We want to make sure you have a smooth and pleasant experience, so we are simplifying our Claims process when submitting expenses. We get questions from members about how to file claims/expense receipts, so we’ve included some information below.
All claims’ receipts and invoices are to be forwarded to: email@example.com.
To protect your Personal Health Information (PHI) privacy, HIPPA requires all information must be sent in a PDF file format. You should have received the Expense Tracker form from us. If you don’t have one or choose not to use it, that is ok. Just remember to include the following information when submitting any receipt to the Claims department.
- Name of the member on the receipt
- For an individual plus one, or family, identify the specific member/s for whom the receipts belong
- Date of service
- Receipt/Invoice is readable
- All receipts/invoices must be submitted within 30 days from the date of receipt/invoice
Please note the following requirements when submitting for laboratory (lab) claims.
- When submitting a claim that is the members’ expense, each claim will need to be accompanied by a provider order.
- If the lab procedure is over $400, the member will need to get a PAR (Pre-Authorization) with medical, homeopathic, or chiropractic service provider orders and a letter of medical necessity. A PAR form can be attained from your Nova Care Advocate at firstname.lastname@example.org or by phone (888)-266/4462 ext. 1003. Or can be sent directly to your service provider.
- When sending in claims for labs, you must have a CPT (Current Procedure Terminology) code. The CPT will be given to you by the provider when referring for lab workups.
- Nova is an open network. Therefore, members can choose laboratories that are convenient for them. However, Nova Pathfinder Healthcare does not cover any cost associated with travel to the selected service provider.
For your convenience, please have the lab submit the bill directly to email@example.com, mail to: Nova Pathfinder Limited 5739 Kanan Rd, Suite 336 Agoura, CA 91301 or Fax to: (805)-375-6090