Where to Submit Claims
Providers should always submit claims based on the information shown on the member’s ID card. The ID card is the source of truth for claims routing, regardless of whether the provider is in-network or out-of-network.
❗❗❗ Yuzu administers many different types of plans with different clearinghouses and claims mailing addresses. It is important to always reference the ID card when looking for claim submission information. ❗❗❗
The card lists:
Payer ID - for electronic claims
Mailing address - for paper claims
sample id card with claims address highlighted
What if I incorrectly submit claims to the wrong address?
For e.g., if a provider submits a claim directly to Yuzu Health using Payer ID IHS15 or mails it to: P.O. Box 824, Arnold, MD 21012 (and this is not the claims address listed on the member’s ID card), the claim will be rejected with a remark code instructing the provider to resubmit the claim to the correct payer.
Common FAQs
I thought I was supposed to submit claims to the TPA responsible for eligibility and benefits?
No, claims must be submitted to the payer ID or mailing address listed on the back of the member ID card
For all questions related to eligibility & benefits or claims status:
call the respective number on the ID card OR
view them on the provider portal: guide here
Claim Submission Issues
If you are having claims submission issues and have confirmed that you are submitting to the right place, here are some steps that can help.
Please learn more about how claims get to Payers by reading this documentation from Stedi.
Your claim is being “scrubbed”. This oftentimes happens through the billing software before the claim even gets sent to insurance. Scrubbing can happen because you are not putting in valid NPI / TIN, are not filling out required fields, or your system is not configured properly.