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G & C Claims Processing Center, INC. has compiled a list of questions that are frequently asked. Although these FAQ's won't answer all of your questions, it will give you some insight as to what we can do for you - that's providing efficient, accurate and quality services. My claim is going to a carrier not listed on the Payer ID List. How do I know which insurance carriers require additional paperwork? How long should I wait before I follow up on late carrier payments? What are the most common errors that cause electronic claims to reject? Q: What do we mean by "payer"? A: Payer refers to those entities that process and adjudicate claims. This includes:
A: A Payer ID Number is a 5 position number (xxxxx) that may be all numeric or may be a combination of letters and numbers. The Payer ID Number is similar to a zip code - it tells the computer which insurance company your electronic claim will be routed to. back to topQ: What is an Insured ID Number? A: Insured ID Number refers to the number by which payers identify the insured person. Please Note: Most patients will have an Insured ID Number that includes their social security number. However some carriers are requiring specific ID numbers. Please check the Insured's ID card to verify the Insured ID Number. back to topA: Provider Number refers to the number by which payers identify the provider of service.
Please Note: If your software does not allow you to enter a unique provider number, G & C Claims can store it and will transit using a unique number, TIN, or social when submitting to the payer. back to topA: The Health Insurance Portability & Accountability Act of 1996 i.e.; Public Law 104-191 which amends the Internal Revenue Service Code of 1986. Title II includes a section, Administrative Simplification, requiring: 1. Improved efficiency in healthcare delivery by standardizing electronic data interchange, and 2. Protection of confidentiality and security of health data through setting and enforcing standards. back to top1. Standardization of electronic patient health, administrative and financial data. 2. Unique health identifiers for individuals, employers, health plans and health care providers. 3. Security standards protecting the confidentiality and integrity of "individually identifiable health information, " past, present or future. back to topQ: My claim is going to a carrier not listed on the Payer ID List. A: If your claim is going to a carrier not listed on the Payer ID List it does not mean that G & C Claims cannot process the claim. G & C Claims will process any insurance plan that accepts the ADA dental form, as well as some carriers that require special forms. Please Note: Any Payer ID showing 06126 will be printed to paper and mailed the next day. back to topQ: How do I know which insurance carriers require additional paperwork? A: You may refer to the Payer ID List. All carriers requiring additional enrollment have a YES in the Additional Enrollment column. back to topQ: How long should I wait before I follow up on late carrier payments? A: As a general rule, claims 30 days in process should be inquired upon. Your desktop software should be able to provide you with an outstanding claims report. back to topQ: What are the most common errors that cause electronic claims to reject? A: The most common errors causing claims to reject are as follows:
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