ProviderConnect is a self-service, easy-to-use tool for completing everyday service requests online. It is available 24/7 giving you access to the following features:
- Eligibility Status
- Claims Search (for specific member(s) and view details of the claim such as claim status, paid date, check number)
- Electronic Claims Submission (both Batch and Single Claim)
- View and Print Correspondence (includes Authorizations)
- Access Your Provider Practice Profile (lookup demographic information, validate and submit changes online)
- Submit Inquiry to Customer Service (send a question to ValueOptions online and get a response in the manner you choose)
- Benefit Status
- Register Outpatient and Inpatient Care
ValueOptions EDI Helpdesk staff is available Monday through Friday, 8 a.m. – 6 p.m. EST to walk you through the entire process. Call the EDI Helpdesk at (888) 247-9311 and press option 3.
In order to maximize the benefit of using this online service, you will need to have your ValueOptions unique Provider ID. You may locate your unique Provider ID in the “Welcome letter” you received when joining the ValueOptions’ network. Your unique Provider ID can also be obtained by calling our National Provider Line at 1-800-397-1630, Monday – Friday, 8:30 a.m. – 5 p.m. EST.
Guide to Using Single Claim Submission - Use this as a reference tool to assist you with Single Claim Submission.
Providers must obtain a User ID before using Online Services. To accomplish this, the following forms must be completed.
Online Services Account Request Form
This form authorizes ValueOptions to receive and process claims electronically and certifies that claims will comply with all laws, rules and regulations governing your contract with ValueOptions. Providers who wish to have inquiry-only access to our system for the purpose of conducting eligibility inquiries and claim status inquiries must also submit this form. All online services users must complete this form.
Online Services Intermediary Authorization Form
This form authorizes an external entity such as a billing agent or clearinghouse to submit claims on the provider’s behalf. This form must be completed only if the provider utilizes the services of a billing agency, clearinghouse or other third party.
Software Downloads for Claims Submission:
The EDI (Electronic Data Interchange) Claims Link for Windows® application provides a method for providers or their designated representatives to submit HIPAA compliant electronic claims to ValueOptions.
HIPAA Resources
ValueOptions is also a HIPAA-compliant organization. The links provide additional information regarding submitting electronic HIPAA transactions to ValueOptions.
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