Make sure new staff members carefully review the manual and all HNS instructions. Please contact your HNS Provider Rep with any questions.

 

• Always obtain a copy of the patient's most current insurance ID card at each and every visit and make sure any changes are noted in your practice management software. 

• Always verify benefits for every patient, but please remember the information you receive from a payor's phone representative does not take precedence over any payor's corporate medical policy for chiropractic.

• All services are subject to contracted payor's Corporate Medical Policies, which can be found on each payor's website. 

• Claims for ALL covered services must be submitted to HNS, regardless of the amount of the co-payment.  This includes any self-funded groups who utilize a HNS contracted payor as a third party administrator.  (Exception to this policy: If a patient does not wish to have their claims filed to their health care plan, providers must comply with this request. However, such requests must be documented in the patient's health care record and the patient must be required to pay in full at the time service is provided.)
• Primary claims should be filed within 30 days of the date services were rendered.

• All claims must be submitted electronically to HNS via HNSConnect  (Exception:  secondary & corrected claims, claims with attachments, and Inclusive Health claims) 

• All claims with errors on HNSConnect should be checked, reviewed, and corrected 24 hours after you have submitted the claim to HNS.

• Claims with errors will not be transmitted to the HNS contracted payors until all corrections have been completed.

• Any paper claims (secondary & corrected claims, claims with attachments, and Inclusive Health claims) must be submitted to the following address:

To help identify claims when they are submitted electronically and on paper, you must change the address of EACH INSURANCE COMPANY shown on your list of HNS contracts to the HNS address listed below so that the HNS address prints on  the top of your CMS 1500 claim form.

This form should be used for all requests to trace claims or for assistance with review of an EOB/NOP.  Take time to complete this form with your provider name, phone and fax number before making copies. This will save you valuable time in the future.

• Review your Quick Reference Guide for each insurance plan for contract specific information.

Each contract has specific requirements unique to the claims payor. Take the time to familiarize yourself with each contract!

• Review the “sample” CMS 1500 claim form for each contract.  

Each contract has specific requirements for proper claim submission so pay careful attention to the sample CMS 1500 claim form for each contract.

• Ensure that all EOB’s sent to you with your HNS remittance are routinely filed in your office for easy access!  (Should you have to resubmit a claim, you will need to attach a copy of the original EOB.) 

You are REQUIRED to keep ALL EOB’s included with your HNS remittances for 7 years and will need easy access to them if you resubmit a claim.