Claims & Payment
We utilize best practices to ensure timely and accurate payment to our network providers. Our provider satisfaction survey showed that 90.6% of our contracted providers across all markets were satisfied with the support we provided regarding claims remittance.
We process 96.01% of electronic claims on average within 30 days.
Cenpatico® developed and implemented an innovative process that maintains standard claim processing timelines and avoids delays when any updates are needed to the system (what we call Risk Mitigation).
Our Prepayment Reviews provide overall system validation and allow us to ensure any non-standard payment agreements are met prior to payment. Prepayment Reviews occur with every check run.
Cenpatico developed and implemented an innovative process that maintains standard claim processing timelines and avoids delays when any updates are needed to the system (what we call Risk Mitigation).
Options for submitting Claims/Encounters
- Direct Key via our Secure Provider Portal (Click Here to Login or Register)
- Paper Claims can be mailed to;
- Providers have the options of submitting 837(P or I)
- Provider Portal
- Via an SFTP, that is established by our Claims Technical Assistance Department.
- Via a clearinghouse;
- The clearinghouses are:
- First Health
- Great Expectations
- Practice Insight
- Physicians CC
- Smart Data Solutions
Electronic Fund Transfer
Cenpatico Integrated Care is pleased to partner with PaySpan to provide an innovative web based solution for Electronic Funds Transfers (EFTs) and Electronic Remittance Advices (ERAs). This service is provided at no cost to providers and allows online enrollment. Providers are able to enroll with PaySpan after they have received their completed contract and submitted a claim. Benefits include:
- Elimination of paper checks - all deposits transmitted via EFT to the designated bank account
- Convenient Payments & Retrieval of remittance information
- Electronic remittance advices presented online
- HIPAA 835 electronic remittance files for download directly to a HIPAA-Compliant Practice Management for Patient Accounting System
- Reduce accounting expenses – Electronic remittance advices can be imported directly into practice management or patient accounting systems, eliminating the need for manual re-keying
- Improve cash flow – Electronic payments can mean faster payments, leading to improvements in cash flow
- Maintain control over bank accounts - You keep TOTAL control over the destination of claim payment funds. Multiple practices and accounts are supported
- Match payments to advices quickly – You can associate electronic payments with electronic remittance advices quickly and easily
- Manage multiple Payers – Reuse enrollment information to connect with multiple Payers Assign different Payers to different bank accounts, as desired
- For more information visit PaySpan’s website: www.payspanhealth.com/.
If you have any questions, please contact: CAZ Claims at CAZClaims@cenpatico.com