Claims and Billing

All your questions and their answers

Does Fieldworker allow submission of claims?

The Fieldworker platform supports and lets you manage your entire RCM (Revenue Capital Management) process.

From obtaining the prior authorization information, capturing patient encounters, matching the encounters to prior auth, and submitting claims, the platform provides multiple ways to adapt the platform to your workflow.

My agency is in the state XXXX. Can I submit my claims through the Fieldworker.

Yes. The Fieldworker supports submitting to a large number of payers in all states of the US. You can find the latest set of payers here.

Is anything changing in the Fieldworker billing?

The Fieldworker Revenue Cycle Management process (aka billing) is continually improving.

• Direct import of the Prior Authorizations

• Matching encounters with Prior Authorizations

• Automatic generation of (error-free) claims

• Manual entry of a claim using the CMS-1500 form interface

• Automatic status capture of claims

• Analytics and reporting on Revenue cycle operations

Can I submit to Medicaid using the Fieldworker?

Yes. The Fieldworker will assist you in submitting to your local Medicaid payers in your state.

What all payers can we submit to?

A sample of some of the payers, supported by the Fieldworker platform in various states, is available here.

Adventist Health Plan Custody Medical Services Program 1199 National Benefit Fund 1st Auto & Casualty - MN Only 6 Degrees Health Incorporated A-G Administrators LLC A-G Specialty Insurance LLC - ERA ONLY A.W. Holdings LLC Dba Benchmark - CT, FL, GA, IN, MD, MI, MO, NJ, NM, TN, VA - CORVEL AAA - Minnesota/Iowa AARP ABLEPAY HEALTH Absolute Total Care Acadia Insurance Company Access Community Health Network Chicago IL Family Health Network patients Access Integra Access Medical Group Accident Fund Insurance Co of America Acclaim Accountable Care Management Group, LLC Accountable HC IPA Accuride Corporation Ace USA Ace Usa (Rocklin Office) ACIG Insurance Company - TX and MN ACS Benefit Services Inc ACS Benefits / Payer Compass ACTIN Care Groups Activa Benefit Services LLC Active Care, Inc ActivHealthCare ACTS Retirement - Life Communities Actuarial Management Resources Acuity, A Mutual Insurance Company ACWA JPI AD-COMP Adelanto Correctional Facility (CA) Administaff -TX,MN,CA,IL,LA,OR,NC Administrative Claim Service, Inc Administrative Concepts Inc Administrative Service Professionals Administrative Services Inc Adminsure Admiral Linen & Uniform Service	AmeriHealth Caritas Pennsylvania AmeriHealth Caritas VIP Care - Delaware DSNP AMERIHEALTH CARITAS VIP CARE - FLORIDA DSNP AmeriHealth Caritas VIP Care Plus (Michigan) Amerihealth First Choice VIP Care Plus SC AmeriHealth HMO New Jersey and Delaware AmeriHealth New Jersey (Non-HMO) Ameriprise Auto & Home Insurance Amerisafe Amerisure Insurance Amerisure Mutual Insurance Ameritas Life Insurance Corp AmFirst Insurance Company Amica Mutual Insurance Company Amplifon Hearing Health Care Amtrust North America - CA, IL, LA, MN, NJ, NY, OR, TX, WI Amwins Connect Administrators Anchor Benefit Consulting Inc Anchor Glass Container Corporation Angel Medical Group Angle insurance Company of Utah Anheuser Busch Antelope Valley Union High School District Antelope Vally Community Hospital Anthem - Tellus EVV ANTHEM EYEMED - OH MEDICAID Anthem Maine Health ANTHEM OHIO MEDICAID Apex Benefit Services AppleCare Medical Management Applied Materials Applied Underwriters AR BCBS AR Medicaid AR Medicaid LTC AR Medicare Part A AR Medicare Part B Aramark (Bunch CareSolutions) ARAZ Arcadia Healthcare Solutions Arcadia Healthcare Solutions - NPA Archer Daniels Midland Company Ardagh Group	Berkley Specialty Underwriters Berkshire Hathaway Direct Insurance Company Berkshire Hathaway Homestate Companies (BHHC) Berkshire Health Partners PPO Wyomissing