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Effective July 15th, Health Services for Children with Special Needs (HSCSN) will implement Optum Financial/Optum Pay as the check payment vendor for provider electronic funds transfer (EFT). The details to the provider letter can be found in this document.

Claims and Billing

Submit your claim Electronically

Note: If you are currently using a practice management system that allows you to submit claims electronically to Change Healthcare, please continue to utilize that service. If you are not sure if your current system has this feature, you may want to contact your practice management system vendor directly.

**For electronic claims, the payer ID is 37290.

Claims Tips

Submit Claims Electronically

Optum Relay Exchange is our new clearinghouse provider. The HSCSN Payor ID is 37290. 

Providers are not required to change their clearinghouse to Optum Relay Exchange, just submit your electronic claims using the HSCSN Payer ID 37290. Providers without a clearinghouse, may enroll with Optum Relay Exchange or select another clearinghouse of their choice.

Clearinghouse Support:
Relay/Exchange: 1-800-543-4997 
iEDI: 1-866-678-8646

Provide complete information on the HSCSN Enrollee

Please provide complete information for items such as the name, date of birth, and gender. Verify that this information matches the HSCSN enrollee’s ID card. Always confirm the correct spelling of the first and last name of the HSCSN enrollee. Errors and omissions of these items cause an unnecessary delay in processing the claim.

Provide complete information for yourself, the Provider

Please provide complete information regarding the provider, including the names of both the treating provider and the billing entity. The taxpayer identification number for the billing entity must be given for the claim to be processed correctly. The billing or remittance address must be accurate for the check and/or voucher to be sent to the correct payee.

Ensure that the treating provider signs the claim form

The treating provider must sign the claim form to verify that the services performed by the provider are accurately reflected in the services reported. The provider is legally responsible for the contents of the claim once the claim form is signed. Do not give a signed claim form to the HSCSN enrollee or designee to complete.

Include the complete diagnosis for the enrollee

If the HSCSN enrollee has more than one diagnosis, please be sure to report all relevant diagnoses on the claim. For the diagnosis code, include all the required digits.

List dates of service for each procedure code

For individual services on different dates, such as office visits, services must be billed on separate claim lines. We cannot accept dates of service combined under “from” and “through” dates. Each date of service must be shown separately.  For spanning services, such as DME rentals, it is permissible to use “from” and “through” date fields for consecutive dates, such as: FROM THROUGH #DAYS/UNITS 9/1/19 - 9/2/19.