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 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 / 
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 Medicare Advantage Dual 

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
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