Property & Casualty Claims - eBilling Overview
P & C Claims - Electronic Billing Overview
(For Workers' Compensation, click here.)
Property and Casualty (P&C) is the broad term given to Liability, Auto Medical Payment Coverage, Auto No-Fault, Homeowners, Worker’s Compensation, Boat, RV, ATV, etc. lines of business. Many P&C policies carry a medical expense reimbursement benefit as part of the coverage.
Unlike Health Plans, Member ID’s/Policy Numbers do not necessarily identify the Covered Persons, since even strangers to the policy (e.g. passengers in the vehicle, customers, and visitors) may be eligible to receive medical expense reimbursement coverage under a P&C policy. While customers may sometimes provide a policy number at the time of service, a Claim Number is the identifier that ties the policy to a covered event.
The inclusion of the Property and Casualty Claim Number is the preferred value to be sent in electronic medical bills. If the Property and Casualty Claim Number is not available, then the inclusion of the State Farm policy number covering the injury along with the date of accident should be sent.
State Farm® Property and Casualty receives the electronic medical bills in the ASC X12N 837 formats mandated by the states which mirror or build upon the HIPAA mandates. This is also true for the non-mandated states. Please refer to the Claim Professional/Institutional/Dental (837) page for additional information on the accepted electronic medical billing formats.
As it relates to electronic billing, the terms “Claim” and “Bill” are sometimes used interchangeably. The ASC X12N electronic billing format is called a Health Care Claim. As a result, the electronic billing format is commonly referred to as a claim. The paper claim formats (e.g. CMS1500, UB04) are most commonly referred to as bills for Property and Casualty.
Electronic Medical Bill Attachments
State Farm® Property and Casualty has the ability to receive electronic medical bill attachments in the ASC X12N 275 format. For details regarding the submission of electronic medical bill attachments, refer to the Additional Information to Support a Health Care Claim or Encounter (275) page for more information.
P & C Claims - Payment Remittance Overview
Access to and/or delivery of payment remittance information depends on the method of payment (electronic, paper) and the method of billing (electronic, paper) that has been used.
Mandated States - Minnesota domiciled providers
Subject to the Minnesota Statutes that require electronic medical billing, the Electronic Remittance Advice (ANSI X12 835 transaction) is available to those MN domiciled providers who bill electronically. A paper Explanation of Review (EOR) is generally not sent, however it is available upon request from the office that generated the payment. A paper EOR may be sent in addition to the 835 when electronic adjustment reasons are insufficient, incomplete, or unavailable.
Minnesota domiciled providers who send paper bills will receive a paper EOR and a paper draft if a payment is made and the provider has not enrolled for Electronic Funds Transfer (EFT).
For State Farm® Property and Casualty, there is no enrollment process necessary to receive electronic payment remittances. Enrollment is only required for EFT payments. Please refer to the Electronic Funds Transfer page for additional information.
When the provider has enrolled for Electronic Funds Transfer (EFT), a copy of the Explanation of Review (EOR) information is made available through the State Farm® B2B website.
State Farm® Property and Casualty does not currently create the Electronic Remittance Advice (ANSI X12 835 transaction) for non-mandated states.
When the provider has enrolled for Electronic Funds Transfer (EFT), Explanation of Review (EOR) information can be accessed through the State Farm® B2B website. A paper EOR is not sent but is available upon request from the office that generated the payment.
When the provider has not enrolled for EFT, a paper EOR is sent. Payment, when applicable, is issued in the form of a paper draft.
Property & Casualty Electronic Funds Transfer
(For Workers' Compensation, click here.)
Electronic Funds Transfer (EFT) is available after initial registration for access to the B2B website and enrollment for EFT have been completed. Providers can submit a Contact Us form or contact the B2B Help Desk at 855-311-2681 for assistance with initial registration for access to the B2B website and EFT enrollment. Providers can also work with the appropriate State Farm® Claim Office for assistance with initiating the EFT enrollment. Once EFT enrolled, the provider will also have access to an EFT Summary on the B2B website.
In order to complete the registration/enrollment for EFT, either a submit a Contact Us form or contact the B2B Help Desk.
Contact Us form
- When filling out the form, make sure to select the Electronic Funds Transfer Payment/Forms option in the Reason for contact field.
- For Medical Providers, if you plan to enroll for EFT using the National Provider Identifier (NPI), then please include the value on the Contact Us form.
- Once you have submitted the form, you will be contacted by a State Farm representative.
B2B Help Desk (855-311-2861)
- Indicate if you are currently registered (already have a logon id and password assigned)
- Have the following information available
- Business Name
- Business Address
- Contact Name
- Contact Phone Number
- Contact Email Address
- Tax Identification Number and/or National Provider Identifier (medical providers only)
Clearinghouse/Payer ID Information
State Farm® utilizes UHIN as our gateway for receiving and processing electronic medical bills and attachments.
If you are already exchanging electronic health care claim transactions with another clearinghouse, they may be able to route your electronic health care claim transactions to State Farm® via UHIN. Providers and Electronic Data Interchange (EDI) clearinghouses can contact UHIN for information on how to create the connection.
If you are not currently exchanging electronic health care transactions, you may contract with any clearinghouse of your choice. However, they must connect with UHIN in order to submit electronic medical bills/attachments to State Farm®.
Note: Submitting electronic bills/attachments to State Farm using an incorrect routing path may result in the bill being rejected, denied, or delayed.
Contact UHIN at 877-693-3071 for enrollment/connection information. The State Farm® UHIN Trading Partner number is: HT005054-001. The State Farm® UHIN Payer ID is 31059.
Below is a list of the known State Farm® Payer ID’s established and used by Intermediary Clearinghouses that connect with UHIN. This is not an all-inclusive list.
|State Farm Payer ID
|State Farm Payer ID
|The SSI Group||31059|
Some billing software uses descriptive company names instead of Payer IDs. Examples of such entries for State Farm are:
- State Farm Property and Casualty
- State Farm Workers’ Comp
- State Farm Auto
If you are unsure about which Payer Id or labeled option to select for routing bills/attachments to State Farm electronically, contact your Clearinghouse or billing software vendor for instructions. If necessary, have your Clearinghouse or billing software vendor contact the State Farm Electronic P&C Billing Support Team at email@example.com for further information.
Obtaining a Property & Casualty Claim Number
Sending the assigned Property and Casualty Claim Number in electronic medical bills is the best way to ensure the bills are associated to the claim.
To obtain the Property and Casualty Claim Number, you can contact the patient or call the patient’s State Farm® claim representative.
Submitting the Property & Casualty Claim Number in an Electronic Health Care Claim Transaction
For State Farm®, the data length of a claim number is typically 9 characters (some claim numbers could be 7 characters if a policy state has not yet been assigned).
In an electronic health care claim transaction, the P&C Claim Number is required to be mapped to the Property and Casualty Claim Number REF segment using the reference qualifier of Y4 at either the Subscriber Loop (2010BA) or at the Patient loop (2010CA). For electronic bills, the P&C Claim Number can be mapped to the either the Subscriber or Patient Loop Property and Casualty Claim Number REF segment.
Contact your billing software vendor to help you determine where to key-in the P&C Claim Number so that it is mapped to the proper location in the electronic health care claim transaction.
The National Uniform Claim Committee (NUCC) instructions indicate that the P&C Claims Claim Number should be entered in Box 11b of the CMS1500 form. This value should then map to the proper field in the electronic health care claim transaction. However, we have noticed that some billing software applications map Box 1a to the P&C Claim Number. You may need to check with your billing software support to ensure your bill routes appropriately.