Provider Online Services and EDI Information
access|RMHP is a Web-based service that participating providers can use to access eligibility, claims status and much more. access|RMHP provides:
Register for access|RMHP now
- Free and secure access 24/7. Except for scheduled maintenance (access|RMHP may be intermittently unavailable on Thursday nights between 10:00 p.m. - 12:00 p.m. for scheduled maintenance)
- A HIPAA-compliant application
- Eligibility and benefits verifications, including copays and deductibles
- Claim summary, detail and status
- Ability to check authorizations
- Ability to search participating providers
Electronic Data Interchange (EDI)
Our EDI system allows providers to submit claims, retrieve remittance advice and claim file acknowledgements from the insurance carrier or clearinghouse.
Rocky Mountain Health Plans promotes fast claims turnaround by accepting electronic claims submission directly from provider offices as well as from many clearinghouses.
To enroll in electronic claims submission to RMHP:
1) Download and complete the Electronic Data Interchange Transaction Request Form.
2) Email the completed form to email@example.com or fax it to 970-244-7880; Attention: IT/EDI.
If you wish to submit electronic claims directly from your office or if your clearinghouse does not currently interact with RMHP, you will need the data specifications provided in the Electronic Data Interchange Companion Document.
3) Once set-up is complete, an EDI representative from RMHP will contact you. If you use a clearinghouse, the payor ID will be provided once enrollment is complete.
If you have questions about electronic claims submission, please contact our EDI representative at 970-244-7893 or firstname.lastname@example.org.
The following preferred clearinghouses currently send electronic claims data to Rocky Mountain Health Plans. This is not an all-inclusive list:
- Cortex EDI
- Healthcare Administration Technologies, Inc
- McKesson (Also known as Relay Health)
- NDCHealth (Also known as Relay Health)
- Practice Insight
- QuadraMed (Also known as Health Fusion)
- The SSI Group
- ViaTrack Systems