The Fidelis Care Blog

Beginning August 13, 2018, providers submitting electronic or paper claims for non-emergent transportation services will be required to submit the pick-up and drop-off location zip codes on the claim.  Please follow the claim billing guidelines below.

Claim Billing Guidelines:

• Electronic claims – Providers should work with their claim submission vendor for claim requirements for the
  837P claim submission.
              o If you are using an online claim submission website – Providers should follow the directions for that
                 specific software application.
• Paper claims – Providers must submit the pick-up location zip code in box 32A and drop-off location zip code in     box 32B on the CMS-1500 claim form.

Non-emergent transportation claims that are billed incorrectly will not be accepted as follows:

 • Electronic claims – Will be automatically rejected back to the provider/billing vendor.
 • Paper claims – Will be closed in our Claims Processing System and a letter will be sent to the provider with the
    rejection reason:
              o “The Pick-Up/Drop-Off Zip Codes in Box 32 were invalid or missing”.            
              o  If your claim is rejected, be sure to submit a new claim form with the required zip codes to Fidelis Care
                  within the timeframe as outlined in your provider agreement. 

For additional information on transportation, download Transportation Provider Manual