Claims and Billing
Filing claims is fast and easy for First Choice by Select Health of South Carolina (First Choice) participating providers. Here you will find the tools and resources you need to help manage your submission of claims and receipt of payments.
First Choice can accept claim submissions via paper or electronically (EDI). For general questions about claims submissions, call Provider Claims Services at 1-800-575-0418.
What would you like to do?
Submit a claim
If you prefer to submit your claims on paper, send your claims to:
Select Health of South Carolina, Inc.
Claims Processing Department
P.O. Box 7120
London, KY 40742
Submit a 275 claim attachment transaction
Select Health of South Carolina is accepting ANSI 5010 ASC X12 275 attachments (solicited and unsolicited) via our preferred vendor Change Healthcare. Please contact your Practice Management System Vendor or EDI clearinghouse to inform them that you wish to initiate electronic 275 attachment submissions via payer ID: 23285.
There are three ways that 275 attachments can be submitted.
- Batch — You may either connect to Change Healthcare directly or submit via your EDI clearing house.
- API via JSON — You may submit an attachment for a single claim.
- Portal — Individual providers can register at Change Healthcare to submit attachments.
The acceptable supported formats are pdf, tif, tiff, jpeg, jpg, png, docx, rtf, xml, doc, and txt.
In addition, the following 275 claims attachment report codes have been added effective 8/1/23. When submitting an attachment, use the applicable code in field number 19 of the CMS 1500 or field number 80 of the UB04, as documented in the Claim Filing Instructions (PDF).
| Attachment type | Claim assignment attachment report code |
|---|---|
|
Itemized bill |
03 |
|
Medical records for HAC review |
M1 |
|
Single case agreement (SCA)/LOA |
04 |
|
Advanced beneficiary notice (ABN) |
05 |
|
Consent form |
CK |
|
Manufacturer suggested retail price/Invoice |
06 |
|
Electric breast pump request form |
07 |
|
CME checklist consent forms (child medical eval.) |
08 |
|
EOBs for 275 attachments should only be used for non-covered or exhausted benefit letter |
EB |
|
Certification of the decision to terminate pregnancy |
CT |
|
Ambulance trip notes/Run sheet |
AM |
Check claim status
- Go to NaviNet or call Provider Claims Services at 1-800-575-0418.
Request reconsideration of a claim
Requests for reconsideration may be submitted through the NaviNet Electronic Claim Inquiry feature. For detailed information on electronic claim inquiry submission, please see the NaviNet Claims Investigation User Guide (PDF).
Claims resources
- Quick-Reference Guide – Inquires, Disputes, and Appeals (PDF)
- Supplemental billing information for modifiers 25 and 59 (PDF)
- Rejection of claims not meeting HIPAA 5010 X12 formatting requirement (PDF)
- NPI
- Explanation of benefit (EOB) codes (PDF)
Receive your payments faster by enrolling for Electronic Funds Transfer (EFT)
Get the most out of EFT by using EDI, ERA, and all the electronic billing services offered.