Reduction Of Paper Claims
Date: 03/27/17
DATE: March 27, 2017
TO: SUNSHINE HEALTH PROVIDERS
SUBJECT: REDUCTION OF PAPER CLAIMS
Introduction
To reduce costs and to act in an environmentally-responsible manner, Sunshine Health is initiating a paper reduction project. We are requesting your cooperation in reducing the number of Sunshine Health claims that you submit on paper.
Electronic Options
Sunshine Health has enhanced the features available on our Secure Provider Web Portal, therefore, reducing the need to submit paper claim forms. Providers can now submit most claims electronically through three methods available on the web portal:
· EDI/Batch Claim Uploads using 837I files and 837P uploads.
· Recurring claim templates for LTC and ADC providers.
· Direct Data Entry with attachments for primary and secondary claims.
If you have not yet begun submitting electronic claims, please consider these simple options, which save money and time. For a detailed explanation on submitting claims, please refer to the instruction manual available on the secure web portal.
Recent Study
Sunshine Health recently identified the most common obstacles providers face when billing their claims electronically. The most common reasons given for submitting paper claims were high percentages of coordination of benefit (COB) claims—that is, claims for members with Medicare and/or other insurance, and special claims processing, including Emergency Medical Services and Claim Adjustment Forms (CAF).
With the enhanced features available on our web portal, providers now have the opportunity to submit COB Claims and Special Claims processing through the Secure Web Portal. There is now an option to select coordination of benefits and attach the primary insurance EOP or remittance; for special claims processing any supporting documentation can be attached.
Additional Questions
Sunshine Health appreciates your assistance in reducing the volume of paper claim submissions, as it reduces state and provider costs. You may also experience fewer claim denials, decreased data errors, expedited claims processing, and account reconciliation. If you do not have an account through our Secure Web Portal please visit our website at www.sunshinehealth.com to register. All you need to register is your tax ID number and email address. If you have any additional questions or concerns, please contact Sunshine Health Provider Services at 1-866-796-0530.