FAX: 512-420-2798 or
Austin, Texas 78761
P.O. Box 15402
Attn: Reconsideration or Refunds
PO Box 14545
Austin TX 78761-4545
All participating providers are responsible for verifying an Enrollee’s eligibility at each and every visit. Providers can verify enrollee verification through one of two methods:
- Contact Vista360health Customer Service at 866-607-0117.
- Access current enrollee information online through the Vista360health Provider Portal. (coming soon!)
You have the option of submitting claims electronically or by mail. We encourage use of electronic claims submission methods to help you:
- Prepare a complete and accurate claim form.
- Receive explanations of payment and your reimbursements more quickly.
- Save time.
Providers choosing electronic submission must use the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) compliant 837 electronic format, or a CMS-1500 and/or UB-04, or their successors.
Vista360health utilizes TriZetto as a clearinghouse. Because most clearinghouses can exchange data with one another, providers should work with their existing clearinghouse to establish EDI with Vista360health. Please contact Provider Relations if assistance is needed.
Paper claims can be submitted to the address on the Enrollee Identification Card noted below:
ELECTRONIC PAYMENT METHODS (EFT/ERA)
Vista360health offers the ability to receive claims payments and remittance advices electronically. Both options offer benefits over paper transactions. Forms can be accessed from our Provider Portal (coming soon!) or your Provider Relations Representative.
Electronic Funds Transfer (EFT)
Electronic Funds Transfer (EFT) is the electronic exchange of claims payments. It is safe, secure and quicker than paper check payments. EFT allows payment to be deposited electronically directly into a bank account once claims payment is released. There is no need to manually deposit checks.
Electronic Remittance Advice (ERA)
Electronic Remittance Advice (ERA) enables you to receive claims payment information electronically. ERA files are transmitted in the HIPAA mandated ASC X12 835 5010 A1 format. ERA allows providers to post claims remittance advices electronically to your billing software vendor or clearinghouse to automate manual processes.
Providers can verify the status of their submitted claim status telephonically by contacting Vista360health Claims Customer Service at 1-800-607-0117 or directly through our Provider Portal. Once claims have been received and entered into our systems, claims in the Provider Portal (coming soon!) will reflect a status of Paid, Denied or Pending.