Claims and Payment
Submitting Claims
Timely filing has past for all States that Bright Healthcare served. If you believe you have a claim that is still valid, you must provide documentation to support the processing/reprocessing of the claim past timely filing. Follow the directions below to submit your claim.
Provider's W-9 are necessary moving forward for any new payments as we process/re-process claims decisions due to appeals, provider disputes, and/or grievances. You MUST submit the provider's W-9 to receive payment, if appropriate.
Availity.com
(ONLY: CA, GA, TX, UT, and VA. Other states must use manual processes outlined below.)
Log in to your Availity account to submit electronic claims. You can find submission details in your Provider Manual and the Provider Quick Reference Guide, which are both located on Availity.
Alternate method
While Bright HealthCare encourages providers to submit claims electronically, you can also submit claims by mail:
Commercial IFP & Small Group for the states of AL, AZ, CO, FL, IL, NC, NE, OK, SC, and TN:
Bright HealthCare Claims
P.O. Box 16275
Reading, PA 19612-6275
Medicare Advantage
AND
Commercial IFP for the states of CA, GA, TX, UT, and VA:
(2022 services effective 1/1)
Bright HealthCare Claims
P.O. Box 211502
Eagan, MN 55121
Bright HealthCare does not accept faxed claims.
Receiving payments
Effective 1/1/2022, Bright HealthCare uses InstaMed to process claim payments for Medicare Advantage in AZ, CO, FL, IL, and NY; and Commercial IFP in CA, GA, TX, UT, and VA. If you have previously enrolled with InstaMed, Bright HealthCare will send you Electronic Funds Transfers by default.
Bright Health will execute commercial claim payments internally for the States of AL, AZ, CO, FL, IL, OK, NC, NE, SC, and TN. Payment will come in the form of a check.
All vendors meet state and federal requirements for electronic payments and are HIPAA compliant. Follow the steps below to get set up.
Using InstaMed
- Register at www.instamed.com/eraeft.
- Once registered you are eligible to receive electronic claims payment.
- For assistance on Electronic Funds Transfers, please call 866-945-7990 to reach a live representative, or email InstaMed at [email protected]
Bright Health
Provider's W-9 MUST be submitted for any payments to be issued. By not submitting the W-9 with the claim, payment will be delayed until the W-9 is received.
Explanation of Provider Payment (EOP)
InstaMed
- Log into Availity to review your EOP. Or register with InstaMed to receive access to InstaMed Online, a free, secure provider portal where you can access payment details 24/7 and view and print remittances.
- You also have the option to have EOPs routed to your existing clearinghouse.
- Also, you may choose to have an SFTP folder set up. Please contact InstaMed at [email protected] for help or with any questions on EOP delivery.
Bright Health
- Your EOP will be mailed separately from your check. The same claim # will be printed on both the EOP and the check so you may align your documentation.
Discuss claim payment options:
- IFP in AL, AZ, CO, FL, IL, OK, NC, NE, SC, TN: email [email protected]
- Medicare Advantage (all states except California) and Commercial IFP in CA, GA, TX, UT, VA, effective 1/1/2022: 866-945-7990 or email [email protected]