Claims and Billing

Change Healthcare System Interruption

Change Healthcare, our electronic data interchange (EDI) clearinghouse for claims and payment cycle management, continues to address their network interruption related to a security incident. Below are updates for our systems and processes:

  1. Out of an abundance of caution, we have disabled connectivity between our systems and Change Healthcare’s systems due to Change Healthcare’s security incident, including those for the submission and payment of claims. We appreciate the inconvenience this is causing you and are exploring alternate options should Change Healthcare be unable to resolve this issue soon.
  2. Electronic claims submission: We have established a connection with Availity to receive electronic claims. If you or your clearinghouse do not currently use Availity to submit claims, you may register at: https://www.availity.com/Essentials-Portal-Registration. You will find registration options for Healthcare and Atypical Provider, so please choose the one that aligns with your business. For registration process assistance and other resources, access the training site link on the Availity registration page.
  3. Manual claims submission: We have established a direct claims entry process through PCH Global. To submit claims directly, please go to https://pchhealth.global and click the Sign-Up link in the upper right-hand corner to register. Complete the registration process and log into your account. You will be asked how you heard about PCH Global; select Payer, then AmeriHealth. Access your profile by clicking on Manage User and then My Profile. You will need to complete all the profile information. When you go to the Subscription Details screen, select the More option on the right-hand side to see how to enter the promo code Exela-EDI. When you are ready to submit claims, use the following information to search for our payer information: NOTE: Select Health Payer name is listed as AmeriHealth-Select Health First Choice.
    1. Payer name: AmeriHealth – Select Health First Choice
    2. PO Box: 7120, London, KY, 40742
    For a detailed walk through of the registration process, refer to the PCH Global Registration manual, found on the PCH Global website in the Resource Menu.
  4. Electronic remittance advice: Electronic remittance are available at this time. However, some individual remittance advices may not be available due to Change Healthcare’s security incident.
  5. Prior authorization submission and processing: The prior authorization systems continue to operate normally.
  6. Eligibility verification, claim status inquiry, and authorization inquiry: These capabilities continue to be available via NaviNet. If you do not have access to NaviNet provider portal, please visit https://register.navinet.net/ to sign up.

Please note, in the interim, our Provider Services Department will not be able to assist with processing of your payments any sooner. If you have other questions, you may contact Provider Services at 1-800-575-0418.

We thank you for your partnership and will continue to provide updates as we work to resolve the downstream impacts of Change Healthcare’s service interruption.

Filing claims is fast and easy for First Choice by Select Health of South Carolina (First Choice) participating providers. Here you will find the tools and resources you need to help manage your submission of claims and receipt of payments.

First Choice can accept claim submissions via paper or electronically (EDI). For general questions about claims submissions, call Provider Claims Services at 1-800-575-0418.

What would you like to do?

Submit a claim

If you prefer to submit your claims on paper, send your claims to:

Select Health of South Carolina, Inc.
Claims Processing Department
P.O. Box 7120
London, KY 40742


Submit a 275 claim attachment transaction

Select Health of South Carolina is accepting ANSI 5010 ASC X12 275 attachments (solicited and unsolicited) via our preferred vendor Change Healthcare. Please contact your Practice Management System Vendor or EDI clearinghouse to inform them that you wish to initiate electronic 275 attachment submissions via payer ID: 23285.

There are three ways that 275 attachments can be submitted. 

  • Batch — You may either connect to Change Healthcare directly or submit via your EDI clearing house.
  • API via JSON — You may submit an attachment for a single claim.
  • Portal — Individual providers can register at Change Healthcare to submit attachments.

The acceptable supported formats are pdf, tif, tiff, jpeg, jpg, png, docx, rtf, xml, doc, and txt.

View the Change Healthcare 275 claims attachment transaction video for detailed instructions on this new process.

In addition, the following 275 claims attachment report codes have been added effective 8/1/23. When submitting an attachment, use the applicable code in field number 19 of the CMS 1500 or field number 80 of the UB04, as documented in the Claim Filing Instructions (PDF).

Attachment type Claim assignment attachment report code

Itemized bill

03

Medical records for HAC review

M1

Single case agreement (SCA)/LOA

04

Advanced beneficiary notice (ABN)

05

Consent form

CK

Manufacturer suggested retail price/Invoice

06

Electric breast pump request form

07

CME checklist consent forms (child medical eval.)

08

EOBs for 275 attachments should only be used for non-covered or exhausted benefit letter

EB

Certification of the decision to terminate pregnancy

CT

Ambulance trip notes/Run sheet

AM


Check claim status

  • Go to NaviNet or call Provider Claims Services at 1-800-575-0418.

Request reconsideration of a claim

Requests for reconsideration may be submitted through the NaviNet Electronic Claim Inquiry feature. For detailed information on electronic claim inquiry submission, please see the NaviNet Claims Investigation User Guide (PDF).


Claims resources

Receive your payments faster by enrolling for Electronic Funds Transfer (EFT)

Get the most out of EFT by using EDI, ERA, and all the electronic billing services offered.