Healthnet: Timely Filing Deadline for Claims with Dates of Service Oct. 1, 2016–June 30, 2017

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Dear Provider,

Health Net Federal Services, LLC (HNFS) appreciates your support in submitting Veterans Choice Program (VCP) and Patient-Centered Community Care (PCCC) claims within program guidelines. We recently communicated with you regarding the acceptance of claims for dates of service in 2015 and 2016. Please be advised, as of Jan. 8, 2018, HNFS will no longer accept VCP/PCCC claims with dates of service Oct. 1, 2016–June 30, 2017. Please allow us through Feb. 28, 2018, to complete processing of claims received by the Jan. 8, 2018 deadline.

  • HNFS ceased accepting VCP/PCCC claims with dates of service Jan. 1, 2016–Sept. 30, 2016 on Nov. 13, 2017. We will complete processing for claims received by the Nov. 13, 2017 deadline by the end of the year.
  • HNFS ceased accepting VCP/PCCC claims with dates of service prior to Jan. 1, 2016, on Oct. 2, 2017. HNFS completed processing claims received with 2015 dates of service on Oct. 31, 2017.

Please visit www.hnfs.com/go/VA for additional timely filing details.

Timely filing guidelines
HNFS has made exceptions for claims submissions with dates of service beyond the 120-day timely filling deadline; however, we are no longer able to make such exceptions. For services rendered on or after July 1, 2017, claims must be submitted timely in order to be considered for payment.

  • Submit VCP claims within 120 days of the date of service, or upon the conclusion of a series of authorized visits.
  • Submit PCCC claims within 90 days of the date of service, or upon the conclusion of a series of authorized visits.

We recommend submitting claims within 30 days after rendering services.

How to submit a claim
To facilitate faster claims processing, we suggest submitting claims electronically. Electronic claims submissions provide you with an electronic acknowledgement of claim receipt and allow for faster payments. Register and submit claims with Change Healthcare atwww.changehealthcare.com/legacy/resources/enrollment-services/medical-hospital-enrollment:

  • Payer Name: Health Net – VA Patient-Centered Community Care Program
  • Payer ID: 68021
    Note: This payer name and ID applies to VCP and PCCC electronic claims.

HNFS will accept paper claims if submitted by U.S. mail on original red/white CMS-1450/1500 claims forms. We do not accept faxed claims for processing. Submit paper claims to the appropriate address:

  • VCP-VACAA, PO Box 2748, Virginia Beach, VA 23450
  • PCCC, PO Box 9110, Virginia Beach, VA 23452

Please include the complete authorization number on your electronic or paper claim to help expedite claims processing.

Resubmitting denied/rejected claims
If you have outstanding VCP or PCCC claims with dates of service Oct. 1, 2016–June 30, 2017, that previously denied or were rejected, you may submit corrected claims for processing. We offer resubmission tips at www.hnfs.com/go/VA > Claims > Additional Tips/Denial Resubmission.

We appreciate your support of our veteran community and your cooperation with these changes.

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