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.
Zelis
Providers have several options to connect with Zelis for ePayments.
If you are currently a Zelis customer or if you want to enroll, you have options based on what works best for your practice. The Zelis team can help you consolidate your current fees and help you determine which options are best for the volume of claims your group bills, including payers in addition to Banner. To discuss options, please reach out to Zelis Customer Service at (877) 828-8770.
No-fee ePayment options are available, with funding from Banner. If you have not signed up for this no-fee option, visit https://bannerplan.epayment.center and click Sign Up Now. You can also call the Zelis ePayment center at (855) 774-4392 or email any questions you have to help@epayment.center.
For fee-based plans using ACH or Virtual Payment Cards, or electronic remittances (835, Excel, PDF), reach out to a Zelis Provider Enrollment Advisor at (855) 496-1571 or visit https://www.zelis.com/provider-solutions/provider-enrollment for more information.
Electronic & Mail Submissions
Please see the table below for information regarding electronic and mail submissions.
Medicaid Plans |
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Banner – University Family Care / |
P.O. Box 35699 |
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Banner – University Family Care / |
P.O. Box 37279 |
Medicare Plans |
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Banner Medicare Advantage Dual |
P.O. Box 38549 |
Dental Claims |
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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