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:

  1. Fill out the EFT and ERA Enrollment Form and send directly to ECHO. (See form for mail, fax, and e-mail address.)
  2. Select enrollment choice: 1) EFT, 2) ERA, or 3) both EFT and ERA.
  3. 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 – University Care Advantage

Related Documents

Electronic & Mail Submissions

 Please see the table below for information regarding electronic and mail submissions.


Medicaid Plans

Banner – University Family Care / 
AHCCCS Complete Care
(B – UFC/ACC)

P.O. Box 35699
Phoenix, AZ 85069-7169
Electronic ID: 09830

Banner – University Family Care / 
Arizona Long Term Care System
(B – UFC/ALTCS)

P.O. Box 37279
Phoenix, AZ 85069
Electronic ID: 66901

Medicare Plans

Banner – University Care Advantage  
(B – UCA) (HMO SNP)

P.O. Box 38549
Phoenix, AZ 85069-7169
Electronic ID: 09830

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
2701 E. Elvira Road
Tucson, AZ 85756