The local telephone and fax lines to HP Enterprise Services are currently unavailable. The Customer Service Call Center telephone numbers are not affected. Provider Enrollment/Re-enrollment Applications may be submitted via email at the following address: email@example.com. Please scan the Application, Provider Contract and all supporting documentation, including all of the documents required per the Enrollment Checklists, and attach all items to one email. Provider information change requests (FA-33), license updates and IRS discrepancy documents can be sent via email to firstname.lastname@example.org.
On July 24, 2014, the Customer Service Call Centers will be available from 8:30 a.m. Pacific Time (PT) to 5:30 p.m. PT to allow for staff training. The Call Centers will resume their usual hours of 8 a.m. PT to 5 p.m. PT on July 25.
The PayerPath Claim Submission Training for the ADA Claim Form scheduled for Wednesday, July 23, has been canceled.
CMS-1500 (02-12) Claim Form Must Be Used Effective May 3, 2014
Due to updates to field instructions, providers are encouraged to review the CMS-1500 (02-12) Claim Form Instructions.
- In Field 24E, the Diagnosis pointers must be alpha characters.
- In Field 30, the space is labeled as reserved for NUCC use, but the Balance Due is required.