliance. Reimbursement.Overpayment. This agreement will terminate upon notice if you violate its terms. 7:00 am to 4:30 pm CT M-Th, DDE Navigation & Password Reset: (866) 518-3251 This is true for both contractor initiated reopenings as well as reopenings requested by a party. WPS GHA Wisconsin Physicians Service ®. Users may also visit the Forgot User Login ID / Password page to recover their User Login ID. Select the option below that best describes you. Claims Department Since claims denied for timely filing do not have appeal rights, the WPS GHA Appeals area cannot grant any waiver to the timely filing deadline after we process the claim. WPS GHA Quick Reference Contact Information Program Participation For questions regarding network participation and contracting, please feel free to contact TriWest Provider Services. End User Point and Click Agreement: Box 14172 Claims Department Manager ... For help with TRICARE, VA, WPS Health Insurance(private), Family Care and Children’s Waiver Program, Arise: Please call: 1-800-782-2680 Option 1. WPS GHA Part B Madison, WI 53708-8667. Madison, WI 53708-8940, Michigan WPS GHA Part B Find a Doctor. Provider Network of America Tricare West Region UMR United Health Care United Health Care Choice Plus United Health Care Medicare Complete United Healthcare Medicare Advantage United Healthcare Medicare Advantage PPO United Healthcare West WPS VACAA/Triwest Healthcare Alliance The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. Showing WPS GHA Portal Content for Jurisdiction, DDE Navigation & Password Reset: (866) 518-3251, DDE Navigation & Password Reset: (866) 580-5986. Prevent Fraud | The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CPT should be addressed to the AMA. The CMS IOM Publication 100-04, Chapter 34 , Section 10.11, states the following: "Third party payer error in making a primary payment determination does not constitute good cause for the purposes of reopening an initial determination or redetermination when Medicare processed the claim in accordance with the information in its system of records or on the claim form. 8:00 am to 5:00 pm ET M-F. You currently have jurisdiction selected, however this page only applies to these jurisdiction(s): . ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. Madison, WI 53707-7665, Kansas The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. Claims Department  The final decision as to where you receive rehabilitation care is up to you. WPS GHA End Users do not act for or on behalf of the CMS. Providers with issues regarding their WPS GHA portal account can contact our Provider Contact Center at (866) 518-3285, or use our Live Chat feature on our website for assistance with their user ID. (866) 234-7331 Login for Secure Services Find the right place to log in for secure services like enrolling, making appointments or checking referrals. (866) 518-3285 CDT IS PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING BUT NOT LIMITED TO, THE IMPLIED WARRANTIES O F MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. For billing or insurance questions please contact our specialists at 907-278-1320. What we do: All rights reserved. In addition, the CMS Internet-Only Manual (IOM), Publication 100-04, Chapter 1 , Section 70.4 states, "When a claim is denied for having been filed after the timely filing period, such denial does not constitute an “initial determination”. Many insurance plans have limits on therapy services, either dollar limits or visit limits. The AMA does not directly or indirectly practice medicine or dispense medical services. An original, paper (red and white) CMS-1500 claim form, plus any documentation needed to process the claim; Documentation proving you met "good cause" for late filing (e.g., a copy of the beneficiary's retroactive Medicare entitlement letter from the Social Security Administration). WPS-VACAA* Medicare* *Participating in network with this insurance. (866) 234-7331 Indiana Claims Manager Box 8890 THE LICENSE GRANTED HEREIN IS EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THIS AGREEMENT. In some cases, your insurance company will guide you to the "in network" providers like Synergy Physical Therapy & Wellness. Failure to do so, regardless of third party payer error, does not constitute “good cause” that will permit reopening beyond one year. 8:00 am to 5:00 pm ET M-F, Inquiries regarding refunds to Medicare - MSP Related Terms of Use | WPS GHA  Madison, WI 53708-8696, When using a delivery service: (866) 234-7331 WPS GHA Part B Asking for a Claim Reopening for a Medicare Denied Claim Not Filed Within the Time Limits due to Third Party Error. CPT codes, descriptions and other data only are copyright 2019 American Medical Association. TriWest is humbled to be awarded the Community Care Network (CCN) Region 4 contract by the U.S. Department of Veterans Affairs (VA) to continue our now six-year partnership with VA and community providers to enhance access to health care for … WPS GHA Part B Circumstances such as backdated Medicare entitlement may also qualify for an extension of the timely filing deadline. Claims Department Manager Claim Status/Patient Eligibility: P.O. CMS does not accept errors caused by incorrect third party payment as justification for not submitting timely claims to Medicare. Wisconsin Physicians Service®. document.write(intYear); Notice of Privacy Practices | Applications are available at the American Dental Association web site. An original UB-04 claim form, submitted as a hardcopy adjustment claim (xx7), plus any documentation needed to process the claim; A letter explaining why you filed the claim late; Documentation proving you met "good cause" for late filing (e.g., a copy of the beneficiary's retroactive Medicare entitlement letter from the Social Security Administration or Medicaid recoupment letter). Since claims denied for timely filing do not have appeal rights, the WPS GHA Appeals area cannot grant any waiver to the timely filing deadline after we process the claim. 34285-200-2008, Travel and Expense Reimbursement Policy for Contractors, Español | Hmoob | 繁體中文 한국어 | Deutsch | العربية | Русский | Tiếng Việt | Deitsch | ພາສາລາວ | Français | Polski | हिंदी | Shqip | Tagalog. Madison, WI 53707-7576, Missouri 7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-Fri You can find specific instructions and contact information in the TriWest Claims and Reimbursement Quick Reference Guide.TriWest Claims and Reimbursement Quick Reference GuideHealth Net Federal Services InformationHealth Net Federal Services (Health Net) was a TPA for VA’s PC3 networks and the VCP. Vendor Security Requirements | Madison, WI 53708-8550, Kansas $("#wps-footer-year").text("").text(year); WPS recommends you use bookmarks in your browser or carefully type the valid URL to avoid begin tricked into visting a malicious lookalike website. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. WPS Small Business Policy | Being a preferred provider does not guarantee reimursement for your insurance scompany. Internet Explorer Compatibility View It looks like you have enabled Internet Explorer Compatibility View or are using an older version of Internet Explorer. P.O. WPS Health Insurance Privacy Policy WPS Health Plan Privacy Policy AspirusArise Privacy Policy 7:00 am to 5:00 pm CT (8:00 am to 5:00 pm ET) M-Fri Box 8602 Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking above on the button labeled "Accept". To be eligible for Medicare reimbursement, providers must file claims within a qualifying time limit. P.O. PHISHING ALERT . BY CLICKING ABOVE ON THE BUTTON LABELED "ACCEPT", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT. Find the right phone number for what you need. Supplier Code of Conduct | CMS indicates that Medicare contractors could determine good cause exists when an administrative error on the part of an official Medicare employee acting on behalf of the Medicare contractor within the scope of his/her authority caused the delay. In such situations, providers must file the claim promptly after the error is corrected. Please enable JavaScript to continue. AARP Medicare Complete ACN (Arizona Care Network) Administrative Enterprises Aetna AHCCCS Arizona Foundation for Medical Care (AZFMC) Banner Health Network BCBS of Arizona BCBSAZ Neighborhood Network BCBS Medicare Adv. 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