Claims

Claim Process at Ease

We believe that compassion and consideration is of utmost importance.

Claims Submission

PsycHealth Care Management, LLC processes claims in accordance with the guidelines of the state Prompt Pay Laws. Clean claims will be processed within 30 days of the date received. All claims for services rendered must be submitted on a completed CMS1500 Form or UB92 Form or equivalent. PsycHealth accepts claims electronically through the Provider Portal and in paper format. To submit your printed claims please submit them to the address below:

PsycHealth Care Management, LLC.
Claims Processing Department
PO Box 4973
Skokie, IL 60076-4973

A Clean Claim is defined as:

A claim that has no defect, impropriety, lack of any required substantiating documentation, or particular circumstances requiring special treatment that prevents timely payment.

A Clean Claim must include the following information at a minimum:

  • Member Name
  • Member Identification Number
  • Date of Birth
  • Insurance Carrier
  • Group, Site and COC Numbers
  • Provider Name and Title
  • Federal Tax Identification Number
  • Location at which the services were provided
  • Date(s) of Service
  • Place of Service Code
  • ICD-10
  • CPT/HCPCS
  • Revenue Code
  • Rates/Charges
  • Authorization number

Member co-payments are to be collected by the provider at the time of services rendered. PsycHealth Care Management, LLC. will deduct co-payments from the rate of reimbursement when processing claims. Under no circumstances is a member responsible for any payment beyond the specified plan co-payment.

Claims status inquiries can be obtained during normal business hours by calling: (847) 864-4961 or (800) 753-5456

Provider Portal

The Provider Portal, also known as QC Portal, is a comprehensive managed care software that is highly flexible, easy to use and powerful. The software allows PsycHealth providers to verify eligibility, enter referral and authorization requests, submit claims and view the status of all data in real-time from any internet web browser.

Call Logs

QC Portal can show the user up-to-date electronic medical records through the call log system.

Claim History and Submission

QC Portal additionally allows for viewing claim history and submission of manually entered claims and 837 EDI files.

Member Eligibility

QC Portal uses real-time data to search and preview member eligibility.

Referral History

QC Portal allows for searching for outpatient mental health service records.

Authorization History

QC Portal also can display authorization history, including inpatient, partial, and intensive outpatient mental health service records.