Your copy of the Medicare Summary Notice (MSN) will include a statement confirming that a secondary claim has been filed with the Plan. When Original Medicare is the primary payer, Medicare processes your claim first. Note: You do not need to preauthorize treatment when Medicare covers your services. Claims for Medicare-primary patients should be submitted to: When Medicare is the primary payer, and will not cover your services, call the Plan at 70 or 888-636-NALC (6252) to obtain benefits. Some MHSA services require priorauthorization, call 87 to receive authorization. OptumHealth SM Behavioral Solutions provides our mental health and substance use disorder (MHSA) benefits. If another group health plan is primary, send a copy of their explanation of benefits.Īll medical claims (except when Medicare is the primary payer) should be submitted to:Ĭhattanooga, TN 37422-8004 Mental Health and Substance Use Disorder Claims.Dates that services or supplies were furnished.Signature of physician or supplier including degrees or credentials of individual providing the service.Name, address, and tax identification number of person or facility providing the service or supply.Member identification number as shown on your identification card.Patient's name, date of birth, address, phone number and relationship to enrollee.Submit services on the CMS1500 or a claim form that includes the information shown below: You receive services outside the United States.In most cases, providers and facilities file claims for you. Member Rights and Protections Against Surprise Medical Bills.Member Login/Register Information for Providers
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