Referral
Form Directions
There
are four steps to submitting a "claim referral"
by e-mail.
Step
#1: Read the directions below regarding "referrals".
What is a "referral"? A referral is a billing/invoice
(HCFA1500/UB-92) that you or your company would like H.H.C.
Group to negotiate with a medical service provider for a reduced
dollar amount. For more details on our Terms of Service, click
here:
Step
#2: Fill
in the information section regarding "your" contact
information. This information will be used to contact you
regarding your current referral and/or future referrals. After
we have your contact information on file, we will promptly
transmit to you an e-mail acknowledgement for each case listed
on your referral form. Upon receipt of your first referral,
we will also assign you a dedicated "H.H.C. Pass Code"
for your company. You may enter this pass code for future
referrals. When you enter the H.H.C. Pass Code on your referral
form, there will be no need to re-enter any contact information
on new referrals (Except when necessary to update your contact
information).
Step
#3 To the best of your ability, please complete the information
on the referral form for each case you submit. Enter the full
name of each patient. Please List :
1) The policy holder's claim number.
2) The Group Policy number.
3) The patient's name and Social Security number.
4) Medical provider's address and contact information.
5) Beginning and ending dates of service to patient.
6) The list charge or amount billed/invoiced.
7) Your policy liability taking into account the patients
coinsurance, deductibles and other non-covered charges or
penalties.
8) List any miscellaneous comments.
Step
#4 When you have filled out as much information as possible
on the Electronic Claims Referral Form, be sure to save it
to your computer's hard disk drive. Our recommended "nested"
filing system will make storage of this form and your online
documents a simple process. An example of this storage system
is included on our Electronic Claims Referral Form diskette;
available to our clients at no charge. Once saved, click the
"Attach" button on the bottom of the form and attach
any supporting invoice documents. When this is done, click
the "Submit" button and your referral will be on
it's way to our web site. We will send you an intake report
and confirming e-mail within 24 hours. We will then update
you every 3-4 business days until the claim is resolved (You
may also contact us directly by e-mail or telephone). referrals@HHCGroup.com
Please note: We use a fixed internet address (static
IP)which, along with a secure firewall on our computer system,
provides security and patient confidentiality. We also host
our site (at a separate server at our office) designed for
this purpose as well.
Click Here for Claim Referral Forms:
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