tracelogoRB Reference Guide for ATC Allwell Medicare & Medicare/Medicaid

 

HNS' contract with Allwell is for their Medicare Advantage Plan (sometimes called "Part C" or "MA Plan").

 

MA Plans are offered by various private companies (such as Allwell, BCBS, 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 Allwell 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 ATC Allwell (Medicare) Quick Reference Guide provides information specific to the Allwell plan concerning claims, members, and policies.

 

General Information

 

Eligibility/Benefits

 

Prior Authorization

 

Referral System

 

Copayments

 

Allwell ID Cards

 

Claims Submission

 

Claims Inquiries

 

Provider Relations

 


general

 

General Information

 

PLEASE REMEMBER: Do not send claims directly to Allwell!

 

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

 

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

 

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

 

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eligibility

 

Eligibility/Benefits 

 

Be sure to ALWAYS verify eligibility for each Allwell member!

 

To verify eligibility and benefits, refer to the telephone number on the member's identification card or call (855) 766-1497.

 

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

 

Allwell 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.)

 

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prior

 

Prior Authorization

 

Prior authorization is NOT required for chiropractic manipulation for Allwell members.

  

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referral

 

Referral System

 

Referrals from PCPs are NOT required.

  

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copays

 

Copayments

 

Unlike most Medicare Advantage plans, the Allwell plan has a $20.00 copayment for chiropractic visits.

 

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cards

 

Allwell ID Cards

 

All Allwell claims 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.

 

 

Group Number

Group or policy number must be in box 11, or if the ID card does not have a group or policy number, please use the first three letters or numbers of the subscriber ID.

 

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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submission

 

Claims Submission

 

All primary claims for Allwell must be submitted to HNS through HNSConnect®.

 

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

  • The submission of the red and white CMS 1500 claim form.  Copies of the form that do not show the red color will be denied.
  • That paper claims must be typed.  They cannot be handwritten.

 

Allwell will deny all paper claims which are not submitted via the red/white CMS 1500 claim form and/or which are handwritten (or which include ANY hand written words on the claim.)

 

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 Allwell claims to adjudicate quickly and accurately, please note the following information regarding claims submission specific to Allwell 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 use the first three (3) letters or numbers of the subscriber ID.
  • HNS/Allwell must be in box 11c.
  • Even when filing claims electronically, the claim must be identified as an Allwell claim in the address section at the top of the CMS 1500 claim form (HNS/Allwell is an acceptable format) using the example address below: 

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

  

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inquiries

 

Claims Inquiries

 

For tracing outstanding claims (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 three business days.

 

Resubmit lost/missing claims through HNS.

 

Refer to the HNS/Absolute Total Care fee schedule to confirm allowable amounts. All HNS fee schedules are located on the secure portal of the HNS website. 

 

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relations

 

Provider Relations  

 

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

 

 

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