Billing and Claims
AmeriHealth Caritas Louisiana can accept claim submissions via paper or electronically (EDI). For questions about claims submissions, call Provider Services at 1-888-922-0007.
- CARC/RARC code updates effective August 15, 2022 (PDF)
- Claim filing instructions (PDF)
- Electronic Billing Services (EDI, ERA, EFT)
- Explanation of Benefits (EOB) Matrix (PDF)
- Flu season billing (PDF)
- ECHO health provider portal user guide (PDF)
Requests for reconsideration may be submitted through the NaviNet Electronic Claim Inquiry feature. For detailed information on electronic claim inquiry submission, please see the NaviNet Claims Investigation User Guide (PDF).
275 attachment claim transactions
- Batch — You may either connect to Change Healthcare directly or submit via your EDI clearing house.
- API via JSON — You may submit an attachment for a single claim.
- Portal — Individual providers can register at Change Healthcare to submit attachments.
The acceptable supported formats are pdf, tif, tiff, jpeg, jpg, png, docx, rtf, xml, doc, and txt.
In addition, the following 275 claims attachment report codes have been added effective 8/1/23. When submitting an attachment, use the applicable code in field number 19 of the CMS 1500 or field number 80 of the UB04, as documented in the Claims Filing Instructions (PDF).
| Attachment Type | Claim assignment attachment report code |
|---|---|
| Itemized Bill | 03 |
| Medical Records for HAC review | M1 |
| Single Case Agreement (SCA)/LOA | 04 |
| Advanced Beneficiary Notice (ABN) | 05 |
| Consent Form | CK |
| Manufacturer Suggested Retail Price /Invoice | 06 |
| Electric Breast Pump Request Form | 07 |
| CME Checklist consent forms (Child Medical Eval) | 08 |
| EOBs – for 275 attachments should only be used for non-covered or exhausted benefit letter | EB |
| Certification of the Decision to Terminate Pregnancy | CT |
| Ambulance Trip Notes/ Run Sheet | AM |
Submit claims electronically via Change Healthcare
Change Healthcare uses a tool called ConnectCenter to improve claims management functionality. Providers who have a limited ability to submit claims through their hospital or project management system may now benefit from key features of the ConnectCenter tool. There is no cost to providers to use ConnectCenter.
Key features are:
- Claims users do not need to choose between data entry of claims and upload of 837 files. All users may do both.
- Secondary and tertiary claims can be submitted.
- Institutional claims are supported.
- Claims created online are fully validated in real-time so that providers can correct them immediately.
- Whether providers upload their claims or create them online, the claim reports are integrated with the claim correction screen for ease in follow-up.
- Dashboard and work list views enable providers to streamline their billing to-do list.
- Remittance advice is automatically linked to provider's submitted claim, providing a comprehensive view of the status of their claim.
To register for ConnectCenter, visit ConnectCenter Sign Up Opens a new window. Use vendor code: 21462. If you need assistance, Change Healthcare customer support is available through online chat or by phone at 1-800-527-8133, option 2.
Electronic claims will need to be submitted to Change Healthcare using a 4-digit ConnectCenter payer identifier (CPID). The CPIDs for AmeriHealth Caritas Louisiana are:
Institutional claims: 4638
Professional claims: 6156
To learn how to navigate ConnectCenter visit the resources below.
User guides
- 275 Claims Attachment Process (video)
- Enrollment Central (PDF)
- Claims — Getting Started (PDF)
- Claims — Status (PDF)
- Claims — Uploading a Claim (PDF)
- Create a Claim (Video)
- Eligibility — Getting Started (PDF)
- Keying Institutional Claims (PDF)
- Keying Professional Claims (PDF)
- Provider Management — Getting Started (PDF)
- Provider Sign-up and User Management (PDF)
- Remits — Getting Started (PDF)