Claims - General Information

If you have questions about claims in general,
call (800) 888-3944. 

Claims Submission/ Address

Reference the address on the member’s identification card, as the address may vary based on payment location.

Member Benefits, Eligibility, and Authorizations

If you have a question about authorization or benefits,
call the (800) number on the back of the member’s identification card.

Member Customer Service

To reach Member Customer Service, call the (800) number on the back of the member’s identification card.

E-Support Services/ EDI Helpdesk

If you have a technical question about EDI (Electronic Data Interchange), our Electronic Claims software, please contact the EDI Help Desk at (888) 247-9311 from 8 am – 6 pm Eastern Standard Time. Please use the following options:

• Option 1 to request software
• Option 2 to leave a voice mail
• Option 3 to speak to an EDI Helpdesk Analyst

Fax: (866) 698-6032
E-mail:e-supportservices@valueoptions.com

Mailing Address:  
ValueOptions
Attn: EDI Helpdesk
PO Box 1287
Latham , NY 12110

Credentialing Status

To obtain information pertaining to your network status, contact our National Provider Line at (800) 397-1630 from 8 am - 5 pm Eastern Standard Time.

Fraud and Abuse

Reports of fraud and abuse, or suspicions thereof, can be made in writing to:

Mailing Address:
ValueOptions
Corporate Headquarters
ATTN:  Special Investigations Unit
240 Corporate Boulevard
Norfolk, VA 23502

Clinical Appeals

To request a clinical appeal on a member’s behalf, call the (800) number included in the adverse determination letter you received.

Administrative Appeal

To request an administrative appeal, call the (800) number included in the administrative denial letter you received.

Complaints/Grievances

To file a complaint/grievance, call the (800) number on the back of the member’s identification card to speak to Customer Service.

Adverse Incident

Report all adverse incidents to the Clinical Care Manager with whom you conduct reviews.

Duty to Warn

Report all potential situations to the Clinical Care Manager with whom you conduct reviews.

Provider Coverage During Absences

Contact the Clinical Care Manager with whom you conduct reviews during absences (i.e. coverage while on vacation).

Changing your Provider Profile (e.g. Name, address)

“Change of Address” forms can be found at www.valueoptions.com and may be submitted by using one of the following options:

Fax : 757/412-6425 or 757/412-6592

Mail Address:
ValueOptions
c/o Practitioner Maintenance
P.O. Box 4080
Virginia Beach, VA 23454

NOTE: A change of address requires an accompanying W-9 form which is also located at www.valueoptions.com.