Providers

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Submitting Claims

The Senior Whole Health Claims Operations contact information is:

Senior Whole Health
Claims Operations
P.O. Box 425027
Cambridge, MA 02142

Claims E-Fax: (617) 812-7859
Claims Fax: (617) 252-6339
Claims Inquiry: (866) 211-1777
EDI Technical Assistance: (617) 551-4155

Mail paper claims to:

Senior Whole Health
ATTN: Claims Department
P.O. Box 425027
Cambridge, MA 02142

Electronic Claims Information:

SWH accepts EDI claims submission for CMS 1500, CMS 1450 (UB-04) and UB92 claims forms in standard 837 format.

Any provider who bills using the standard 837 format can submit claims electronically to SWH's payor ID 83035. Providers can submit claims using any electronic clearinghouse or claims service.

For more information on submitting claims electronically, please call EDI technical assistance at 617-551-4155.

Claim submission requirements:

  • Provider number
  • Date of service
  • Place of service
  • Procedure code
  • Diagnosis code
  • Units
  • Charge
  • Referral/authorization number
  • NPI in Box 33 and wherever else applicable
  • Box 31 must contain the name or signature of the physician or supplier with a date

Last modified: 09/15/2010