Beacon Health Options Claim Form Address

Frequently asked questions pdf resources.

Beacon health options claim form address. Authorization for use or disclosure of medical information. Special investigations unit 1400 crossways blvd suite 101 chesapeake va 23320. Beacon health options attn. Sample member claims form.

The new address is. Claims must be submitted within 90 days of being incurred and original receipts itemized bills must be attached. Autorización para que beacon health options opciones de salud de beacon divulgue información confidencial. Box 1850 hicksville n y.

To be completed by employee insured. If you have not submitted a 1099 to beacon in the past please fax a copy to 757 412 6425. Forms claims form sample member claims form empire claim form authorization for use or disclosure of medical information autorización para que beacon health options opciones de salud de beacon divulgue información confidencial cms 1500 claims form tips for completing the cms 1500 outpatient review form frequently asked questions pdf resources claim submission mental health parity. Electronic claims can be sent individually to beacon via.

Beacon must have a current w 9 on file for the address to which this claim will be paid box 12. Tips for completing the cms 1500. Have you ever had this ailment before. 7 17 2017 effective immediately there is a new mailing address for claims submissions to beacon health options.

Attach that form to this form for which you have completed part i. Beacon health options p o. If yes state. Beacon health options 200 state street boston ma 02109 tel.

Beacon health options claims department p o. D m yr when did symptoms of the ailment first appear. 11802 1850 beacon health options strongly encourages providers to submit claims electronically. Box 1850 hicksville n y.

Department client or contact name po box 1950 po box 1347 po box 1830 po box 1920 po box 1860 po box 803 po box 399 po box 870 po box 1800 po box 1408 post office boxes originally housed in wixom mi po box 930829 beacon po box 1854 hicksville ny 11802 1854po box 930321 health options inc. Beacon must have a current 1099 on file for the address to which this claim will be paid box 12. If you have not submitted a w 9 to beacon in the past please fax a copy to 866 612 7795. Address is no longer valid for claims submissions.