{"id":189,"date":"2022-10-05T09:30:40","date_gmt":"2022-10-05T16:30:40","guid":{"rendered":"https:\/\/goldenbayhp.wpengine.com\/?page_id=189"},"modified":"2023-12-21T19:47:48","modified_gmt":"2023-12-22T03:47:48","slug":"claims","status":"publish","type":"page","link":"https:\/\/gbhp.org\/es\/for-providers\/claims\/","title":{"rendered":"Reclamos"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;border-width: 0px 0px 0px 0px;border-color:var(--awb-color3);border-style:solid;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-1\"><p><strong>Plan de salud de Golden Bay<\/strong> Los delegados reclaman el procesamiento de pagos a <strong>Organizaci\u00f3n de servicios de gesti\u00f3n de servicios m\u00e9dicos del noreste<\/strong> (NEMS MSO). NEMS MSO acepta reclamos enviados electr\u00f3nicamente o en papel por correo.<\/p>\n<h5>Presentaci\u00f3n de reclamaciones EDI<\/h5>\n<p>Las reclamaciones EDI pueden enviarse electr\u00f3nicamente utilizando una de las c\u00e1maras de compensaci\u00f3n asociadas de NEMS MSO.<\/p>\n<\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-0 fusion_builder_column_inner_1_6 1_6 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-nested-column-0{width:16.6666666667% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-nested-column-0 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 11.52%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 11.52%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-nested-column-0{width:16.6666666667% !important;order : 0;}.fusion-builder-nested-column-0 > .fusion-column-wrapper {margin-right : 11.52%;margin-left : 11.52%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-nested-column-0{width:100% !important;order : 0;}.fusion-builder-nested-column-0 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-1 fusion_builder_column_inner_1_2 1_2 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\">\n<div class=\"table-2\">\n<table width=\"100%\">\n<thead>\n<tr>\n<th align=\"left\">C\u00e1mara de compensaci\u00f3n<\/th>\n<th style=\"text-align: center;\" align=\"left\">Identificaci\u00f3n del pagador<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td align=\"left\">Reclamaci\u00f3nRemedi<br \/>\nSalud Experian<br \/>\nSoluciones electr\u00f3nicas, Inc.<br \/>\nnThrive, Inc.<br \/>\nSoluciones para proveedores Trizetto, LLC<br \/>\nV\u00eda Track<br \/>\nEstrella del camino<br \/>\nCompa\u00f1\u00eda ZirMed, Inc.<\/td>\n<td style=\"text-align: center;\" align=\"left\">GBHP<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">Oficina Aliada, Inc.<\/td>\n<td style=\"text-align: center;\" align=\"left\">GBHP1<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div><style type=\"text\/css\">.fusion-body .fusion-builder-nested-column-1{width:50% !important;margin-top : 0px;margin-bottom : 0px;}.fusion-builder-nested-column-1 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 3.84%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 3.84%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-nested-column-1{width:50% !important;order : 0;}.fusion-builder-nested-column-1 > .fusion-column-wrapper {margin-right : 3.84%;margin-left : 3.84%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-nested-column-1{width:100% !important;order : 0;}.fusion-builder-nested-column-1 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-2 fusion_builder_column_inner_1_4 1_4 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-nested-column-2{width:25% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-nested-column-2 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 7.68%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 7.68%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-nested-column-2{width:25% !important;order : 0;}.fusion-builder-nested-column-2 > .fusion-column-wrapper {margin-right : 7.68%;margin-left : 7.68%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-nested-column-2{width:100% !important;order : 0;}.fusion-builder-nested-column-2 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><\/div><div class=\"fusion-text fusion-text-2\" style=\"margin-top:20px;\"><p>Para consultar sobre c\u00e1maras de compensaci\u00f3n que no est\u00e1n en la lista, comun\u00edquese con Relaciones con proveedores de MSO de NEMS al <a href=\"mailto:Provider.Relations@nems.org\"><strong>Proveedor.Relaciones@nems.org<\/strong><\/a>.