Claims

Medical Health

Claims must be submitted detailing all services rendered for all capitated and fee-for-service encounters within 90 days of the date of service or discharge. Please allow 30 days from claim submission date to receive payment for Medicare claims, 45 days for all other claims.

• Claims for all members can be submitted electronically using Emdeon Payer ID# 13265.
• Paper claims must be submitted on HCFA 1500 or UB-04 forms.

Send paper claims for Medicaid, Child Health Plus, Essential Plan and MetroPlusHealth Gold to:

MetroPlus Health Plan
P.O. Box 830480
Birmingham, AL 35283-0480

Send paper claims for Medicare Plans to:

MetroPlus Health Plan
P.O. Box 381508
Birmingham, AL 35238-1508

Behavioral Health

For Behavior Health Claim information, click here.

Claim Status

For claim status, log into the MetroPlusHealth Provider Portal or call Member Services.