1) Inquiries: Member Eligibility, Claims and Authorizations
For claims processed by the new system (service dates after April 1, 2015), call MHP Provider Services at 1-800-647-0550. For claims processed with service dates prior to April 1, 2015, Provider InSite will continue to be available for accessing member eligibility, authorizations and claims information
2) Health Care Professional Data
It is very important that MHP maintain current, accurate data about the health care professionals at your organization in order to process your claims timely and accurately. Claims submitted without accurate professional data will be considered non-clean claims and take longer to adjudicate, or these claims will be denied at the clearinghouse level.
The new system requires that new service authorizations be issued for those members who currently have approved IDX service authorizations with service dates beginning April 1, 2015. MHP will mail copies of these new authorizations to your clinic. All sections of the MHP Medical Service Authorization Request Form must be completed, which is a change to MHP's current practices. In particular, MHP will now require the ICD-9 and CPT codes be on the form whereas previously, MHP did not require these codes. MHP is unable to process the service authorization request without these codes on the request form; incomplete forms will be returned to the provider. The new service authorization number is required to be submitted on the claim. Claims submitted with service dates beginning April 1, 2015 that do not have the new service authorization number will be denied.
The new claim processing system has been extensively tested with the provider’s contractual reimbursement rate. However, should you notice incorrect reimbursement rates, contact MHP Provider Services at 1-800-647-0550.