To ensure prompt adjudication, please remember to send all claims to PHP using one of the following options:
Partners Health Plan
P.O. Box 16309
Lubbock, TX 79490
Set up electronic claims submission thorough
Change HealthCare EDI Claim Submission
Providers can now easily create and upload a professional or institutional single claim as a pdf file via the provider portal (php.healthsmart.com).
Please note that only valid claim forms (CMS 1500 or UB 04) may be uploaded using this method.
PHP would like to remind our providers of the ease of establishing and submitting claims electronically. In addition, we would like to also remind everyone to regularly confirm with their billing service (Clearinghouse) that all electronic submissions have been successfully transmitted and received. If the claim is not successfully transmitted, there will be delays in PHP’s ability to adjudicate the claims on a timely basis. Please check all error logs and resubmit the claim accordingly – timely filing rules still apply for resubmissions.
Balance Billing is not Permitted: Please be reminded that under New York State Law, a Provider participating in the Medicaid program, or a Medicaid Managed Care plan, is prohibited from requesting any monetary compensation from a Medicaid beneficiary, or their responsible relative. In addition, a Medicaid beneficiary, including a Medicaid managed care member, must not be referred to a collection agency for collection of unpaid medical bills or otherwise billed.
The Partners Health Plan Network Development and Provider Relations team is here to assist you with your billing, claims, authorization, education, and any other general inquiry. Use the Contact Us button below to complete a Provider Ticket Submission Form.