Medical Provider Claims: Frequently Asked Questions
Here are some of the commonly asked questions we receive from healthcare providers about the claims submission process.
- What information do I need to submit a claim?
- How do I submit a claim to PAN?
- What if I have questions about submitting a claim?
- How can I submit more than one claim?
- How long does it take for a claim to be processed?
- What are the payment methods for claims?
- How do I check claims and payment status?
- How can I receive faster claim payment?
- My claim was denied. What should I do?
- When I resubmitted my claim with all the required information, it was denied and marked as a “duplicate claim.” What should I do?
- Where can I find a listing of covered diagnosis codes?
- Where should refunds be mailed?
- What if I have questions about the PAN Provider Portal?
» Billing ID Number, which contains numerals only, and can be found on the patient’s PAN welcome letter.
» Group Number, which can be found on the patient’s PAN welcome letter.
» Claim form (HCFA-1500, UB-04 or UB-92). Click here for a list of required fields on the claim form.
Note: Providers must submit the actual claim form. Copies of electronic forms will not be accepted.
» Supporting documentation
» Primary and secondary explanation of benefits, as applicable.
» W-9 (required annually with your practice’s first claim of the year).
Note: PAN’s Direct Member Reimbursement (DMR) forms are for member reimbursement only.
You can submit claims electronically through your billing system, or by fax or mail using the contact information below:
» Electronic: Payer ID 38225 (Payer ID is tied to NGS American)
» Fax: (844) 726-4728
» Mail: PAN Foundation
PO Box 2310
Mt. Clemens, MI 48046
Electronic claims must be submitted one at a time. To fax or mail more than one claim, please complete and include the PAN Medical Claim Fax Cover Sheet between every individual medical claim.
The standard processing time for complete claims is 10 to 14 business days. Claims are processed on a first-come, first-served basis. Please keep in mind that any missing information may lead to delays in claim processing time.
There are three payment options for providers: QuicRemit virtual credit cards, ACH transfers or paper checks. QuicRemit virtual credit cards are the default payment method. All direct member reimbursement claims are paid by check only.
There are two ways to check claims and payment status:
» View payment details through the PAN Provider Portal at providerportal.panfoundation.org
» Call PAN at 866-316-7263, Monday through Friday, 9 a.m. to 7 p.m. ET.
For faster payment, we recommend submitting claims electronically. Electronic claim submission ensures that claims are complete, and reduces the turnaround time by two business days.
Want to sign up for electronic claim submission? Contact your billing vendor for more information.
If your claim was denied, it will be returned to you along with a letter indicating the reason for denial. You can also check the provider remittance for the claim denial reason. If additional information is required or you would like the claim to be reconsidered, please resubmit the claim with both the original documents and updated information.
10. When I resubmitted my claim with all the required information, it was denied and marked as a “duplicate claim.” What should I do?
If you are resubmitting a claim with all the required information, be sure to write “Corrected Claim” at the top of the claim form so the PAN team knows that new information has been added.
If you have questions about the PAN Provider Portal, please contact PAN at 866-316-7263, Monday through Friday, from 9 a.m. to 7 p.m. ET.