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Claims with dates of service prior to July 1, 2019


​As of October 31, 2019, HealthSmart officially stopped accepting PEIA claims with dates of service prior to July 1, 2019. PEIA and UMR have been able to resolve most claims prior to this date, however, we realize that there will be a few exceptions.
Below is what we are doing to make sure these exception claims are handled as efficiently as possible:
- UMR will get a list of all claims paid by HealthSmart with dates of service between January and June 2019 to check for duplicates.
- UMR will get a list of the deductibles and out of pocket amounts met for 2019.
- HealthSmart’s claims address will be forwarded to UMR.
- HealthSmart’s fax number will be closed so no claims can be faxed to them.
- After November 1, providers should use UMR’s electronic routing number for everything. 
- For in state claims, pre notification will be waived.
Getting this information into UMR’s system to allow them to process these claims will be a long process. The payment of claims with dates of service prior to July 1, 2019 will be delayed.  These claims will be paid with the 2020 fee allowances, therefore, the amounts may be slightly different than expected.

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