PA IHS Gateway Payer Berkshire Intergroup Berkshire Lehigh Partners Berwind Corporation Best Life Health Insurance Co Beverly Alianza IPA BI-Mart Bienvivir Senior Health Big 5 Corp Big Spring ISD Bituminous Fire and Marine Bituminous Insurance Company Block Vision Blue Cross Blue Shield of Arizona Advantage Blue Cross Community Options Blue Cross Complete of Michigan Blue Shield of California Promise Health Plan BMC HealthNet Plan BMW North America Boeing Company Boeing Company - WC ONLY Boise Cascade Company Boler Company BOLLINGER INCORPORATED Boncura Health Solutions BoonChapman Benefit Administration Brand New Day (FFS) Brand New Day Encounters Braven Health Bravo Health Breckpoint Brentwood Service Administrators Brentwood Services Administrators, Inc. Briad Restaurant Group, LLC Bridgefield Indemnity Insurance Company BridgeSpan Bridgeway Arizona BRIGHT HEALTHCARE
Cambridge Healthcare Services, LLC Cambridge Integrated Services Camp Lejeune Family Member Program Can Select Personal Can Summit Logistics Capistrano Unified School District (CA) Capital Blue Cross Capital Blue Cross Facility PA Capital Health Plan Capital Insurance Group WC Capitol Administrators Capitol Indemnity Capitol Insurance Companies Caprock Health Plans CARDIOVASCULAR CARE PROVIDERS Care Improvement Plus Care N Care Care To Care Care Wisconsin Health Plan CareCentrix CARECENTRIX CIGNA CARECENTRIX FLORIDA BLUE CARECENTRIX HORIZON CareCore National CareCore National LLC WellCare New York POS 11 Rad Claims CareCore National, LLC (Oxford Radiology Claims) CareFirst Administrators (Charlotte) CareFirst Community Health Plan Maryland Caremore CareOregon Inc CarePartners of Connecticut CarePlus Health Plans Inc CARESOURCE ARKANSAS Caresource Indiana Inc CareSource KY CareSource North Carolina CareSource of Georgia CareSource of West Virginia CareSource OH CARESOURCE OH MEDICAID CARESOURCE OH VISION Carewest - Corvel	Delta Health Systems DentaQuest Vision Denver Health and Hospital Authority Denver Health Medical Plan Denver Health Medical Plan Inc Department of Labor Department of Labor Black Lung Department of Labor Energy Division Department of Water and Power of the City of Los Angeles (LADWP) Deseret Mutual Desert Medical Group Desert Valley Medical Group Detego Health Devoted Health Diabetes Heart Care CSNP Diamond Insurance Group, LTD Dignity Health Chw Dignity Health Medical Foundation Direct Care Administrators Direct Pay Provider Network - Institutional Direct Pay Provider Network - Professional Directory Distributing Assoc. Discount Tire Discover Re (Burger King) Disneyland Resorts (Bunch CareSolutions) Diversified Administration Corp Diversified Benefit Admin DME Region A DME Region B DME Region C DME Region D DMEnsion Benefit Management DOCTOR'S PROFESSIONAL SERVICES CONSULTANTS Doctors Healthcare Plans Dolton Medical Group Dominion National DRISCOLL CHILDRENS HEALTH PLAN DSW Inc. Duke University Dunn and Associates Benefits Adm Dunn-Edwards Corporation Durham County, Nc	Farmers \ Fire Insurance Exchange Farmers \ Mid-Century Insurance Company Farmers \ Neighborhood Spirit Property and Casualty Company Farmers \ Truck Insurance Exchange Faxed Claim FCCI FCE Benefit Administrators FCS Administrators Federal Mogul Federated Claims Service Corp. Federated Mutual Insurance Company Federated Rural Electric (TX) Federated Services Insurance Company Fenix Medical Group FFVA Mutual Insurance Fidelis Care New York Fidelity Security Life Fincor Firefly Health Firemans Fund Insurance Company Firemen's Insurance Company First Choice Health Administrato First Choice MA Plans First Choice Medical Group/Meritage FIRST CHOICE NEXT A PRODUCT OF SELECT HEALTH SOUTH CAROLINA INC First Choice VIP Care(SC D SNIP) by Select Health of South Carolina, Inc. First Health Network fka CCN First Managed Care Option, Inc FIRST SOLUTIONS FirstCare FIRSTCARE - MEDICAID FirstCarolinaCare - New Firstcomp FirstNation Health Fiserv HealthKansas FKI Industries, Inc. FL BCBS FL MCO PHCPHP FL Medicaid FL Medicare Part A FL Medicare Part B Florida Community Care FLORIDA COMPLETE CARE
