• Faster turnaround times and adjudication
• Claims status availability within five days of receipt
• Immediate image retrieval by IntegraNet staff for claims information, allowing more timely and accurate response to provider inquiries

To use OCR technology, claims must be submitted on original red claim forms (not black and white or photocopied forms) and laser printed or typed (not handwritten) in a large, dark font. Providers must submit a properly completed UB-04 or CMS-1500 (08-05) within 90 days from the date of discharge for inpatient services or from the date of service for outpatient services, except in cases of coordination of benefits/subrogation or in cases where a member has retroactive eligibility. For cases of coordination of benefits/subrogation, the time frames for filing a claim will begin on the date the third-party documents resolution of the claim.

In accordance with the implementation timelines set by CMS and NUBC, IntegraNet now requires the use of the new CMS-1500 (08-05) for the purposes of accommodating the National Provider Identifier (NPI).

In accordance with the implementation timelines set by CMS and NUBC, IntegraNet now requires the use of the new UB-04 CMS-1450 for the purposes of accommodating the NPI.

CMS-1500 (08-05) and UB-04 CMS-1450 must include the following information (HIPAA-compliant where applicable):

• Patient's ID number
• Patient's Name
• Patient's date of birth
• ICD-9 diagnosis codes/revenue codes
• Date of service
• Place of service
• Description of services rendered CPT-4 codes/HCPC codes/DRGs
• Itemized charges
• Days or units
• Provider tax ID number
• Provider name according to contract
• IntegraNet provider number
• NPI of billing provider when applicable
• Name of ordering physician
• NPI of ordering physician when applicable
• Name of performing physician
• NPI of performing provider when applicable
• State Medicaid ID number
• Coordination of Benefits/other insurance information
• Authorization/precertification number or copy of authorization/precertification
• Name of referring physician
• NPI of referring physician when applicable
• Any other state-required data

IntegraNet cannot accept claims with alterations to billing information. Claims that have been altered will be returned to the provider with an explanation of the reason for the return. IntegraNet will not accept claims from those providers who submit entirely handwritten claims, except in New Jersey where providers are permitted to submit handwritten claims.

Paper claims must be submitted within the timely filing limits noted below from the date of service:

Submit paper claims to the following address: