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Frequently Asked Questions
 
This FAQ section is for providers that have question pertaining to claims submissions and is divided into two sections: Paper Claims Submissions and Electronic Claims Submissions. Just click on the question under each section or scroll down the page to find the answer to your question.
 
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Paper Claims Submission
 
 
What address do paper claims get mailed to?
Submit all paper claims to this address:
Community Behavioral HealthCare Network of PA
Attention: Claims Department
PO Box 6600
Harrisburg, PA 17112
 
Can claims be faxed?
Original claims must be mailed to the above address. Corrected claims can be faxed to
717-671-6522. For guidelines on corrected claims, reference the claims section of the Provider Manual.
 
How can a claim be submitted for payment?
Depending on the service provided, one of two claim forms may be used.
  • CMS 1500 is used for ambulatory services or services billed with a procedure code
    Note: This form has been revised. For details please see the link below.
     NCUU – for information about the NEW CMS 1500
  • UB 92 should be used for inpatient or other services that are billed with a revenue code
    Note: This form has been revised to UB 04. For details please see the link below.
    NUBC – for information about the UB 04
What if I have a question about a paper claim?
Contact the claims department by telephone or fax for all paper claims questions or problems at:
  • 1-888-700-7370 – Telephone
  • 717-671-6522 – Fax number
What information is needed when calling the claims helpdesk?
The following information is needed:
  • Caller’s name and phone number
  • Provider’s name
  • Member’s name and SSN
  • CPT code and date of service
***If you are calling to check on the status of a claim, please review your most recent CBHNP EOB prior to calling.
 
What is the timely filing limit for claims submissions?
Depending on the type of claims submission, the time frames are:
  • Original submission – 60 days from date of service
  • TPL submission – 60 days from primary insurance EOB date
  • Corrected claim – 60 days from CBHNP EOB Date
How can a provider appeal an administrative denial?
Reference Provider Info, Administrative Appeal Request for detailed instructions.
 
 
Electronic Claims Submission
 
What are the benefits of submitting claims electronically?
Filing claims electronically is more efficient in several ways:
  • Because the processing is done electronically rather that manually, claims can be paid quicker
  • Keeping track of or filing paper claims is no longer necessary
  • Confirmation of receipt of claims is sent out within two days of filing on a Processing Confirmation Report. This report includes the details of the file, including the total amount billed, the total number of claims within the file, and any errors on claims within the file
Can paper claims still be submitted?
Yes. Paper claims will continue to be accepted.
 
What is the process for submitting claims electronically?
Providers can submit electronic claims using an 837 and the steps to begin the process are as follows:
  • Step One – Download the companion document and supplemental guide form
  • Step Two – Establish a Trading Partner Agreement with CBHNP using the forms in the companion document
  • Step Three – Procure software or service with a clearinghouse or other entity that will generate an 837 in the HIPAA compliant format
  • Step Four – Begin testing with CBHNP using the guidelines in the companion document
CBHNP will soon deploy a web-based direct entry claim submission tool on our website. The tool will permit entry of claims using the CMS Form 1500 or the UB-04 and will be useful for providers who choose not to use the 837 files.
 
What if I have a question or need help with electronic claims submission?
Contact the claims helpdesk with problems or questions about electronic claims from 8:00 a.m. until 4:30 p.m. Monday through Friday at:
Is there a fee for submitting claims electronically?
No. CBHNP does not charge a fee for receiving electronic claims submitted using ANY of the methods above.
 
What should be done if a claim is rejected for payment?
First – Read rejection notices thoroughly. If you still have questions, call the claims phone number on the notice (Processing Confirmation Report) for further assistance.
Second – Correct the error and re-submit the claim. If all errors detailed in the notice are not corrected, the claim will be rejected repeatedly.
 
What if a notice (Processing Confirmation Report) is received stating claims were accepted but payment is not received?
Call the claims phone number on the Processing Confirmation Report.

Do not re-submit the claim as this will result in a duplicate claim denial and you may be subject to unnecessary clearinghouse charges.
 
What if a different clearinghouse is being used?
To submit claims electronically to CBHNP, your clearinghouse would need to contact CBHNP to establish a Trading Partner Agreement and begin testing.
 
Can a small practice submit claims electronically?
Yes. Any size practice can submit claims electronically.