Claims and Billing

Resources

• 2021 Billing Manual (PDF)
• Claims Submission Reminder Guide (PDF)
• 835 EDI Companion Guide (PDF)
• 837 EDI Companion Guide (PDF)
• 2022 AMA Coding Guidelines for Social Determinants of Health (PDF)
• Coordination of Benefits Entry Walkthrough (PDF)
• Guidance for Submitting CLIA Claims (PDF)

EFT and ERA

• Payspan is an innovative web-based solution for Electronic Funds Transfers (EFTs) and Electronic Remittance Advices (ERAs). By using Payspan, you can speed up the processing and payment of your claims. 
• Payspan: A Faster, Easier Way to Get Paid (PDF)
• To contact Payspan: Call 1-877-331-7154, Option 1 – Monday thru Friday 8:00 am to 8:00 pm est.
• Payspan Provider Trainings:  
  • Jun 15, 2022 | 1:30PM - 3:00PM EDT
  • July 20, 2022 | 1:30PM - 3:00PM EST
  • August 17, 2022| 1:30PM - 3:00PM EST
  • August 17, 2022| 5:30PM - 7:00PM EST
  • Sept 21, 2022 | 1:30PM - 3:00PM EST
  • Oct 19, 2022 | 1:30PM - 3:00PM EST
  • Nov 16, 2022 | 1:30PM - 3:00PM EST
  • December 14, 2022 | 1:30PM - 3:00PM EST
  • December 14, 2022 | 5:30PM - 7:00PM EST

Definitions

• Paid in Full - The claim has been adjudicated, processed and reimbursed in accordance and with the executed provider contract on file including the coordination of benefits, as applicable per claim.
  

Claims Office Hours Support

• What: Claims support office hours for providers
• When: Tues and Thurs / every 2nd and 3rd week of each month / 4 – 5 pm
• Duration: For 8 months starting August 19, 2021
• Provider must submit email for link to Zoom meeting to NCCH_Claims_NetworkOperations@carolinacompletehealth.com
• Providers can submit questions in advance to NCCH_Claims_NetworkOperations@carolinacompletehealth.com

Provider Claims Payment Schedule