ProxyMed is pleased to announce
that HFN, Inc can now accept medical claims electronically
through ProxyMed.
The Payer ID is 36335.
Please enter this Payer ID into your Practice Management
/ Billing System for electronic submitting purposes. The
office ID can be entered as NOCD.
There will be no Enrollment or
Authorization required and HFN, Inc is considered a Participating
payer.
Please send claims through 36335
that have the bill to address of:
P.O. Box 3428, Oakbrook, IL 60522-3428
or 1315 W. 22nd Street Suite 300, Oak Brook,
IL 60523.
Attached please find detailed
information necessary to submit electronically.
If you have any questions regarding
this bulletin, please contact the ProxyMed Customer Support
department at (714) 979-4467 ext: 439.
GENERAL INFORMATION
| PAYER INFORMATION |
COMMENT |
| Payer Contact |
Rob Rykaczewski
630-472-8560 or Dave Parsons - 630-472-8554 |
| Payer Id |
36335 |
| Payer Type |
Participating |
| Payer Status Reporting |
Non Participating |
| Affiliated IPA’s
/ MG’s or plan names |
Condell, Elmcare, Fox Valley
Medicine, Glen Ellyn Clinic, Highland Healthcare, Mercy,
Kankakee Integrated Care Network, Our Lady of Resurrection,
Tri County IPA, Advocate Dreyer, North Suburban Clinic,
Advocate Bethany Health Partners, Advocate Christ Hospital
Partners, Advocate Good Samaritan Health Partners, Advocate
Ravenswood Health Partners, Advocate South Suburban
Health Partners, Advocate Trinity Health Partners, Advocate
Lutheran General Health Partners, Family Medical Network,
Mid-America Health Partners, America WholeHealth Network,
Family Chiropractic America, Podiatric Independent Physician
Association, Foot First Podiatry, Samaritans Health
Partners, St Mary Medical Center PHO, Alexian Brothers
Health Providers Association, Centegra Primary Care
Network, Ingalls Provider Group, Centra, Midwest Medical
IPA, Alliance Health Inc., Partners in Health Inc.,
American Foot and Ankle Specialists IPA, Suburban Heights
Medical, Michael Reese Physicians, MacNeal Health Providers,
ENH Medical Group IPA, Lake Forest IPA, OSF Health Systems
Galesburg, OSF Health Systems Peoria, OSF Health Systems
Pontiac, OSF Health Systems Bloomington, OSF Medical
Health Systems Rockford, Illinois Chiropractic Health
Plans, Indiana Chiropractic Health Plan, Mt. Sinai Community
Foundation dba Sinai Medical Group, Unity Health Network,
Saint Therese Physician's Association, Loyola University
Medical Center, Loyola University Physicians Foundation,
Children's Neurosurgeons, Children's Memorial Medical
Group, Children's Urology, Pediatric Anesthesia Associates,
Swedish American Health Alliance, ENH Medical Group
Anestheia, Midwest Orthopedic Network, Slucare |
CLAIM / ENCOUNTER
SUBMITTING INFORMATION
| Field Name |
Field Requirement |
| Billing Provider Name, Address,
Zip Code, And Phone |
Required |
| Diagnosis Code (ICD9) |
Required |
| Insured Gender |
Required |
| Insured (Subscriber) Group
Identification Number |
Optional |
| Insured (Subscriber) Identification
Number |
Required. Cannot contain
all zero’s, all 9’s, or 123456789. |
| Insured Address |
Required |
| Insured Date of Birth |
Required |
| Insured Last Name, First
Name |
Required |
| Patient Date of Birth |
Required when Patient is
not the Insured |
| Patient Last Name, First
Name |
Required when Patient is
not the Insured. |
| Patient Relationship to Insured
Code |
Required. Cannot be 09 or
99. |
| Patient Gender |
Required when Patient is
not the Insured. |
| Payer Identification |
Required. Must equal 36335 |
| Place of Service Code |
Required. Valid Codes: 11,
12, 21, 22, 23, 24, 25, 26, 31, 32, 33, 34, 41, 42,
50, 51, 52, 53, 54, 55, 56, 61, 62, 65, 71, 72, 78,
99 |
| Procedure Charges |
Required. |
| Procedure Code (CPT, HCPCS) |
Required. |
| Procedure Units |
Required |
| Referring Provider Identification
Name, Number |
Optional. |
| Rendering Provider ID |
Required. Provider ID Number
can be State License # of Provider or Tax Id of Facility. |
| Type of Service Code |
Required. Valid Codes: 01,
02, 03, 04, 05, 06, 07, 08, 09, 10, 11, 12, 13, 14,
15, 16, 17, 18, 19, 20, 21, 99 |
|