Hartford Casualty Insurance Company Hartford Fire Insurance Company Hartford Insurance Company of the Midwest Hartford Life and Accident Insurance Company Hartford Life and Annuity Insurance Company Hartford Life Insurance Company Hartford Underwriters Insurance Company Harvard Pilgrim Health Care Harvard Pilgrim Stride Health Plan MA Hastings Mutual HAWAII MEDICAL ASSURANCE ASSOCIATION (HMAA HWMG) Hawkeye HCA-Hosptial Corporation of America HCC Life Insurance Company HEALTH 2 BUSINESS Health Alliance Medical Plans Health Alliance Plan of Michigan Health America Inc Health Care LA IPA Health Care Network of Wisconsin Health Choice Generations Utah Health Choice Pathway Health Choice Utah Health Cost Solutions (HCS) Health Design Plus Hudson OH Health First Health Plans Health Management Concepts Health Net of California and Oregon Health Network One Health Network Solutions (HNS) - Absolute Total Care SC Health Network Solutions (HNS) - BCBS NC Health Network Solutions (HNS) - CIGNA NC Health Network Solutions (HNS) - CIGNA SC Health Network Solutions (HNS) - HealthSpring NC Health Network Solutions (HNS) - HealthSpring SC Health Network Solutions (HNS) - MedCost NC Health Network Solutions (HNS) - MedCost SC Health Network Solutions (HNS) - Select Health SC Health Network Solutions (HNS) HealthTeam Advantage NC Health Network Solutions (HNS) WellCare SC Health New England Health Partners PA Health Payment Systems Inc	HEALTHSMART MYDECISION HealthSmart Preferred Care Inc Healthsource GA CIGNA Healthsource KY Healthsource OH Healthsource TN CIGNA HealthSpring HMO Medicare Choice HealthSun Health Plans Healthteam Advantage Healthy Blue Dual Advantage Healthy Blue LA Healthy Blue Missouri Healthy Blue Nebraska Healthy Blue North Carolina Healthy Blue South Carolina Healthy York Network Heartland Express Heartland Health and Wellness Fund HEB Grocery Company, LP Help At Home Holdings Hemet Community Medical Group (HCMG) Hemet Unified School District (CA) Hennepin Health Hereford Insurance Hereford ISD Heritage Group Heritage IPA Heritage Victor Valley Medical Group Hewittt Coleman HFN Inc HHH Medicare J15 HHH Medicare J6 - CA HHH Medicare JM HHS National Disaster Medical System-Apprio HI Blue Cross HI Medicaid HI Medicare Part A HI Medicare Part B High Desert Medical Group (Regal) Highmark BCBSDE Health Options Inc Highmark Health Options West Virginia Highmark New York, Inc Highmark Senior Health PA	LA Medicare Part B LACH HealthNet by MedPOINT Lake Area Community Health Plans (VHS) Lakeside Medical Group Lakeside Medical Group (Regal Lakeside) Lakewood IPA Lancaster General Health Group Landin Inc. Landmark Healthcare Inc Landry's Landstar Bco Wc Program Lane County (Or) Las Vegas Firefighters Health LaSalle Medical Associates Lasso Healthcare MSA Lasso Healthcare MSA Lawndale Christian Health Center LBA Health Plans LCTA Workers' Comp (Louisiana Commerce & Trade Association) League of Minnesota Cities Insurance Trust LEON HEALTH PLANS Leon Medical Center Health Plan LFP Corporation Liberty Advantage Liberty Health Share Liberty Mutual Liberty Mutual Insurance Liberty Union Life Benefit Plan LIFE Pittsburgh Life Trac LifeShield National Insurance Lifewise OR Lifewise WA LifeWorks Advantage Limited Benefit Group Supplemental Lincoln Heritage (Medicare Supplement) Line Construction Benefit Fund Lineage Logistics Holdings, LLC LineCo Link Snacks (Jacks Links) Little Caesars Of San Antonio, Inc. Little Company of Mary
