A Commitment to Values -- St. Joseph Network Support Services
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Network Support Services is a division of St. Joseph Heritage Healthcare. Our goal is to provide exceptional service to our affiliated networks and health plans.

This web site is dedicated to supporting our provider care partners. The following services are available on-line:

  • Check status of claims
  • Appeal claim decisions
  • Check Status of referrals
  • Submit Referral requests online
  • View Documents and Guidelines for UM
  • Download explanation of benefits
  • Download documents and forms
  • Important links to other Web Sites
  • Become an EDI provider
  • Check enrollment status
  • Update your National Provider Identifier

Announcements:

Patient Centered Care
Patient Centered Care: Cliché or Commitment By James L. Kyle, II, MD, MDiv CMO St Joseph Heritage Healthcare

ICD-10 Communication
On January 16, 2009, the U.S. Department of Health and Human Services (HHS) released the final rule mandating that everyone covered by the Health Insurance Portability and Accountability Act (HIPAA) must implement the International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10), for medical coding. Given the magnitude of the change, HHS, updated the final rule on August 24, 2012, which moves the ICD-10 compliance date from the initial proposed deadline of October 1, 2013 to October 1, 2014. Click on the communication title to open related documents.

Communication-Regarding Referrals
SJHH Announces Regional Referrals.

Fraud, Waste & Abuse Training
CMS is requiring that all Medicare Part C (Medicare Advantage) & D downstream providers complete a Fraud, Waste and Abuse training annually. As a contracted provider that provides benefits or services to Medicare Advantage beneficiaries you are required to complete a Fraud, Waste & Abuse (FWA) general training program by December 31, 2010 and annually thereafter.

CMS-1500 Claim Form
Effective July 2, 2007 St. Joseph Heritage Healthcare will ONLY accept the revised version of the CMS-1500 Health Insurance Claim Form (version 08/05) which accommodates the reporting of the National Provider Identifier. All claims including corrected claims, tracers, appeals and provider disputes submitted after July 2, 2007 must be submitted on the revised form regardless of date of service. Any claim received after July 2, 2007 on the CMS-1500 Health Insurance Claim Form (version 12/90) will be returned requesting the revised version.

 

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