Claims and Payment
Submitting Claims
Bright HealthCare makes it easy to submit claims
Availity.com
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.
Via EDI connection
Effective 1/1/2022, the new Payer ID for all Bright HealthCare plans (excluding California Medicare Advantage) is BRGHT.
Alternate method
While Bright HealthCare encourages providers to submit claims electronically, you can also submit claims by mail:
Medicare Advantage for the states of AZ, CO, FL, IL, and NY:
(services up to 12/31/2021)
Bright HealthCare MA - Claims
P.O. Box 853960
Richardson, TX 75085-3960
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 for the states of AZ, CO, FL, IL, and NY: (2022 services effective 1/1)
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.
V-Pay is used for commercial claim payments for the states of AL, AZ, CO, FL, IL, OK, NC, NE, SC, and TN.
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]
V-Pay
Once your first claim is processed, you will receive a notification asking how you wish to receive payment (Electronic Funds Transfers, Paper Check, V-Card) and remittance notifications (835, EOP, etc.).
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.
V-Pay
- You can choose how you'd like to receive your EOP. V-Pay can send them via fax, mail, or as 835 remittance advice.
Discuss claim payment options:
- IFP in AL, AZ, CO, FL, IL, OK, NC, NE, SC, TN: 877-714-3222 or 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]