We believe providers deserve to be paid accurately and on time for the important role they play in their patient’s overall health. We create efficient, streamlined claims submission process to make that happen, and support it all with a strong customer service team that is ready to serve you.
When it comes to processing claims, start by checking the participant’s ABS-issued ID card for instructions. Many PPOs require that claims are submitted directly to the PPO. If not, providers can submit claims to ABS in a number of methods:
Regardless of the method of submission, ABS adheres to:
The following describes the claims submission options available for providers submitting claims to ABS.
ABS’ contracted clearinghouse is RelayHealth. Claims can be processed directly through RelayHealth’s Connectivity Services to ABS. For additional information in establishing a link between your office and RelayHealth you can contact them at
1-800-527-8133, Option 2
The easiest and quickest way to submit your claims to ABS is to setup a link directly with our contracted clearinghouse-RelayHealth. If you have a current agreement with another clearinghouse, however, you can still utilize their services provided they either have an established relationship with RelayHealth or be able to push your files to another clearinghouse that does have a relationship with RelayHealth. It is possible to have two or more clearinghouses linked where one has a relationship with another, who has a relationship with RelayHealth.
To determine if your clearinghouse has a relationship with RelayHealth please contact RelayHealth at the telephone number listed above or your own clearinghouse.
ABS has a direct portal connection through the RelayHealth PCS Portal. The portal is administered by RelayHealth, but is a direct link to ABS. We recommend that trading partners transmitting claim volumes larger than 200 claims daily utilize the PCS Portal. Partners that wish to use the portal should contact ABS – EDI Support.
ABS has the capability to either host a FTP or connect to a client-hosted FTP site. While we have the ability to support this method, it is not recommended to utilize this approach because of the additional features offered through utilizing a clearinghouse. If you choose this method, you must contact ABS EDI Support so that we can implement the proper protocols to support your FTP needs.
ABS also accepts and processes claims provided to us in a paper form. ABS accepts claims in UB-92 (institutional) and CMS-1500 (professional) forms. The submission of claims in paper form is not recommended due to the higher error ratio associated with incorrect, missing or unreadable characters. Providers whose only option is to provide paper claims can arrange such submission by contacting ABS.
ABS is committed to making your claim payment process as easy and error free as possible. Once we determine the preferred method of data communication the next step is to verify and test the process.
We have a comprehensive implementation and testing plan and Guide, which will include everything you need for submitting claims to ABS as well as information on the electronic acknowledgment process.
ABS allows the option for providers to receive their Explanations of Benefits (EOBs) in either electronic (EDI X12) or paper form.
Paper EOBs are provided automatically with each claim. Providers wishing to receive electronic EOBs, however, will need to arrange for that service by contacting Emdeon to arrange for electronic delivery:
One Century Place
26 Century Blvd, Suite 601
Nashville, TN 37214
Email: ABS EDI Support
Please refer to the claims submission address on the member ID card.