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Claims

Harmony Health Plan wants to ensure that claims are handled as efficiently as possible. Providers can help facilitate timely claim payment by having an understanding of our processes and requirements.

Institutional Claims/Encounter Guides

Explains rules and state, line of business and CMS-specific regulations regarding 837P EDI transactions.

Explains rules and state, line of business and CMS-specific regulations regarding 837I EDI transactions.

Professional Claims/Encounter Guides

Explains rules and state, line of business and CMS-specific regulations regarding 837P EDI transactions.

Explains rules and state, line of business and CMS-specific regulations regarding 837P EDI transactions.

Other Resources

Effective January 1, 2019, Harmony Health Plan and Meridian Health Plan, both WellCare companies, will become Meridian Health, a WellCare Company. This announcement is to assist providers with changes affecting current Harmony members’ 2018 and 2019 Claim Submissions, Member Eligibility, Claim Status Inquires and Customer Service information. We would like to help your billing department get your claim submissions processed as efficiently as possible. We ask that you please use the date of service guidance below to submit any claim submission.

Effective 05/04/2017, non-atypical providers billing CMS1500/837P and UB-04/837I submissions for Medicaid patients enrolled in Harmony Health Plan, a WellCare Company, will be required to bill with the appropriate taxonomy code.

Instructions on how to submit a corrected or voided claim.

Harmony maintains close alignment with industry standards and coding updates release by health care industry sources.

Explains how to receive, load and send 834 EDI files for member information.

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Last Updated On: 12/4/2018
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