Michigan Commercial Ins. Mutual (MCIM) Michigan Millers Mutual Mid America Benefits Midlands Choice Inc Midwest Drywall (Except CA, NM, NV) Midwest Family Mutual Midwest Family Mutual Insurance Co (Work Comp Only) Midwest Health Partners Midwest Health Plan Midwest Insurance Midwest Operating Engineers, Fringe Benefit Fund Midwestern Insurance Alliance Millard Refrigerated Mills Peninsula Medical Group (SPS - Sutter) Mirra Health Care, LLC Mission St Joseph Heritage Healt Mississippi Physicians Care Network Missoula County Medical Benefits Mitchell Energy & Devel Mitsui Sumitomo Insurance Group - Toyota Claims Only Mitsui Sumitomo Insurance USA Inc. - Toyota Claim Only MMIC MMSI MN BCBS MN BCBS - Blue Plus Medicaid MN BCBS - BlueRide Transportation MN Blue Medicare Advantage MN Insurance Guarantee Association MN Medicaid MN Medicare Part A MN Medicare Part B MN-Department of Labor MO BCBS MO Medicaid MO Medicare Part A MO Medicare Part B Moda Health MOE Funds Molina Complete Care of Arizona Molina Complete Care of Virginia Molina Healthcare of CALIFORNIA Molina Healthcare of California (Encounters Only)	NH Medicare Part B NH/VT Medicare Part A NHBCAUX NHC Advantage Niagara Bottling, LLC Nike, Inc Nippon Life Insurance Company of America NJ BCBS NJ Medicaid NJ Medicare Part A NJ Medicare Part B NJ Property-Liability Insurance Guaranty Assoc. (NJPLIGA) NM BCBS NM BCBS - Community Centennial NM Medicaid NM Medicare Part A NM Medicare Part B Nonprofit Insurance Trust Nordstrom, Inc. North American Insurance Company d/b/a Oxford Life North American Medical Management California, Inc. North American Risk Services (NARS) North Bay Schools Insurance Authority (NBSIA) North Carolina Farm Bureau North Carolina Guarantee Insurance Association North Dakota Workforce Safety and Insurance (CARISK) North East Independent School District (NEISD) North Forest Ids North Orange County Community College District North River Insurance Company North Shore LIJ Healthfirst North Star Mutual Insurance Co. Northeast Medical Servces (NEMS) Northern Illinois Health Plan Northern Kentucky University Northern Nevada Trust Fund Northland Auto - AL, CA, FL, GA, IA, KS, MA, MN, MS, MO, NE, NJ, NV, NH, ND, RI, SD, VT Northwell Direct Northwest Administrators Northwest Carpenters Health and Security Trust NORTHWEST COMMUNITY HEALTH PARTNERS Northwest Suburban IPA Illinois Northwestern Medicine Physicians Network	Risk Transfer Technologies, Inc. RISRx RIVER CITY MEDICAL GROUP Riverport Insurance (MN School Board Association) Riverside Medical Clinic RiverSpring Health Plans Rockford Mutual Insurance Company Rocky Mountain Pace ROYAL HEALTH ON BEHALF OF EXTENDED CARE MLTC Royal Neighbors Of America (Medicare Supplement) RSC Insurance Services, Ltd. Rural King Supply, Inc Rush Prudential Health Plans HMO Ryder Services, Inc. S S Healthcare Strategies SA Recycling, LLC Sacramento Regional Transit District-Conflict Safeco Insurance SafeCo Insurance Safety-Kleen Corporation Sagamore Health Network Sage Technologies PBS SAINT MARYS HEALTH PLAN Sally Beauty Holdings, Inc. Salt Lake City Corporation Salus Claims Management LLC (THF/Occusystems) Samaritan Given Samaritan Health Plans Samera Health San Bernardino City Unified School District San Bernardino City Usd San Diego Community College District (CA) San Diego County Medical Services CMS San Diego County Ryan White Care Act San Diego PACE San Diego PACE San Diego/Imperial Schools JPA (CA) San Francisco Health Plan San Francisco Municipal Transportation Agency (SFMTA) - CA Only San Miguel Consolidated FPD Sana Benefits Sandhills Center Sanford Health Plan

My agency submits to NJMMIS using the Fieldworker app. Do we need to make any changes to our process?

No. If your agency in the state of New Jersey is already submitting the claims via the Fieldworker platform, your agency will continue to use the current process, requiring no mandatory changes.

However, it is recommended that to avail all the benefits of the latest RCM solution provided by the Fieldworker, let your agency migrate to the new RCM process.