Claims Submission Requirements
Providers can submit claims either electronically
or by mailing in a paper format. We strongly encourage
you to use electronic transactions. Electronic
transactions include:
- Claims submission
- Electronic funds transfer (EFT)
- Electronic remittance advice (ERA)
- Claim status and eligibility requests
Information required on paper claim forms is also
required for electronic transactions.
| Description
of form |
Requirements |
UB-04 claim
form requirements for facilities |
All participating
Regence hospitals are required to submit most UB-04 claims
electronically.
|
CMS-1500 (08/05)
claim form requirements for professional
services
|
Regence requires professional
claims to be submitted electronically or on
an original standard CMS-1500 (08/05)
claim form.
|
| ADA J-400 claim
form requirements for dental services |
Regence requires
professional claims to be submitted electronically
or on an original standard American Dental
Association (ADA) J-400 through J-404 claim
form.
Please do not include any type of attachment
(e.g., X-rays, dental records, accident reports),
except Federal Employee Program (FEP) dental
injury claims. If additional information
is required to process the claim, we will
send you a request.
Note: If an attachment is received with a claim, it will not be returned to your office. |
Taxonomy codes
Our taxonomy code requirements can be found in the above claim form requirement documents.
Taxonomy codes are national specialty codes used by providers to indicate their specialty or provider type on a claim. When applying for a National Provider Identifier (NPI), you choose your provider taxonomy code(s). The Washington Publishing Company publishes the various provider specialty designations with their corresponding taxonomy codes.
Taxonomy codes indicated at the time of your NPI application are reflected on the confirmation notice document received from the National Plan and Provider Enumeration System (NPPES) along with the provider’s assigned NPI number. Current taxonomy code(s) registered with NPPES may be obtained on an inquiry basis by visiting the NPI Registry website.
View all the Health Care Provider Taxonomy Code sets.
Paper claim reminders
Paper claims are scanned and converted into electronic
images once received. Please use the following guidelines
to ensure your paper claims are successfully imaged:
- Do not use highlighters. The imaging equipment ‘blacks
out’ highlighted information, making the information
unreadable.
- Key or type all information. Handwriting and stamps
are not always dark or legible enough to be captured
by our imaging equipment. Note: The
Centers for Medicare & Medicaid Services (CMS)
does not accept signature stamps.
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