Cofinity - update to claims submissions

March 13, 2019

As you know, Cofinity is migrating to a new claims repricing platform that requires a change in the traditional Cofinity claim submission workflow. The new platform will streamline their administrative processes and help improve the service they provide to you and their payer clients.


How this impacts you

Cofinity has already started the payer migration and will continue that process through July 1, 2019. Once a payer migrates to the new platform, you’ll need to submit claims for your Cofinity members to the payer, instead of Cofinity. You can use the attached payer migration list to identify those who’ve completed the migration. The list will also be posted on their secure website,, starting in mid-March. You’ll need to log in with your secure credentials, then go to the Provider Tools page.

You’ll also find the following claim submission information on your patient’s member ID card:

·         Payer’s electronic payer ID

·         Mailing address for non-electronic claims


Grace period for making the change

They realize 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, they are accepting provider-submitted claims through November 30, 2019. After that date, they will return claims to the submitter with a reminder to check the patient’s ID card for the claim submission instructions.

Please note that this change has occurred for the following Cofinity payors effective 2/1/2019:

Healthgram for Fabri-Kal employees

Insight Benefit Administrators for Life EMS/Life Care Ambulance employees

Have questions?

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