Provider Manual

CLAIMS ADJUSTMENTS

All claim adjustments must be submitted by mail, facsimile (855-439-2443), web inquiry (ProviderConnect), or phone to the VBH-PA Engagement Center within 90 days of the date of the provider summary voucher.  Requests for adjustments to outpatient claims may also be submitted via ProviderConnect by utilizing ProviderConnect Change/Reprocess of Professional Claims for all corrections to CMS-1500 or 837 Professional Claims. To access ProviderConnect, visit www.vbh-pa.com/providers. 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 engagement center to request an adjustment, status a claim, or verify authorization, please have the following information available:

  • Provider Tax Identification Number and/or NPI
  • Member’s ID number
  • Member’s Date of Birth
  • Claim Number (if known)

When sending in a corrected claim via mail or fax, please include the following information:

  • Reason for correction
  • Copy of the Provider Summary Voucher
  • Primary Insurance Explanation of Benefits (EOB)

Please mail all correspondence regarding claims questions to:

Beacon Health Options
Pennsylvania Claims
P.O. Box 1853
Hicksville, NY 11802-1853

This address is to be used for all paper claims submissions (new or corrected claims).