NPI is Now Required for All Providers

Claim Resubmissions

Contracted and Non-Contracted Providers:

For Claim Resubmissions including a response to an invalid or incomplete claim submission and/or a claim resubmission with previously missing claim information, submitters have 365 calendar days from the date of service to file a timely resubmission request via EDI or to the following address:

Advantage by Bridgeway Health Solutions

Attention: Claim Resubmissions

PO Box 3060

Farmington, MO 63640

Claim Adjustments

For Claim Adjustments that include a correction to a billing error in the initial claim submission or to request claim reprocessing due to a previously partially paid claim.

 Contracted Providers:

Submitters have 60 calendar days from the last timely processed claim (as confirmed by the EOP) to request processing of a claim adjustment via EDI or to the address below.

 Non-Contracted Providers:

Submitters have 365 calendar days from the date of service to request processing of a claim adjustment via EDI or to the address below.

 Advantage by Bridgeway Health Solutions

Attention: Claim Resubmissions

PO Box 3060

Farmington, MO 63640

*************

Bridgeway would like to remind physicians, providers and suppliers submitting Medicare claims for payment, that as a result of the Patient Protection and Affordable Care Act (PPACA), effective immediately, all claims for services furnished on or after January 1, 2010, must be filed no later than one calendar year (12 months) from the date of service – or Bridgeway will deny those claims.

If you have claims with service dates from October 1, 2009, through December 31, 2009, those claims MUST be filed by December 31, 2010, or Bridgeway will deny those claims. Claims with service dates from January 1, 2009 to October 1, 2009, keep their original December 31, 2010 deadline for filing.

Claims for services that require reporting a line item date of service, the line item date will be used to determine the date of service. For other claims, the claim statement’s “From” date is used to determine the date of service.

For additional information about the new maximum period for claims submission filing dates, contact Bridgeway, or review the Medicare MLN Matters articles listed below related to this subject:

CPT codes, descriptors and other data only are copyright 2009 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.

(Last Updated: 5/01/2012)