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Submit Professional Claim: Step 1

Step 1 of the Submit Professional Claim panel is used to provide required claim information for the header of the claim. The provider can add and update the header information. Header information includes the Provider and Member information.

Multi-step process

Submitting a professional claim requires multiple steps.

• Step 1-Provider and Member and Claim Information
• Step 2-Diagnosis Code and Other Insurance Information
• Step 3-Service Details and Attachments

Note: Upon the initial display of any step in the submission process, all panels are displayed. Click Collapse All to close all panels, or click minus icons on each panel to close only that panel.

Submitting Claims

1. Review the provider information.
2. Enter any applicable Rendering provider in the Provider Information section. Click the magnifying glass icon to search for a rendering provider or service facility.
3. Complete all required member and claim information fields.
4. If the member has other insurance, click on the Include Other Insurance check box.
5. Click Continue to complete Step 2 of the Multi-step process.

Additional Help

If you need additional help, call Customer Assistance or your provider representative.

Consult the Claims and Billing Procedures Modules for Claim Submission help.

Basic Information on using HealthCare Portal.

Warning!

Do not use the bread crumbs at the top of the page to navigate between steps of the claims submission process. You may lose data. Use the Back to Step X buttons at the bottom of the page to move between steps.