ELECTRONIC CLAIMS

Mesa Mental Health accepts electronic claims with DDE (direct data entry) after the provider enrolls through the following link https://office.emdeon.com/vendorfiles/Mesa.html . This service is offered at no charge to the provider. The initial training period for the service provides assistance from Emdeon directly and will require 90% of the claims to process before the provider is cleared for use of the application. Once the billing information is entered, a patient profile is created so that the provider may update the sequential bill with the stored information. The registered provider may also check the claim status through the Emdeon account. For support call 877-469-3263.

You may also choose a clearinghouse to transmit your claims; the claims will be routed by your clearinghouse to us. Some clearinghouses charge providers for this service. Mesa Mental Health accepts electronic claims in the ASC X12N Version 4010 format required by HIPAA. Mesa Mental Health is Payer 85035.

CLEARINGHOUSES that work with Mesa Mental Health are:
Emdeon (formerly Envoy)WebMD Envoy
Availity (formerly THIN)
Navinet
Gateway EDI
Office Ally

PAPER CLAIMS

Mesa Mental Health accepts paper claims on the HCFA-1500 form using codes from the International Classification of Diseases (ICD-9), Current Procedural Technology (CPT-4), and other codes required by HIPAA. Please remember that DSM-IV codes are no longer acceptable. Paper claims can be faxed or mailed to:

MESA MENTAL HEALTH
PO Box 92165
Albuquerque, NM 87199-2165
Fax (505) 816-6702

Claims filing limits are specified in the contracts that Mesa Mental Health has with network providers. For out-of-network providers, filing claims is the responsibility of the member and filing limits are specified in the member booklet and vary from plan to plan. Out-of-network providers may also submit claims directly to Mesa Mental Health on behalf of the member and the member filing limits of the individual member’s plan will apply.

Providers may request claim status, replacement checks, and corrections and adjustments to claims for up to one year from the date of service.