Claim Submission Guidelines for
OHIO HEALTH CHOICE


Ohio Health Choice is neither an insurance carrier nor third party administrator and does not process claims or make claim payments. However, there are employer groups for which Ohio Health Choice will re-price and then forward those re-priced claims to the appropriate Third Party Administrator or Insurance Company for processing. Those claims are sent to PO Box 3619, Akron, OH 44309-3619 instead of the specific carrier. Please pay attention to the card as to where the claims should be sent.

The following should be noted when obtaining billing information for submitting claims for OHC members:
  • Provide adequate information on the claim

    1. Providerís name, TIN, address, phone number

    2. Obtain a current insurance card, verify OHC logo and TPA or Insurance Carrier

    3. Patientís name

    4. Name and SS# of member or insured

    5. Pay special attention when filing a HCFA 1500 to lines 11a-d and that the information is complete and UB Field 50 Payer A & Field 94. Indicate the third party administrator Ė or insurance carrier. Remember this WILL NOT be Ohio Health Choice

    6. On line 11 and 11b of a HCFA 1500 and Field 61 and 62 on a UB - complete the employer name and/or number if applicable

    7. Pertinent CPT and ICD-9-CM Codes

    8. Executed patient assignment

    9. Type, Print or Stamp OHC on the billing form

  • By following these steps, you will 1) benefit from an increased turn around time in claims processing and 2) prevent potential delays on payments of claims.
Thank you for your cooperation. If you have any further questions, please contact our Customer Service department at 1-800-554-0027.

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