Effective Jan. 1, 2026, ConnectiCare began enforcing CMS paper claim form standards for all paper claim submissions. Claims that do not meet these standards, such as those submitted on black-and-white copies or misaligned forms, will be rejected.
As a reminder, when submitting paper claims:
- Paper claims are required to be submitted on original red and white CMS-1500 and CMS-1450 (UB-04) claim forms.
- Paper claims not submitted on the required forms will be rejected and returned. This includes black and white forms, copied forms, and any altering to include claims with handwriting.
- Claims must be typed with either 10- or 12-point Times New Roman font, using black ink.
- Paper claim submissions are not considered to be “accepted” until received at the appropriate claims P.O. Box; claims received outside of the designated P.O. Box will be returned for appropriate submission.
ConnectiCare Claims
P.O. Box 36010
Louisville, KY 40233
Please take a moment to review and ensure compliance with the following CMS guidelines:
- Only claim forms printed in Flint OCR Red, J6983 (or exact match) ink are acceptable.
- Downloaded or photocopied CMS-1500 forms cannot be used, as they may not meet scale and OCR color standards.
References:
