Billing and claims
Please review our Reimbursement Policy Manual for details on specific types of reimbursements.
Electronic claims and transactions
We encourage electronic claim submission--your office gets quicker submission, higher accuracy, better tracking and lower administrative costs.
Direct connection to Moda Health
We support direct connections between our offices, provider offices and health systems. The transaction standard is the 837 Professional Claim or 837 Institutional Claim required by HIPAA Administrative Simplification. See our Electronic remittance explanation codes for details. For help with Moda Health EDI transactions, either contact us or send an email to edigroup@modahealth.com.Claims clearinghouses
Below is a list of claims clearinghouses we use:
Availity
12400 Coit Rd. #700
Dallas, TX 75251
800-282-4548
Payor ID = 13350
Change Healthcare (formerly Emdeon) (both medical and hospital)
3055 Lebanon Pik
Nashville, TN 37214
(615) 932-3000
Payor ID = 13350
1740 S. Glenstone #B
Springfield, MO 65804
417-890-6164
MD On-Line Inc.
6 Century Dr
Parsippany, NJ,07054
888-499-5465
Office Ally
P.O. Box 872020
Vancouver, WA 98687
360-975-7000
RelayHealth (both medical and hospital)
301 Data Court
Dubuque, IA 52003
563-557-3925
Systems that submit directly to Moda Health:
LINCARE Inc.
19387 US 19 N
Clearwater, FL 33764
727-431-8231
Mailing address
Medical Claims
P.O. Box 40384
Portland, OR 97240
Pharmacy Claims
P.O. Box 3625
Portland, OR 97208