When submitting claims for services, drugs or procedures performed by physicians that do not have a specific CPT or HCPCS code, do not select a code that merely approximates the services provided. If no such procedure, drug or service codes exists, report the service using the appropriate unlisted procedure, drug or service code.
The following will help to expedite the processing of claims with unlisted codes.
- When submitting an unlisted code for drugs, include Name of Drug, NDC number and dosage given.
- When submitting an unlisted code for surgical procedures, include description of procedure and operative and pathology notes.
- When submitting an unlisted code for radiology service, include description and radiology report.
- When submitting an unlisted code for equipment or other services, include description.
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Find out who to contact for questions about participating with us, updating participation status or practice information, fee schedules, staff in-services, billing, contracting efforts, and more!
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PHP accepts electronic claims from all clearinghouses, as well as HIPAA-compliant files from providers. Our payer ID number is 12399.*
If you have any questions or issues regarding electronic claim submission, please contact PHP Customer Service at (260) 432-6690, ext. 11; toll-free at 1-800-982-6257, ext. 11; or custsvc@phpni.com.
* Our payer ID number is also 12399 for electronic remittance advice (835).
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If you have a healthy group of 25 or more people in your company or organization, you should consider a self-funded plan. This means the employer is financially responsible for the healthcare…
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Would you like to know more about the products PHP has to offer? Do you need to check on the status of a claim or have questions about benefits? Would you like to leave feedback about your customer experience? You can count on our caring customer service staff getting you the answers you need promptly, professionally, and reliably.
If you would like to talk to a Customer Service Representative for claims status, benefit information, and general assistance during PHP's office hours of 8:00 AM to 5:00 PM, Monday through Friday, please contact:
Voice: 260-432-6690, ext. 11
Toll Free: 1-800-982-6257, ext. 11
Fax: 260-432-0493
Email: custsvc@phpni.com
Address: 1700 Magnavox Way, Suite 201, Fort Wayne, IN 46804
Online Chat is also available through your member account weekdays from 8:00 AM - 5:00 PM.
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If you're looking for self-funding options that will allow you to attract and retain employees, our Third Party Administration services can help. Customize your employees' benefits package…
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