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Network Support Services is a division of St. Joseph Heritage Healthcare. Our goal is to provide exceptional service to our affiliated networks and health plans.
This web site is dedicated to supporting our provider care partners. The following services are available on-line:
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Check status of claims
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Appeal claim decisions
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Check Status of referrals
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Submit Referral requests online
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View Documents and Guidelines for UM
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Download explanation of benefits
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Download documents and forms
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Important links to other Web Sites
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Become an EDI provider
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Check enrollment status
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Update your National Provider Identifier
Announcements:
Fraud, Waste & Abuse Training
CMS is requiring that all Medicare Part C (Medicare Advantage) & D downstream providers complete a Fraud, Waste and Abuse training annually. As a contracted provider that provides benefits or services to Medicare Advantage beneficiaries you are required to complete a Fraud, Waste & Abuse (FWA) general training program by December 31, 2010 and annually thereafter.
CMS-1500 Claim Form
Effective July 2, 2007 St. Joseph Heritage Healthcare will ONLY accept the revised version of the CMS-1500 Health Insurance Claim Form (version 08/05) which accommodates the reporting of the National Provider Identifier. All claims including corrected claims, tracers, appeals and provider disputes submitted after July 2, 2007 must be submitted on the revised form regardless of date of service. Any claim received after July 2, 2007 on the CMS-1500 Health Insurance Claim Form (version 12/90) will be returned requesting the revised version.
UB-04 Claim Form
Effective May 23, 2007 St. Joseph Heritage Healthcare will ONLY accept the UB-04 Institutional Claim Form which accommodates the reporting of the National Provider Identifier. All claims including corrected claims, tracers, appeals and provider disputes submitted after May 23, 2007 must be submitted on the revised form regardless of date of service. Any claim received after May 23, 2007 on the UB-92 Institutional Claim Form will be returned requesting the revised version.
DID YOU KNOW YOU CAN NOW DOWNLOAD CAPITATION REPORTS?
At St Joseph Heritage we are continually looking for ways to improve our processes. We have completed the process of adding the capitation reports on-line. You can print or download this information to your computer.
Once you are signed in, just click on the Capitation link on the left side of this page to try it.
HAVE YOU GOTTEN YOUR NPI?
PLEASE CLICK ON THE NPI link on the left side of this screen to learn more about NPI and instructions on how to obtain your NPI.
At St Joseph Heritage Healthcare we are taking the necessary steps to ensure we can continue processing and paying your claims in a timely manner.
You can also click on this link to go directly to CMS' Web Site.
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Application development services provided by:
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Stone Six Solutions
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