Electronic Billing Overview

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.