Provider Manual

E-commerce requirements

Effective January 1, 2015, providers in the Beacon Health Options network will be expected to electronically conduct all routine transactions, including:

• Submission of claims
• Submission of authorization requests
• Verification of eligibility inquiries
• Submission of re-credentialing applications
• Submission of POMS
• Electronic fund transfer
• Provider claims and authorization status checks

New providers with a contract date of July 1, 2014 or later will be expected to comply immediately with this requirement upon joining Beacon.  To conduct these transactions referenced above, Beacon requires providers to utilize the resources detailed in the Electronic Resources section of Beacon Health Options’ website.  Additional information on E-support Services/ProviderConnect and Electronic Claims can be found here: https://www.beaconhealthoptions.com/wp-content/uploads/2016/11/Appendix-2C-2-EDI-Resource-Document-E-Support-Services-for-ProviderConnect-and-Electronic-Claims.pdf If a participating provider does not submit claims electronically, claims may be delayed.  For questions or further assistance regarding this requirement, please contact your Provider Field Coordinator or call the Beacon Health Options Provider Service Line at (800) 397-1630 Monday through Friday, 8 a.m. to 8 p.m. EST.