ValueOptions is continually striving to provide you, our Providers, with the information necessary to ensure timely and efficient processing of claims. This “Tip Sheet” is designed to provide you with quick reference guidelines for submitting claims to ValueOptions. In addition to utilizing this reference, consider
signing-up for electronic claims submission. On average, claims filed electronically are received and processed quicker. Use this information freely in your practice or facility as an easy-to-use guide for claims processing with ValueOptions.

• When seeing a new patient, please follow these guidelines for best results:
• Contact ValueOptions ACCESS LINE to verify Patient Eligibility.
• Submit Your Uniform assessment form and fax to 1-877-888-6444
• Claims submission:
• Must be on one of the two National Industry Standard Billing    Forms: Outpatient Claims - CMS-1500 (Formerly called HCFA    1500) Inpatient/Alternative Levels of Care - Uniform Billing Form UB 92
• Submit typed claims on the original (red) Standard CMS-1500 or UB 92 claim forms. Use of photocopied or hand written claim forms will delay claims processing.
• Providers may also set-up an e-provider account and submit claims electronically.
• Claims Customer Service Guidelines:
• Call the Enrollee and Provider Services at, 1-888-800-6799
• Clean Claims Guidelines:
• Patient must be eligible for benefits on date(s) of service for which a claim is filed.
• CMS-1500/UB92 must contain all required information to accurately process a claim.
• The CMS-1500 form claim must include CPT Service codes, and UB92 forms must include the revenue code and when appropriate, the corresponding HCPCS code. ICD-9 diagnosis codes must be used on both forms.
• The claim must have no defect, impropriety, or inaccurate information.
• The dates of service must be contained in the authorization.
• A claim that is missing information will be denied or returned to the provider or facility requesting the information needed to process the claim.
• Participating providers are required to file claims within 90 days from date of service.
• If the provider does not agree with the claim determination, s/he must submit a written request for reconsideration within 60 days of the VO provider voucher date.
• See the Provider Handbook, Section XI (Claims and Billing Information) for more detailed instructions on completing the claims submission forms.
• Electronic (EDI) Billing Guidelines:
• Contact the EDI Helpdesk at (888) 247-9311 if you would like to sign-up or if you have any questions.
• Please be sure to use your correct Provider Number and Vendor Number when submitting electronic claims.
• Claims Mailing Addresses:
• Check your authorization letter or call 1-888-800-6799 for the correct mailing address.