Frequently Asked Questions
Need to define a word? Check the Glossary for a list of common healthcare terms.
What is your electronic payor ID?
Our electronic payor ID is 36215. However, make sure to follow claim filing directions on the back of the member’s ID card. Many claims must be filed directly with the appropriate network in which case their electronic payor ID should be used.
What types of services require precertification?
All networks require precertification of in-patient admissions. Some networks have additional precertification requirements. Remember to check the member’s ID card for requirements and follow specific network rules.
Where do I submit claims?
Claim filing instructions vary by network and type of service. Follow the instructions on the back of the member’s ID card.
How long does it take to process a claim?
Electronic claims may take up to 30 days to be processed after being received by TeamCare, especially if further information needs to be reviewed. Paper claims may take up to 30 days from submission.
- How do I tell if a claim was received?
Are there any specific plan exclusions?
TeamCare does not cover procedures that are cosmetic, experimental, or investigational in nature. A list of other plan exclusions is available in the Summary Plan Description.
How long do I have to file a claim?
Unless your network contract states otherwise, there is a 12-month filing limit on claims.
Does TeamCare provide coverage for pre-existing conditions?
Yes, TeamCare covers pre-existing conditions.
Do I contact the Network or TeamCare regarding a claim payment dispute?
If you are a provider in one of our networks, please contact that network for assistance. Otherwise you can contact TeamCare regarding the claim payment dispute.