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. 
  • https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/MUE

• Provider Manual and Quick reference Guide available online:  www.usfhp.net