tracelogoRB Reference Guide for ATC Medicaid

 

The ATC Medicaid Quick Reference Guide provides information specific to ATC  concerning ATC claims, ATC members, and ATC policies. The information in this section is in addition to the HNS/Payor Policies.

 

The ATC Medicaid Quick Reference Guide contains the following information specific to ATC and provides you with helpful information regarding your ATC claims.

 

General Information

 

Eligibility/Benefits

 

Referral System

 

Absolute Total Care ID Cards

 

Claims Submission

 

Claims Inquiries

 

Provider Relations

 


 

General Information

 

 

PLEASE REMEMBER: Do not send claims directly to ATC!

 

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 ATC provider through HNS and our instructions for filing claims supersede information given to you by ATC Representatives!

 

Absolute Total Care (ATC) is a Medicaid health plan in South Carolina with a commitment to delivering results for the people they serve. They partner with physicians, hospitals, and other providers to ensure that each member gets the right care at the right time, in the right setting.

 

ATC is also a part of the South Carolina Healthy Connections Kids (HCK) program. Absolute Total Care HCK is a program that provides health insurance coverage for uninsured kids from birth through the month of their 19th birthday.

 

With only a few exceptions, All claims for COVERED SERVICES provided to a beneficiary of a HNS contracted payor MUST be submitted to HNS. 

 

If you have any questions about ATC, please contact your HNS Service Representative at (877) 426-2411 before calling ATC.

 

 

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Eligibility/Benefits

 

Be sure to ALWAYS verify eligibility for each ATC member! 

 

Please remember to ask for specific information on chiropractic benefits for each member. CLICK HERE to see a sample Verification of Eligibility/Benefit Form.  

 

To verify eligibility and benefits - Refer to the telephone number on the member's identification card or call (866) 912-3604.

 

ATC covers only spinal manipulations . Limited to 6 visits per year.

 

ATC has attached the HNS EIN to all HNS providers, so you MUST use the HNS TAX ID number (56-1971088) in order to receive in-network verification.  (If you use your own EIN when verifying eligibility and benefits, you will be told that you are not listed as a participating provider.)

 

To verify eligibility and benefits - Refer to the telephone number on the member's identification card or call (866) 912-3604. 

  • Prior authorization is NOT required for covered services.

  

 

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Referral System

 

  • A referral from ATC is not needed.

 

 

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Absolute Total Care ID Cards

 

All ATC plans must be submitted to HNS. Please remember to obtain a copy of the front and back of the insurance card and maintain this in the member's health care record.

 

If you are uncertain about where to file the claim, please email your HNS Service Representative a clear, legible copy of the member ID card and we will respond back to you with an answer within 24 hours.

 

 

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Claims Submission

 

All primary claims for ATC must be submitted through HNSConnect®

 

If necessary to submit a claim via paper (primary, secondary, corrected claims or claims with attachments), ATC requires:

  • The submission of the original red and white CMS 1500 claim form.  Only the standardized, red/white form (printed in Flint OCR Red or an exact match) will be accepted.
  • That paper claims must be typed.  They cannot be handwritten (and cannot include any handwritten words on the claim).

 

ATC will deny all paper claims which are not submitted via the red/white CMS 1500 claim form and/or which are handwritten. 

 

Corrected Claims:  CLICK HERE for information on filing corrected claims.

 

Ignore any instructions regarding where to submit claims by payor phone representatives. HNS instructions regarding where to submit claims supersede all other instructions given by payor representatives when verifying eligibility and benefits.

 

In order for ATC claims to adjudicate quickly and accurately, please note the following information regarding claims submission specific to ATC is in addition to the HNS Billing Guidelines. 

  • 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.

     

  • HNS/Absolute Total Care or HNS/ATC must be in box 11c.

     

  • Even when filing claims electronically, the claim must be identified as an ATC claim in the address section at the top of the CMS 1500 claim form (HNS/ATC is an acceptable format) using the example address below:

     

Example:    HNS/ATC
                    PO Box 2368
                    Cornelius, NC 28031 

 

 

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Claims Inquiries

 

For tracing outstanding claims (after 60 days from your billing date), please email your HNS Service Rep 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 three business days.

 

Resubmit lost/missing claims through HNS.

 

Refer to your HNS/Absolute Total Care fee schedule to confirm allowable amounts.

 

 

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Provider Relations  

 

Questions relating to your participation in Absolute Total Care (ATC) should be directed to your HNS Service Representative at (877) 426-2411.

 

 

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