Cofinity Claims Submission Process Update - September 2019

September 19, 2019

US Health & Life is the only remaining LCN contracted payor who is a part of our Cofinity contract  that remains to switch for claims address changes.  Their change date is set for 10/1/19.

Important:  Some Payer EDI #’s were updated since the last version, please look for the Payers with an asterisk next to their name as those EDI#’s will need updated for accurate routing!

Additional Note- All payers that have completed migration have sent new ID cards to all members, Cofinity Network will be identified with Cofinity logo on the front of the ID card and all Claim info/addresses have been updated on the back of the card.  Cofinity will still be pricing the claims for the payers, so nothing is changing contractually. 

 

 

Here is the original article posted last month under our LCN - News section  on the claims submission processes for Cofinity:

Lakeland Care has several payors who are a part of our Cofinity contract.  These payors are listed below:

  • Group Marketing
  • Liberty Union
  • Physicians Health Plan (PHP of Mid Michigan)
  • Secure One
  • Trustmark - Starmark, Nippon lIfe, CoreSource, NGS CoreSource, FMH
  • Claim Choice
  • Group Resources
  • Healthgram
  • Prairie States

NOTE:  the only payor that at this time has not completed the migration is US Health & Life 

Claims for patients with these payors have always been sent to Cofinity, but that process has changed!

  • Now, claims for any of the above payors go to the payor directly, NOT to Cofinity!

All plan members of these payors have been issued updated ID cards that indicate the new claims submission address.

Please note the payor’s name and the Cofinity logo will still remain on the ID card.  The electronic payor ID and the new claims address will be found on the back of the new cards.

Cofinity will continue to reprice your claims at the Lakeland Care fee schedule.

 

Additionaly, Cofinity has provided this statement below and attachment to help explain this new claims submission process:

Grace period for making the change

Cofinity realizes that you may need to make system changes to ensure claims are sent to the correct payer. To allow you time to make the change, we’re accepting provider-submitted claims through November 30, 2019. After that date, Cofinity will return claims to the submitter with a reminder to check the patient’s ID card for the claim submission instructions.

 

Have questions? We’re here to help

Cofinity values our relationship and want to ensure that there’s no disruption in the processing of your claims. If you have any concerns contact Cofinity Customer Service at 800-831-1166 with questions.