The CBHA claims department is dedicated to paying claims quickly and accurately and providing a clear explanation of claims status. A claims examiner is available to provide a prompt and courteous response to claims inquiries. CBHA claims examiners are trained and willing to consult with providers concerning any billing issues that may deny or delay reimbursement. You may call 1-800-475-7900, Monday through Friday from 8:30 am to 5:00 pm to reach a representative without going through phone prompts or being routed to voicemail.
CBHA network providers, by contractual agreement, must submit claims, including claims with corrected information, within 180 days of the date of service. Providers are advised to file in a timely manner. If claims are denied or paid based on incorrect information submitted on the claim, the provider has 180 days from the date of service to submit a corrected claim.
Paper claims, both CMS-1500 and UB-04 claims, are accepted by CBHA. The mailing address for paper claims: CBHA, PO Box 571137, Winston-Salem, NC 27157-1137.
or click this link to send a scanned claim document Send a Claim File
Claims may be submitted electronically through the CBHA clearinghouse, Claimsnet. Go to the Claimsnet website, http://www.claimsnet.com/cbha, click register at the bottom of the page. A representative from Claimsnet will contact you to provide a routing number if your electronic billing software has established connectivity with Claimsnet. If you use billing software that has no established connectivity with Claimsnet, Claimsnet will assist you in establishing routing by which you can submit electronic claims to CBHA, at no cost to you
To avoid delays in processing, it is important to route only behavioral health claims to CBHA.
In order for a claim to be processed fully, the claim must contain all required patient, provider and service information in readable form.
If another insurance is primary to the plan benefit processed by CBHA, file the primary insurance first. Attach the payment or denial remittance statement from the primary insurance to the claim then filed to CBHA. CBHA will extend the filing time limit beyond 180 days from date of service for co-ordination of benefit claims, but not longer than 60 days from the date on the primary remittance. In no event will the filing time limit be extended beyond 18 months.
V Codes will be denied. Services for V codes are outside benefit reimbursement and are billable to the patient.
Charges for missed appointments will be denied. The patient may be billed for missed appointments
A primary diagnosis code of 799.9 (diagnosis deferred) will be denied for all services with the exception of a prior-authorized initial evaluation.
Two sessions of psychotherapy on the same day are not covered. One session will be denied.
Medication management by a psychiatrist and psychotherapy by a therapist on the same day are allowed. Both services will be reimbursed if all other benefit and eligibility provisions are met.
If a claim is submitted with a payment address, physical location or Tax ID number that is different from the information entered in the CBHA provider eligibility file, processing of the claim may be delayed. Always notify CBHA if you change location, payment address or TAX ID number. Your provider file will be updated and future claims processed without delay.