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Claims and Billing Procedures

Important Notice: As of October 1, 2017, the MedStar Family Choice contract to provide Medicaid services to residents in the District of Columbia has ended. Learn more >

Claims must be submitted on a CMS-1500 or UB04 form as appropriate. Claims must be submitted within 180 days from the date of service. MedStar Family Choice claims should be sent to the following address:

MedStar Family Choice
Claims Processing Center
5233 King Ave., Suite 400
Baltimore, MD 21237
Phone: 800-261-3371

Tips

  • Providers have 180 days from the date of a payment retraction to submit a clean and corrected claim for processing. Providers do not have to file a claims appeal for an administrative denial issue if they are within their 180 day timely filing period; a new corrected claim should be resubmitted in this situation.
  • It is important to clearly mark a corrected claim with "corrected claim" boldly and written on the claim.
  • For institutional UB04 claims, the first submission of the claim should never have a bill type XX7. (replacement claim).
  • It is critical for UB04 claims to have CPT/HCPCS codes and units documented, as appropriate.
Information current as of: 10/09/17