Request Health Coverage Proposal

If you want a marketing report/proposal, the following elements for each report are required to fulfill the request.

Accessibility Report

Data must be in MS Excel format

  • Zip codes of employees (from census)
  • Access standards from the client

Sample format

Disruption Analysis

Data must be in MS Excel format

  • TIN#'s
  • Providers' names (please separate the first and last names)
  • Providers' addresses (street, city, state and zip)

Sample format

Claims Repricing

  • Claim Type (HCFA/UB) * (Required)
  • Bill Type (for institutional claims)
  • Provider TIN
  • Provider Organization Name
  • Rendering Provider Last Name (for Professional claims)
  • Rendering Provider First Name (for Professional Claims and must be in separate column from Last Name)
  • Provider Address
  • Provider City
  • Provider State
  • Provider Zip
  • Number of Days for Service (required for inpatient institutional claims)
  • Place of service (required for Professional Claims)
  • Revenue Code (for institutional claims)
  • HCPCS Code (required for professional claims and if present on institutional claims)
  • DRG Number
  • Units of Service
  • Charges
  • Allowed Amount (required for WC)
  • Modifier (if present on the claim)
  • No punctuation in headers
  • Excel Format (dates should be expressed as MM/DD/YYYY)
  • Although it is not required, it would be helpful to have both service and billing addresses for providers so we can determine the best and most accurate provider match

HFN Turn-Around Times

  • Accessibility Reports: 3 business days
  • Disruption Analysis: 3 to 5 business days
  • Average Discounts: 3 business days
  • Hospital Listings: 3 business days
  • RFP's or RFI's: 10 to 14 business days

All requests may be submitted to Account Management.

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