Claims System New Payer ID -- Action Needed

On or AFTER July 1, 2018:

  • Submit any new or corrected correct claims to the New Payer ID 66008.
  • To avoid denied claims, please be sure to follow the instructions below for a corrected claim on CMS-1500 or UB 04:
    • Professional Claims (CMS-1500): Per industry standards, please include the appropriate frequency code “7” in Box 22 (loop and segment 2300 CLM05-3) on the left-hand side. On the right-hand side, please also include the original claim number in Box 22 (loop and segment 2300 REF02 with an F8 qualifier in the REF01).
    • Institutional Claims (UB 04): Please include the frequency code in Box 4 (loop and segment 2300 CLM05-3). Please also include the original claim number in Box 64 (loop and segment 2300 REF02 with an F8 qualifier in the REF01).
    • Providers can submit corrected claims via paper; please use the standard processing rules for submitting claims paper.Passport Advantage (Claims)
      PO Box 3805
      Scranton, PA 18505

Claims submissions for dental, vision and pharmacy services (with the exception of Part B) as well as Passport Health Plan (Medicaid) will not change.

New Provider Portal Set-Up-- Action Needed

Additional Information Pending

New Electronic Funds Transfer Claims On or After 07/01/18-- Action Needed

Training Materials

Additional Information Pending

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Last Modified: July 10, 2018