Medical Claims Submission
VHP must receive claims and encounter data from contracted providers within ninety (90) days from the date of service. VHP has 45 working days from the date of receipt to reimburse, contest, or deny a claim.
All paper claims for covered services provided to eligible Members must be submitted on CMS 1500 Form (for all professional services, durable medical equipment (DME) and supplies and Laboratory Services) or on UB 04 Form (for all institutional facility charges inpatient/outpatient). All claim forms and claim-related documents, and disputes, must be signed and dated by the provider or a designee.
Claims must be sent to the appropriate address listed below.
Electronic Medical Claims Submission
You can electronically submit VHP Employer Group, Covered California, and Individual and Family Plan claims through VHP’s clearinghouse, Utah Health Information Network (UHIN). Please have your clearinghouse contact UHIN directly for set-up: