IMPORTANT CHANGES
EFFECTIVE SEPTEMBER 1, 2022
- Transitioning to new claims vendor – Conduent Inc
- Members will be issued new ID Cards – please note Group #s have changed
- All paper claims must be submitted to our new clearinghouse address:
- US Family Health Plan
- PO Box 14847
- Lexington, KY 40512
- Our Payor ID will remain:
- Claims Submission & ERA – Payor ID 13407
- Member Eligibility – 270/271 – Payor ID SVMNY
- Claims Status 276/277 – Payor ID SVMNY
- IVR will no longer be available to check membership eligibility.
- Eligibility can be checked through our Provider Portal or via 270/271 transactions.
- Click for Portal Registration – Select “Create Account”
- Appeals for Medical Necessity should be submitted to our new address:
- US Family Health Plan
- 8440 Jefferson Hwy Ste 101
- Baton Rouge, LA 70809
- FAX: 866-337-8690
- The POS benefit is now applicable to diagnostic lab services.
- Preferred labs include:
- LabCorp of America
- Quest Diagnostics
- Northwell Health Labs
- BioReference
- Referring to labs outside the network will result in higher cost for your patients.
- USFHP will utilize CMS’s Medically Unlikely Edits (MUE) to determine the maximum units of service. The TRICARE® Limits will not be utilized for editing purposes.
- Provider Manual and Quick reference Guide available online: www.usfhp.net
