San Francisco Municipal Transportation Agency (SFMTA) switched bill review services, from Mitchell to EK Health.
The change is effective August 29, and affects bills for all dates of service. Intercare Holdings Insurance Services remains SFMTA’s claims administrator, and claim numbers remain the same. However, providers must submit all requests for authorization (RFA), original bills, and second review appeals to EK Health.
With the change in bill review comes a change in clearinghouse. Bills submitted via Intercare’s former clearinghouse Jopari’s Payer ID will result in rejections.
As always, DaisyBill’s Billing Software is updated to reflect the latest changes.
SFMTA: Same TPA, New Bill Review
SFMTA uses third-party administrator (TPA) Intercare Holdings. But while the claims administrator remains the same, the switch in bill review service requires providers and their billing agents to submit RFAs, bills, and appeals to EK Health.
For non-electronic billing, providers should submit to:
EK Health Services
Attn: Medical Bill Processing - SFMTA
2351 Sunset Blvd
Rocklin, CA 95765
Providers should submit RFAs to EK Health at:
Fax number 408-912-1031, or
Providers must submit second review appeals to EK Health, even if the original bill was submitted to Intercare via Mitchell.
For electronic billing, providers formerly submitted bills to Intercare via the clearinghouse Jopari, using a Jopari-specific Payer ID number. Currently, Intercare’s clearinghouse is WCEDI, and the Payer ID number is updated to WCEDI-specific Payer ID LT784.
Providers may direct any questions directly to EK Health at 888-507-0616.
We’re on top of it. Changes to TPAs, clearinghouses, and bill review services are just one part of what DaisyBill navigates on behalf of our providers. If you’re ready to make authorization, billing, and appeals easier, faster, better, schedule a free demonstration today.