EDI number: 56144
Claims filing address:
Healthgram
PO Box 11088
Charlotte, NC 28220-1088Verify benefits and eligibility: 704-719-2709 or 877-371-3720
Precertification: 877-371-3720
Claim form submission:
Claims shall be submitted on the standard CMS 1500 or UB 92 forms or electronically through a national clearinghouse such as WebMD/Emdeon.
Providers must submit claims within 90 days of service to be considered for payment for Healthgram members. All incomplete claims will be denied and the denial code on the provider’s explanation of payment will indicate what information is necessary to reprocess the claim.
If an injury is work related or caused by a third party, the provider agrees to relay this information to Healthgram as soon as possible. This information is required to determine if Workers’ Compensation insurance applies and if coordination of benefits or subrogation rights should be invoked.
To ensure prompt payment, please ensure all pertinent information is on the claim form:
- A provider name must be listed in Item 31.
- The facility name needs to be listed in Item 33.
Electronic claims submission:
Healthgram uses Emdeon (WebMD) for electronic claims receipt.
Please keep in mind the following information needs to be accurate on the Healthgram member’s claim form to ensure electronic claims are properly loaded into our system:
- Group number
- Date of birth
- Identification (ID) number
- Gender