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. Most 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) can receive medical expense reimbursement coverage under a P&C policy. The P&C Automobile Insurance Card identifies the Insured and the covered vehicle. The policy number is rarely identified at the time of the claim submission. Instead, the P&C claim number, which is used to tie the expense to a covered event, is the key to identifying the patient.

The Property and Casualty Claim Number is required for electronic medical bills that are associated to State Farm® Property and Casualty lines of coverage, except for a handful of Worker's Compensation Jurisdictions which allow the value of "UNKNOWN" if the P&C Claim Number is unavailable.

State Farm Property and Casualty receives electronic medical bills per the various state mandates. In addition, State Farm Property and Casualty voluntarily receives electronic medical bills for the other non-mandated states.

At this time Property and Casualty lines of business are not Covered Entities under the Health Insurance Portability and Accountably Act (HIPAA) and Patient Protection and Affordable Care Act (PPACA). State Farm Property and Casualty does receive 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 billing formats are most commonly referred to as bills.