Claims

How to file a claim for professional services
Are you an Ascension network provider? 
Ascension network (Tier 1) providers should submit claims to Automated Benefit Services (ABS) - SmartHealth's claim processor. 
Please follow the instructions below to ensure claims are processed in a timely manner.
**Claims must be received within 12 months from the date of service.

To submit a paper claim mail to:
ABS for SmartHealth
PO Box 37705
Oak Park, MI 48237-7705

To submit an electronic claim:

Submit under Payer ID 38259 using one of the following vendors:

  • CAREVU
  • AllScripts
  • Web MD/Envoy
  • THIN
  • MCSI
  • ENS
  • ProxyMEd
  • Claimsnet.com
  • McKesson
  • NDC

Online Provider Claims Submission Portal

If you do not have the ability to send claims electronically, you are able to use our online provider claims submission tool. This tool allows you to manually enter claims that are then electronically submitted to ABS for processing.  Note: Registration must be completed prior to using the portal.

 
There are several required elements for a clean claim including additional documentation as reasonably required by the health plan. Claims will be denied if elements are incomplete, illegible or inaccurate.


Are you a National network or out-of-network provider?

Bill the local Blue Cross Blue Shield using the alpha prefix found on the Member's ID card.

 

ABS provider portal

Please visit the ABS provider portal to verify eligibility, view claims history and payment status.

New to the ABS provider portal? In order to gain access to this secure website, please complete and return the form, ABS provider web portal access application, via email to abssupport@abs-tpa.com.

Claim cost management

The Ascension SmartHealth program utilizes a variety of vendors and tools to ensure that claims submitted for reimbursement are bill appropriately and eligible for payment under the plan. Tools and services utilized under the program may include, but are not limited to:

  • Claim editing for bundling and unbundling
  • Up coding
  • Duplicate claim submission
  • Separate billing of services included in global care
  • Incorrect or inappropriate billing for services rendered

All coding edits are based on CPT, MPA and industry standard (NCCI) policy and guidelines.

Member portal

If you are a member, visit the portal to view plan benefits and summaries, access claims and explanation of benefits, view your current deductible and more.