inclusive health quick reference guide for chiropractic
Inclusive Health Quick Reference Guide For Chiropractic
The Inclusive Health Quick Reference Guide provides information specific to Inclusive Health concerning Inclusive Health claims, Inclusive Health members, and Inclusive Health policies. The information in this section is in addition to the HNS/Payor Policies, HNS Documentation, and HNS Billing Guidelines.
The Inclusive Health Quick Reference Guide contains the following information specific to Inclusive Health and provides you with helpful information regarding your Inclusive Health claims.
General Information
Eligibility/Benefits
Referral System
Inclusive Health ID Cards
Claims Submission
Claims Inquiries
Provider Relations
General Information
PLEASE REMEMBER: Do not send claims directly to Inclusive Health, CoreSource, or MedCost!
Please ignore the claims billing address on the member ID card or any address given to you on the telephone when verifying eligibility and benefits. HNS instructions for filing claims supersede information given to you by Inclusive Health or CoreSource Representatives!
Inclusive Health, also known as the North Carolina Health Insurance Risk Pool (NCHIRP), has contracted with MedCost to use their provider network. As the chiropractic network for MedCost, HNS providers are participating providers with Inclusive Health.
Inclusive Health is NOT a MedCost payor, and should never be filed to MedCost. Inclusive Health is a separate entity that contracts with MedCost for their provider network.
In 2007, the North Carolina General Assembly passed Session Law 2007-0532, which created the NCHIRP. Their mission is to provide affordable health insurance coverage for North Carolina residents who are unable to obtain insurance through work or obtain reasonable insurance coverage due to pre-existing, high-risk health conditions. NCHIRP, now doing business as Inclusive Health, began plan coverage starting in January 2009.
CoreSource has been selected as the administrator for Inclusive Health. This includes eligibility and benefits, as well as adjudication of claims.
With only a few exceptions, aAll claims for COVERED SERVICES provided to a beneficiary of a HNS contracted payor MUST be submitted to HNS.
If you have any questions about an Inclusive Health/CoreSource claim, please contact your HNS Provider Rep at (877) 426-2411 before calling Inclusive Health/CoreSource.
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Eligibility/benefits
Please remember to ask for specific information on chiropractic benefits for each member. CLICK HERE to see a sample Verification of Insurance Form.
- Refer to the number on the member’s identification card or call
(866) 665-2117
Inclusive Health members will have a choice of three plan benefit options. All plans cover chiropractic services up to 30 visits per plan year. Chiropractic visits are subject to the patient’s deductible and will have a coinsurance after the deductible has been met. Please see below for Inclusive Health Benefit Plan details.
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Referral System
- When necessary to refer to another healthcare provider, referrals within the network are strongly recommended.
- No referral form is needed.
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Inclusive Health ID Cards
All Inclusive Health plans are filed through HNS. Inclusive Health provides each of their members with an ID card.
If you are uncertain about where to file the claim, please use your HNS Fax Inquiry Form and fax a clear, legible copy of the member ID card to HNS and we will respond back to you with an answer within 24 hours.
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Claims Submission
All claims for Inclusive Health must be submitted to HNS.
All claims for Inclusive Health members must be submitted to HNS through the HNSConnect system. Exceptions include secondary claims, corrected claims, any claim with an attachment.
Ignore any instructions regarding where to submit claims by payor phone representatives. HNS instructions regarding where to submit claims supersede all other instructions given by payor representatives when verifying eligibility and benefits.
In order for Inclusive Health claims to adjudicate quickly and accurately, please note the following information regarding claims submission specific to Inclusive Health is additional information to the HNS Billing Guidelines.
- Group or policy number must be in box 11.
- Inclusive Health must be in box 11c.
- Even when filing electronically, the claim must be identified as an Inclusive Health claim in the address section at the top of the CMS 1500 claim form (HNS/Inclusive Health is an acceptable format) using the example below:
Example:
HNS/Inclusive Health
PO Box 2368
Cornelius, NC 28031
Important Note: Inclusive Health participates with the MedCost Network only for the purpose of using their provider network. Inclusive Health claims DO NOT get filed to MedCost. All claims must be filed directly to HNS.
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Claims Inquiries
- For tracing overdue claims (after 60 days from your billing date), complete the HNS Fax Inquiry Form and fax to HNS. Please include the patient name, date of birth, member ID number, and each date of service you would like traced. We will gladly trace the claim for you. We will fax the results to you within 3 business days.
- Resubmit lost/missing claims through HNS.
- Refer to the current year's Medicare rates for reimbursement amounts
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Provider Relations
Questions relating to your participation in Inclusive Health should be directed to your HNS Provider Rep
at (877) 426-2411.
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