We generate weekly remittance advices to our participating providers for claims that have been processed. Benefits are not assignable; you will receive direct payment even if your patient signs an assignment authorization. Corresponding to the claims listed on your remittance advice, each member receives an Explanation of Benefits notice outlining balances for which they are responsible.
View or download your remittance advices using Availity Essentials: Claims & Payments>Remittance Viewer or by enrolling to receive ANSI 835 electronic remittance advices (835 ERA) on Availity Essentials: My Providers>Enrollments Center>Transaction Enrollment.
Remittance advices contain information on how we processed your claims. A single payment may be generated to clinics with separate remittance advices for each provider within the practice.
Remittance advices include:
- Line by line breakdowns
- Specific error messages
- Boxes around the headers for each amount
Codes billed by line item and then, if applicable, the code(s) bundled into them
Claims for your patients are reported on a payment voucher and generated weekly. They are sorted by clinic, then alphabetically by provider. Each claims section is sorted by product, then claim type (original or adjusted). Within each section, claims are sorted by network, patient name and claim number. The main pages include original claims followed by adjusted claims that do not have an amount to be recovered.
View our message codes for additional information about how we processed a claim
Members can use their Health Savings Account (HSA) funds to make payments to providers for qualified medical expenses. Many of our members who have an HSA as their chosen health plan product use HealthEquity, one of the largest Health Savings Account (HSA) non-bank custodians.
HealthEquity offers the following payment options::
- Reimbursing members directly for any out-of-pocket expenses they incurred once the claim is processed
- Providing a debit card that the member can use to pay for expenses from their HSA account
Paying the provider directly through the HealthEquity virtual card payment process, once the claim has been processed
If a member chooses the virtual card payment process, the provider will receive a payment voucher via fax. If HealthEquity does not have the provider's fax number, they will mail the initial payment voucher to the address indicated on the claim and will then work with the provider to set up the faxing option for future use. The voucher indicates the member's account information and the payment amount with instructions for how to obtain the payment using a merchant terminal.
The virtual card option benefits include faster payment delivery and funds availability, no trips to the financial institution to make deposits, plus better fraud protection. Contact HealthEquity Customer Service at (866) 919-0537 with any payment questions.
If you disagree with a decision regarding reimbursement, care management, or medical or dental policy, resubmit the claim with additional clarifying information, such as history and physical, operative report or narrative of unusual considerations that support the medical necessity of the service. If the determination is not reversed in this claims review or if you disagree with the subsequent determination, you may wish to use the appeals process.
Regence receives an administrative fee for each HealthEquity Integrated HSA. The fee allows for a high level of support and integration between Regence's health plans and HealthEquity health savings accounts.