How can providers submit electronic claims directly to BMC HealthNet Plan?
BMC HealthNet Plan can receive electronic claims directly from a provider or the provider’s billing agency, instead of via a clearinghouse, and this method should be less costly for the provider since clearinghouse fees tend to vary based on the number of claims processed on a provider’s behalf, and because the Plan charges no fees for direct submission. To send claims directly to the Plan, the provider or its billing agency must be able to produce a HIPAA-compliant 837 file, have an Internet connection (to transmit the claims files), and have either Secure FTP software (e.g., FileZilla) or PGP encryption software to satisfy HIPAA Privacy/Security regulations. Providers or billing agencies interested in submitting claims directly to BMC HealthNet Plan should contact us at 617-748-6175; our EDI Claims Companion Guide is also available online (click “Companion Guide” on the left under “EDI Information”). At this time BMC HealthNet Plan does not have functionality on its Web site to accep
