Claims

In an effort to continuously collaborate with our provider network, we want to ensure that your claims are received and processed in a timely and efficient manner. Therefore, effective immediately please follow the criteria below when submitting claims to Harbor Health.

Electronic Claims Submission

Harbor Health Medicaid is currently accepting claims through Emdeon. Please submit your claims for payment electronically. This will enhance our ability to process your claims in a timely manner. Please use the following Payer ID when submitting claims electronically through the clearinghouse: Payer ID #70259

Contact your system vendor or clearinghouse if you have any difficulty submitting electronic claims.

Specialty physician claims should include a referral form or prior authorization number(s) for payment. 

For the Billing Provider: In addition to your Federal tax ID; when submitting electronic claims to Harbor Health, you must enter either your Harbor Health assigned Provider ID Number or your NPI Number.

Harbor Health Provider ID

Format: 6-9 digits
CMS Claim Reference: Box 33b
UB Claim Reference: Box 57

NPI Number

Format: 10 digits
CMS Claim Reference: Box 33a
UB Claim Reference: Box 56

If you have any questions, concerns or need additional information please contact Harbor Health Customer Services Department at 1-800-543-0161.

Claims Submission Requirements:

Harbor Health requires the standard CMS 1500 or UB 04 Claim Form. Member ID number must be accurate and indicated in box 1a of the CMS 1500 and in box 60 of the UB04 claim form.

Submit Harbor Health Plan Claims to:
 Harbor Health (Medicaid) 
P.O. Box 830850
Birmingham, AL 35283-0850

HARBOR HEALTH PLAN PROVIDERS SIGN UP FOR ELECTRONIC FUNDS TRANSFER AND ELECTRONIC REMITTANCE ADVICE

Get paid faster and reduce administrative paperwork with electronic funds transfer (EFT) and electronic remittance advice (ERA). 

Need help?

Send us an email at HPR@harborhealthplan.com

About EFT

When you enroll in EFT, Harbor claims payments are deposited directly in the bank account(s) of your choice. The funds are delivered within one day of the ERA.

EFT payment transactions are reported with file format CCD+, which is the recommended industry standard for EFT payments. The CCD+ format is a NACHA Automated Clearinghouse (ACH) corporate payment format with a single, 80-character addendum record capability. The addendum record is used by the originator to provide additional information about the payment to the recipient. This format is also referenced in the ERA (835 data file). Contact your financial institution if you would like to receive this information. 

Fees may be associated with EFT payments. Consult with your financial institution for specific rates.

EFT Authorization Form

About ERA

The ERA replaces the paper version of the explanation of remittance (EOR). Harbor Health Plan delivers 5010 835 versions of all ERA remittance files that are compliant with the Health Insurance Portability and Accountability Act (HIPAA). 

Harbor Health Plan uses Availity® and Change Healthcare (Formerly Emdeon) as the central gateway for delivery of 835 transactions. You can access your ERA through your clearinghouse or through the secure provider tools available at the Availity Web Portal.

If you have questions Contacts Us