Please follow the Enrollment Instructions to become an electronic submitter for Value Options.

Required Documents for those applying for new Submitter IDs

The following documents are required enrollment documents that must be completed, signed and returned to the Value Options office prior to initiation of electronic claims submission or inquiry.

1. ProviderConnect Online Services Account Request
2. Online Provider Services Intermediary Authorization Form (For Providers using Billing Services ONLY)

If the links listed above to now work properly, you may access these forms here:
www.beaconhealthoptions.com

If you have any questions regarding any of the documents in this package, please call the Value Options EDI Technology Support Center at (888) 247-9311.

We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.

Online Provider Services Account Request Form

• Please enter your Business or Provider name

• Enter your Beacon Health Options Provider Number and NPI #

• Enter your TAX ID

• Complete your demographic and contact information

• Please select “Electronic Batch Claims Submission (837)", "277CA Claim Acknowledgement File" and "999 Acknowledgement File"

• If you are using a Billing Service, please select “Yes” and complete the "Billing Intermediary Authorization Form”

• Please select the type of claims you will be submitting

• Enter your contact name and E-mail address

• Please select if you are the provider or office staff then complete the signature section

Online Provider Services Intermediary Authorization Form

(This form is to authorize a third party/billing service to submit claims and receive responses on behalf of a provider. If you are not using a Billing Service you may skip this form)

• Enter the Billing Services Name, Submitter ID (if applicable) and Contact information

• On the right, Enter Your (Providers) Name, NPI and Beacon Health Options Provider ID number

• Please select “Batch Claim Submission & Claim Adjustment”

• Have the Billing Services Representative sign and date the left

• The Provider or Provider’s authorized staff must sign and date the right

Submitting your Forms

It is recommended that you keep a copy of all the forms you will be submitting for your records. Fax the completed forms to:

1-866-698-6032

It is very important that you complete and return the entire enrollment packet as described above. Incomplete packets will not be processed and will be returned to the submitter.

Waiting for a Response

Once the complete provider enrollment packet has been received, the documents will be processed. Processing will take approximately two weeks from the date of receipt

After processing, a confirmation will be emailed to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact the Technology Support Center toll-free at (888) 247-9311.

Testing

Once you have received your Submitter ID and password from Value Options, please call the Claimshuttle Support Team at 602-439-2525 and set an appointment for assistance with the Mailbox setup and your first batch of claims submission.