Gateway Health Plans through RelayHealth

RelayHealth has direct connection with Medicare Assured and Medicaid Ohio for Institutional Claims (UB-04) as of August 27th 2008. To take advantage of sending electronic claims through RelayHealth please begin using CPID#2912 for Medicare Assured - Gateway Health Plan for Institutional Claims and Remittance and CPID#3972 for Medicaid Ohio Gateway Health Plan - Institutional Claims.

** Payor Agreements are not required to submit claims electronically to meaning you can send claims now.
** 277U and RelayHealth standardized Payor Reports will follow after claim submission

Payor Speicifc Edits have been added also:
CPID#2912 for Medicare Assured - Gateway Health Plan for Institutional ClaimsEdit 01 0091C:INVALID SUBSCRIBER ID - IN LOOP 2010BA, NM109 MUST BE EITHER 8, 10, 11 OR 12 ALPHANUMERICS.

Edit 21 0023C:MISSING REND PROV NAME/NUMBER - LOOP 2310B MUST BE SENT

Edit 21 0453C:MISSING RENDERING PROV NBR - IN LOOP 2310B, IF NM108 IS NOT XX, THEN THERE MUST BE A REF01=G2

Edit 52 0071C:MISSING RENDERING PROVIDER NBR - IN LOOP 2310A, IF NM108 IS NOT XX, THEN THERE MUST BE A REF01=G2.

CPID#3972 for Medicaid Ohio Gateway Health Plan - Institutional ClaimsEdit 01 0089C:INVALID SUBSCRIBER ID - IN LOOP 2010BA, NM109 MUST BE EITHER 8 OR 12 NUMERICS.

Edit 52 0071C:MISSING RENDERING PROVIDER NBR - IN LOOP 2310A, IF NM108 IS NOT XX, THEN THERE MUST BE A REF01=G2.

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