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Electronic Claims

ProvidersSubmit a ClaimElectronic Claims

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Filing claims has never been faster

Faster responses mean everything in the healthcare industry, so let’s reduce the time it takes to process your claims. By filing electronic claims, you can expect:

  • More timely payments
  • Faster claim status responses
  • Lower overhead costs
  • More control over claim data accuracy

You may also submit claims through the HIPAA-compliant Availity Web Portal.

About Availity

Availity offers a secure web portal that is simple to use, integrating with software systems typically found in most physician’s offices and hospitals around Texas. Availity also delivers information beyond what is available in standard HIPAA transactions.

  • Providers submit batch claims for free
  • Medical software vendors may charge a fee for installation and maintenance of system enhancements that support claims transmissions
  • You must use your National Provider identifier (NPI) number when submitting claims through Availity so proper provider identification can be made
  • When submitting claims, use the Scott and White Health Plan Payer Number 88030
  • Both UB-04 and CMS 1500 claim forms are accepted electronically
  • You are strongly advised to review your accepted/rejected reports from Availity daily to determine if any claims were rejected by SWHP
  • Patients' Member Identification Numbers must be complete (and include the two-digit suffix) for a claim to be accepted electronically

Non-contracted providers must fill out an EDI Intake Form before filing claims to SWHP for the first time. The EDI Intake Form is for our Configuration team to enter your provider information into our claims adjudication system.

For more information, visit Availity or call them at 1-800-282-4548.