Reference Guide for HTA Medicare Advantage
HNS’s contract with HealthTeam Advantage is for their Medicare Advantage Plan (sometimes called “Part C” or “MA Plan”).
MA Plans are offered by various private companies, (such as HealthTeam Advantage, BCBSNC, United Healthcare, etc.) that have been approved by Medicare.
Individuals that join a Medicare Advantage Plan still have Medicare, but coverage is from the Medicare Advantage Plan and not original Medicare.
The HealthTeam Advantage MA plan covers those same chiropractic services covered by original Medicare. Just as with Medicare, please be sure to include the AT modifier, as applicable.
This Quick Reference Guide provides information specific to the HealthTeam Advantage plan concerning claims, members, and policies.
With HealthTeam Advantage, it is NOT necessary to obtain either a referral from the member’s Primary Care Provider (PCP) or prior authorization from HealthTeam Advantage.
General Information
Please do not send claims directly to HealthTeam Advantage. All HealthTeam Advantage claims must be sent to HNS.
Please ignore the claims billing address on the member ID card or any address given to you on the telephone when verifying eligibility and benefits. You are under contract as a participating HealthTeam Advantage provider through HNS, and our instructions for filing claims supersede information given to you by HealthTeam Advantage Representatives!
If you have any questions about HealthTeam Advantage, please contact your HNS Service Representative. Your HNS Service Representative’s email address is displayed on the provider dashboard on the secure section of the HNS website.
Eligibility/Benefits
Be sure to ALWAYS verify eligibility for each HealthTeam Advantage member!
To verify eligibility and benefits, refer to the telephone number on the member’s identification card.
Please remember to ask for specific information on chiropractic benefits for each member. CLICK HERE to see a sample Verification of Eligibility/Benefit Form.
HealthTeam Advantage ID Cards
HealthTeam Advantage Plan I PPO:
HealthTeam Advantage Plan II PPO:
HealthTeam Advantage Eagle PPO:
HealthTeam Advantage Vitality PPO:
Subscriber ID:
For services provided on or after July 1, 2018, the subscriber ID must begin with the letter “T”, followed by the 10 digit ID number.
Claims submitted without the “T” as the first character in the subscriber ID will be rejected by HTA. (Example: T9808012345)
Claims Submission
With few exceptions, all HealthTeam Advantage claims must be submitted electronically to HNS.
Exceptions: Tertiary claims, corrected/voided secondary claims, corrected/voided tertiary claims, or claims with attachments.
CLICK HERE for information on filing corrected claims.
In order for HealthTeam Advantage claims to adjudicate quickly and accurately, please note the following information regarding claims submission specific to HealthTeam Advantage is in addition to the HNS instructions under Filing Claims to HNS.
- Group or policy number must be in box 11, or if the ID card does not have a group or policy number, please put the first three letters or numbers of the subscriber ID.
- HealthTeam Advantage must be in box 11c.
- Even when filing the claim electronically, the claim must be identified as a HealthTeam Advantage claim in the address section at the top of the CMS 1500 claim form (HNS/HealthTeam Advantage and or HNS/HTA are acceptable formats).
Example:
HNS/HTA
PO Box 2368
Cornelius, NC 28031
Claims Inquiries
To check claims status directly with HealthTeam Advantage, email HTA at the following email address: providerclaims@healthteamadvantage.com. Please include all of the following information in your email: your name, your telephone number, the name of the provider, the HNS EIN, the patient’s full name, subscriber ID, date of service, and billed amount.
For assistance from HNS on claims status, (after 60 days from your billing date), please email your HNS Service Representative and include the patient name, date of birth, member ID number and the dates of services in question. We will gladly trace the claim for you and will respond back to you within 3 business days.
Resubmit lost/missing claims through HNS.
Refer to your HNS/HealthTeam Advantage fee schedule to confirm allowable amounts. All HNS fee schedules are located on the secure section of this website.
Provider Relations
Questions relating to your participation in HealthTeam Advantage should be directed to your HNS Service Representative. Your HNS Service Representative’s email address is displayed on the provider dashboard on the secure section of the HNS website.