Tips for submitting claims for US Family Health Plan patients
Posted 05/08/25
To ensure accurate and timely claims processing for your US Family Health Plan patients, please follow these guidelines when submitting claims.
For Subscriber/Members
Each US Family Health Plan member has a unique identification number. When submitting a claim for a patient who is the subscriber, include the following details:
- Patient Last Name: 2010BA NM103
- Patient First Name: 2010BA NM104
- Patient code qualifier "MI": 2010BA NM108
- Patient ID #: 2010BA NM109
- Patient Date of Birth: 2010BA DMG02
- Patient Gender: 2010BA DMG03
For Newborns Without a Member ID
(Dependent of US Family Health Plan Subscriber/Member)
If the patient is a newborn who does not yet have a member ID number, submit the claim using the following fields in Loop 2010BA (Subscriber) and Loop 2010CA (Patient):
- Subscriber Last Name: 2010BA NM103
- Subscriber First Name: 2010BA NM104
- Subscriber Code Qualifier ("MI"): 2010BA NM108
- Subscriber ID #: 2010BA NM109
- Subscriber Date of Birth: 2010BA DMG02
- Subscriber Gender: 2010BA DMG03
- Patient Last Name: 2010CA NM103
- Patient First Name: 2010CA NM104
- Patient Date of Birth: 2010CA DMG02
- Patient Gender: 2010CA DMG03
