This is a reminder of the types of information we sometimes request from members. Sometimes the claims you submit to us may pend until we receive certain information from our members. Once we receive and process the information, your claims will complete processing.
Note that many of our plans are what we refer to as "pay and chase." For these plans, if we have no OHI information on file or if the member is due to update this information, we will process the claim as primary and send the member a questionnaire. We will update our information on file:
If we do not receive a response to the questionnaire, we will continue to pay primary until we receive information to the contrary. We will continue to send the member OHI questionnaires until we receive a response.
If you have questions about this bulletin, please contact Provider Education at firstname.lastname@example.org or by calling 803-264-4730.