CLAIMS ADJUSTMENTS
All claim adjustments are handled through the Customer Service Department at VBH-PA. Requests for adjustments may be submitted by mail, facsimile
(855-439-2443) or phone to the VBH-PA Service Center within 90 days of the date of the remittance advice (voucher). Requests for adjustments to outpatient claims may also be submitted via ProviderConnect by re-starting the claim submission process and opting to submit a Corrected or Replacement claim. To access ProviderConnect, visit www.vbh-pa.com/providers.htm. To obtain a User ID, click on register, complete the required form, and click on “submit.”
If there is an error on your claim, please contact a Member and Provider Service Representative at 877-615-8503. When calling the service center to request an adjustment, status a claim, or verify authorization, please have the following information available:
- Member’s ID number
- Date of service
- Procedure code
- VBH-PA provider number
- Claim number (if known)
When sending in a corrected claim or a request for reconsideration of a claim via mail or fax, please include the following information:
- Detailed reason for the reconsideration
- Copy of the voucher or the corrected claim
- EOB, if needed
- Letter of explanation as to why the adjustment request was not sent in a timely manner, if past the 90 day adjustment timely filing limit.
Please mail all correspondence regarding claims questions to:
VBH-PA HealthChoices Program
Attn: Corrected Claims
520 Pleasant Valley Road
Trafford, PA 15085
Please do not mail adjustment requests to the claims submission address. This address is to be used for initial submission of claims only. Using this address for adjustments will cause a delay in receiving an adjustment, and quite possibly an error in the adjustment requested.
