News
19-404 Behavioral Health Claims Submission Change
Date: 05/30/19
Starting July 1, 2019, CHWP’s behavioral health administrator is changing from Cenpatico to MHN Services (MHN)
On July 1, 2019, California Health and Wellness Plan’s (CHWP’s) behavioral health administrator will change from Cenpatico® to MHN for behavioral health services. Refer to letter 19-183 dated March 8, 2019, that told you about this change, including the assignment of your Participating Provider Agreement (PPA) with Cenpatico.
SUBMIT CLAIMS TO MHN FOR SERVICES AFTER JULY 1, 2019
Behavioral health providers must follow the guidelines below to submit claims to MHN with dates of service (DOS) July 1, 2019, and after.
- Behavioral health providers should check eligibility to confirm the member’s information before providing behavioral health services.
- Providers will continue to be paid their current contracted rate. Providers must continue to accept payment from MHN for DOS July 1, 2019, and after as payment-in-full for covered services and may not charge a copayment or balance bill CHWP members.
- Outpatient services must be billed within 180 days.
- Preauthorization for outpatient behavioral health treatment is not required for network providers, except for psychological testing and applied behavioral analysis (ABA).
MHN CLAIMS QUESTIONS
- For questions about a claims payment with a DOS July 1, 2019, and after, contact MHN’s Claims Department at 1-800-444-4281.
- Continue to submit claims to Cenpatico for DOS prior to July 1, 2019.
MHN PAPER CLAIMS SUBMISSION
MHN only accepts standard paper claim forms submitted on CMS-1500 printed in Flint OCR Red, J6983 (or exact match) ink. Paper claim forms must be typed in black ink with either 10 or 12 point Times New Roman font, and on the required original red and white version to ensure clean acceptance and processing.
Claims submitted on black and white, copied, handwritten, or nonstandard forms will be rejected and returned to the provider.
Submit behavioral health paper claims for CHWP members to:
MHN
PO Box 14621
Lexington, KY 40512-4621
MHN ELECTRONIC CLAIMS SUBMISSION
For faster processing, behavioral health providers are encouraged to submit claims electronically to one of the MHN clearing houses, using payer ID 22771 for DOS July 1, 2019, and after.
Clearinghouse |
Website |
Telephone number |
Ability (formerly Md on-line) |
MHN website at www.MHN.com (to access the Ability website link) |
1-800-548-2890 |
change healthcare (formerly emdeon) |
Change Healthcare website at www.changehealthcare.com |
1-866-817-3813
|
ADDITIONAL INFORMATION
For questions about MHN claims payments, contact MHN’s Claims Department at 1-800-444-4281.
For questions about the behavioral health services change from Cenpatico to MHN, contact the CHWP Provider Services Department at 1-877-658-0305 or your local provider network specialist.