Compliance
It is the policy of ValueOptions® to comply with all local, state, and federal laws governing its operations; to conduct its affairs in keeping with the moral, legal and ethical standards of our industry; and to support the government's efforts to reduce healthcare fraud and abuse. The ValueOptions Corporate Compliance Program establishes a culture within the organization that promotes prevention, detection, and resolution of instances of conduct that do not conform to federal and state law, and federal, state, and private payor health care program requirements. Agents, subcontractors, vendors, and consultants who represent the company are expected to adhere to the Compliance Program. For more information, please read the Code of Conduct and Ethics in its entirety.
ValueOptions is also a HIPAA-compliant organization. Under HIPAA Privacy Rule at 164.514(h) a covered entity prior to making any disclosure permitted under the privacy regulations must (1) verify the identity of a person requesting protected health information (PHI) and the authority of such person to have access to protected health information under this regulation, if the identity or any such authority of such person is not known to the covered entity. Accordingly, ValueOptions requires that anyone requesting access to PHI be appropriately identified and authenticated. Members and personal representatives, for example, are required to provide the member identification number or subscriber number and the member’s or subscriber’s date of birth. You or your administrative staff are identified and authenticated in a number of ways and may be asked for your federal tax identification number (TIN), your national provider identification number (NPI), or physical address as part of this verification process. Having this information available prior to making contact with ValueOptions will expedite your request.
The links below provide additional information regarding submitting electronic HIPAA transactions to ValueOptions.
- How to Submit Electronic Claims in HIPAA 837 Format
- Behavioral Health Revenue Codes Approved by NUBC (PDF)
ECLW Resources
- EDI Claims Link for Windows® 3.5 Quick Start Guide (PDF)
- EDI Claims Link for Windows® 3.5 User's Manual (PDF)
- EDI Claims Link for Windows® 3.5 (Application)
- How to Run ECLW Installation Video
- How to Run ECLW Update Video
- Provider and Patient Data Maintenance Video
- Institutional Claim Instructional Video
- Professional Claim Instructional Video
ValueOptions EDI Resources
ValueOptions Claims and Authorization Resources
- Guide To Online Authorization Requests (PDF)
- Guide To Direct Claim Submission for Professional Claims (PDF)
- Guide to Changing or Reprocessing Professional Claims Online (PDF)
- Guide to EAP Claim Submission Online (PDF)
General Information
- How to Send Secure E-mail to ValueOptions Employees (WORD)
- How to Setup a Secure Email Account (PDF)
- How to Check a Secure Email (PDF)
- Where to Learn More About HIPAA
Contact Information If you need technical assistance, please contact us at (888) 247-9311.
