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Enrollment in the Health Benefits for Immigrant Adults (HBIA) program will be temporarily paused effective July 1, 2023.

Enrollment in the Health Benefits for Immigrant Seniors (HBIS) program will be temporarily paused effective Nov. 6, 2023.

Elizabeth M. Whitehorn, Director

Managed Care Billing/Payment Issues

Billing and payment issues for patients enrolled in MCOs should be addressed as follows:

If the provider is in the network, the provider should work with the MCO.

If the provider is not in the network:

  • The provider should bill the participant's site.
  • The provider can obtain information on the participant's site by calling the MCO Member Services number or by calling the department's Provider Eligibility Inquiry Hotline at 1-800-842-1461. This number will be answered by the Automated Voice Response System. The provider should select the option to speak to a Provider Hotline representative.
  • If the site rejects the claim, the provider should bill the MCO and include a copy of the rejection from the site.
  • If the provider is not satisfied with the resolution of the claim by the MCO, the provider should file a grievance using the MCO's provider grievance process.