• All claims must be for authorized services to be considered for payment.
• The authorized service must be provided during the approved authorization period. If services are delayed and fall outside the authorization period, a new authorization request must be submitted prior to the completion of services.
• CPT codes submitted on the claim must match what has been authorized. I.
• Ryan White Program’s generally have a contract period with defined end dates that must coincide with claims submission.  Based on county and/or grant specifics, AHF will alert providers annually via written notice of this deadline and the final date of which claims can be submitted for the coinciding contract year. For example, the 2022 contract year ends on February 28^th, 2023. Claims with a date of service between March  1^st, 2022 thru February 28, 2023   must be submitted no later than March 31^st, 2023.
• Claims received outside of the submission timeframe will be denied and not considered for reimbursement; unless valid proof of timely filing is submitted.

Electronic claims:

Electronic submission of claims is required to ensure accurate and timely payments. Claims may be submitted electronically through any clearinghouse. The Payer ID is 95433.  Dental claims should be submitted to Payer ID 95411.

The claim must include the following:

• Patient Name
• Place of Service
• Date of Service
• Patient Address
• Physician Name
• Billed Charges
• Patient Date of Birth
• NPI Number
• CPT Code(s)
• Patient Insurance Name
• Provider License Number
• Applicable ICD Codes
• AHF Patient ID Number
• Tax ID Number
• HCPCS Codes

For claims status, contact the Claims Department at claims@positivehealthcare.org or (888) 662- 0626.

Paper claims:

Providers may submit claims via paper. Authorized specialty services provided to program-eligible clients by network providers must be sent to the following address:

AIDS Healthcare Foundation

Attn: Claims

P.O. Box 472377

Aurora, CO 80047

All paper claims must be received at the address above prior to the County contract year end date with AHF. Claims must be submitted on a properly completed CMS1500, UB92, or UB04 claim form

Electronic Payment Methods via Change Healthcare

Ryan White Specialty Pools Program partnered with Change Healthcare and Echo Health, Inc to provide the following new electronic payment methods.

• Virtual Card Services:
• EFT Payments: To sign up for EFT, through Settlement Advocate for AHF only, visit;

https://enrollments.echohealthinc.com/EFTERADirect/AIDShealthcarefoundation/   No Fees apply.

• Medical Payment Exchange (MPX): If you are not enrolled with us to receive payments via electronic funds transfer (EFT) and you opt-out of virtual card, and have enrolled for MPX with another payer, you will continue to receive your payments in your MPX portal account.  Otherwise, you will receive a paper check via print and mail. (County Specific)
• Paper Check: To receive paper checks and paper explanation of payments (EOP), you must opt out of the Virtual Card Services by visiting; https://echovcards.com/letter. To access this site, use your Tax ID and verification access. New providers will not have a client ID/verification access but can contact ECHO directly for assistance.

835 Electronic Remittance Advice (ERA): 

• Providers who enroll for EFT payments will continue to receive the associated ERAs from ECHO with the Change Healthcare Payer ID. If you have not already, please make sure that your Practice Management System is updated to accept the Change Healthcare Payer ID: 95433 for Ryan White programs. All generated ERAs will be accessible to download from the ECHO provider portal (providerpayments.com).
• Changes to the ERA enrollment or ERA distribution can be made by contacting the ECHO Health Enrollment team at (440) 835-3511.
• In addition, we want to make you aware of another enhancement. You can now log into providerpayments.com to access a detailed explanation of payment for each transaction. 
• If you have any difficulty with the website or have additional questions, please call Echo Healthcare, Inc at (800) 886-5918. You can also reach out to your Provider Relations team for assistance.