Family Health Network - Practitioner and Provider Manual

Claims Submission, Disputes, and Inquiries

Timely filing is 120 days from the date of service or the date of discharge unless
otherwise specified in the provider contract.

Submission Disputes and Inquiries

Electronic Submissions:
Clearing House: EMDEON
PAYOR ID: 85468
Paper Claim Submissions:
Family Health Network
P.O. BOX 981731
El Paso Texas, 79998-1731
Submit by mail:
ATTN: Claim Payment Disputes
P.O. BOX 981731
El Paso Texas, 79998-1731
Time Frame: 60 days from date of EOP
Paper Claim Submissions:
MCPID@myfhn.com

Submitting Corrected Claims

EDI Corrected Claims Paper Corrected Claims
Professional Claim Type Submission Codes: “Corrected Claim” must be clearly marked
7 = Replacement of Prior Claim at the top of the claim with the original
claim number indicated in FLD 22 to avoid
8 = Void/Cancel Claim duplicate claim denials
Institutional Claim Bill Types:
XX7 = Replacement of Prior Claim
XX8 = Void/Cancel Claim

Resources Available on Our Website

Please visit www.fhnchicago.com to find information on our:
• Claim Submission portal link
• Practitioner and Provider Directory search
• Practitioner and Provider Notices and Resources
•Q
 uality Management Program – what we do to promote quality and how we
are doing in meeting our goals
•D
 isease Management Programs – Diabetes and Asthma. This also includes how
we work with your patients to meet their goals and manage their conditions
•C
 linical Practice Guidelines – new and revised for certain chronic medical and
behavioral health conditions
• Preventive Health Practice Guidelines – this covers all age groups and pregnancy
• Utilization Management Criteria – what we use to make utilization decisions
•P
 harmaceutical Restrictions and Preferences – what the formulary includes
and excludes and how it is managed
• Pre-Certification Form
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