Electronic Claims
Electronic claim submission is an EDI service, provided by a clearinghouse that provides you with the most efficient, cost-effective way for submitting all types of medical claims to ConnectiCare. Currently, ConnectiCare has relationships with the following clearinghouses:
How Do I Get Started?
To sign up for electronic claim submission you will need to contact one of the clearinghouses listed above. The clearinghouse can provide additional convenience to you in that they have a relationship with a number of other health plans in addition to ConnectiCare. And, once you sign on with the clearinghouse, you also have the option of receiving your explanation of payment statement (EOP) electronically.
How Does it Work?
When you submit claims electronically you will need to send to the clearinghouse all claims you wish to submit to ConnectiCare, as well as other health plans. The clearinghouse will sort the claims by health plan and check the information to identify any submission errors. This often results in less opportunity for claims to deny for incorrect billing. The information is then forwarded to ConnectiCare, where it is processed on a daily basis.
How Do I Verify That ConnectiCare Has Received My Claims?
Each time you submit claims electronically, the clearinghouse will provide you with an acceptance report that will identify all the claims that have been submitted to ConnectiCare on your behalf. When they detect billing errors prior to submitting your claims, they will also provide you with a rejection report so that you can correct any errors prior to actual submission.
I Have More Questions.
If you have additional questions regarding electronic claim submission, please call 1-800-828-3407.
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