Claims
The Claims Department will adjudicate all properly submitted, authorized claims that meet “clean claims criteria” within 45 days of receipt unless otherwise stipulated in your contract.
A claim is considered a “clean claim” if it is submitted on the appropriate form, contains the correct billing information according to CMS 1500, ADA 2002 and UB-04 requirements and has all the supporting documentation as required for medical and claims review.
ERAs and EFTs
B – UHP has partnered with ECHO to process Electronic Funds Transfer (EFT) and Electronic Remittance Advices (ERA) enrollments.
- Electronic Remittance Advice (ERA): ERAs provide an electronic report of payments, reconciliations, and more. To enroll and receive ERAs, please fill out the form below.
- Electronic Funds Transfer (EFT): EFT allows us to send claims payments directly to our provider bank accounts. Use the form below to sign up for this payment method.
EFT/ERA Enrollment Instructions:
- Fill out the EFT and ERA Enrollment Form and send directly to ECHO. (See form for mail, fax, and e-mail address.)
- Select enrollment choice: 1) EFT, 2) ERA, or 3) both EFT and ERA.
- E-sign or print and manually sign form. Mail, fax, or e-mail (secure email is recommended) to ECHO Health Inc.
*Please Note: A separate form will need to be filled out for each of our plans you would like to enroll for:
- Banner – University Family Care / ACC
- Banner – University Family Care / ALTCS
- Banner Medicare Advantage Dual
Related Documents
Electronic & Mail Submissions
Please see the table below for information regarding electronic and mail submissions.
Medicaid Plans |
|
Banner – University Family Care / |
P.O. Box 35699 |
Banner – University Family Care / |
P.O. Box 37279 |
Medicare Plans |
|
Banner Medicare Advantage Dual |
P.O. Box 38549 |
Dental Claims |
|
DentaClaims of Arizona, LLC |
DentaQuest of Arizona, LLC - Claims Office: (800) 440-3408 P.O. Box 2906 Milwaukee, WI 53201-2906 Web Site: dentaquest.com |
Resubmissions
Be sure to clearly mark "Resubmission" on the claim form or select the appropriate box on the claim form if sending electronically.
Appeals
Banner – University Health Plans
Attn: Grievances and Appeals Department
5255 E Williams Circle, Ste 2050
Tucson, AZ 85711
ICD-10 Z Codes
To help us fulfill our mission to make health care easier, so life can be better, Banner Health Plans wants to partner with you to incorporate Health Related Social Needs (HRSN) ICD-10 Z codes on the claims you submit. Z codes will help us better track and address health inequities and the social needs of our members. Any clinician (physician, nurse, social worker, community health worker, case manager, or other providers) can document a person’s HRSN. Learn more about incorporating ICD-10 Z codes in your claims in the document below.
- ICD-10 Z Codes For Health-Related Social Needs/SDOH English