<\/p>\n<p>Las siguientes gu\u00edas complementarias pueden servir de referencia para la implementaci\u00f3n de transacciones de reclamaciones electr\u00f3nicas profesionales e institucionales 837:<\/p>\n<ul>\n<li>Profesional - <strong><a href=\"https:\/\/gbhp.org\/wp-content\/uploads\/NEMS-MSO-837P-HIPAA-Companion-Guide.pdf\" target=\"_blank\" rel=\"noopener\">Gu\u00eda complementaria NEMS MSO 837P HIPAA 5010A1<\/a><\/strong><\/li>\n<li>Institucional \u2013 <strong><a href=\"https:\/\/gbhp.org\/wp-content\/uploads\/NEMS-MSO-837I-HIPAA-Companion-Guide.pdf\" target=\"_blank\" rel=\"noopener\">Gu\u00eda complementaria NEMS MSO 837I HIPAA 5010A2<\/a><\/strong><\/li>\n<\/ul>\n<h5>Presentaci\u00f3n de reclamaciones en papel<\/h5>\n<p>Las reclamaciones en papel y cualquier documento de respaldo se pueden enviar por correo a NEMS MSO. Las reclamaciones en papel deben presentarse en los formularios de reclamaci\u00f3n originales actuales y est\u00e1ndar. NEMS MSO no acepta copias de las reclamaciones enviadas por fax.<\/p>\n<h5>Direcci\u00f3n de correo para reclamaciones<\/h5>\n<\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-3 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div ><style>.fusion-imageframe.imageframe-1{ margin-top : 20px;margin-bottom : 20px;}<\/style><span class=\"fusion-imageframe imageframe-none imageframe-1 hover-type-none\"><img decoding=\"async\" width=\"20\" height=\"20\" title=\"espaciador\" src=\"https:\/\/gbhp.org\/wp-content\/uploads\/spacer.png\" alt class=\"img-responsive wp-image-298\"\/><\/span><\/div><div class=\"fusion-content-boxes content-boxes columns row fusion-columns-1 fusion-columns-total-1 fusion-content-boxes-1 content-boxes-icon-boxed content-left\" data-animationoffset=\"top-into-view\" style=\"margin-top:;margin-bottom:0px;\"><style type=\"text\/css\">.fusion-content-boxes-1 .heading .content-box-heading {color:var(--awb-color5);}\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-link-icon-hover .heading .content-box-heading,\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-link-icon-hover .heading .heading-link .content-box-heading,\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-box-hover .heading .content-box-heading,\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-box-hover .heading .heading-link .content-box-heading,\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-link-icon-hover.link-area-box .fusion-read-more,\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-link-icon-hover.link-area-box .fusion-read-more::after,\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-link-icon-hover.link-area-box .fusion-read-more::before,\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .fusion-read-more:hover:after,\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .fusion-read-more:hover:before,\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .fusion-read-more:hover,\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-box-hover.link-area-box .fusion-read-more,\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-box-hover.link-area-box .fusion-read-more::after,\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-box-hover.link-area-box .fusion-read-more::before,\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-link-icon-hover .icon .circle-no,\n\t\t\t\t\t.fusion-content-boxes-1 .heading .heading-link:hover .content-box-heading {\n\t\t\t\t\t\tcolor: var(--awb-color7);\n\t\t\t\t\t}\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-box-hover .icon .circle-no {\n\t\t\t\t\t\tcolor: var(--awb-color7) !important;\n\t\t\t\t\t}.fusion-content-boxes-1 .fusion-content-box-hover .link-area-box.link-area-box-hover .fusion-content-box-button {background: #f5862a;color: var(--awb-color1);}.fusion-content-boxes-1 .fusion-content-box-hover .link-area-box.link-area-box-hover .fusion-content-box-button .fusion-button-text {color: var(--awb-color1);}\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-link-icon-hover .heading .icon > span {\n\t\t\t\t\t\tbackground-color: transparent !important;\n\t\t\t\t\t}\n\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-box-hover .heading .icon > span {\n\t\t\t\t\t\tborder-color: var(--awb-color7) !important;\n\t\t\t\t\t}<\/style><div class=\"fusion-column content-box-column content-box-column content-box-column-1 col-lg-12 col-md-12 col-sm-12 fusion-content-box-hover content-box-column-last content-box-column-last-in-row\"><div class=\"col content-box-wrapper content-wrapper-background content-wrapper-boxed link-area-link-icon content-icon-wrapper-yes icon-hover-animation-slide fusion-animated\" style=\"background-color:var(--awb-color3);\" data-animationtype=\"fadeInLeft\" data-animationduration=\"0.3\" data-animationoffset=\"top-into-view\"><div class=\"heading heading-with-icon icon-left\"><div style=\"margin-left:-30px;top:-80px;\" aria-hidden=\"true\" class=\"image\"><img decoding=\"async\" src=\"https:\/\/goldenbayhp.wpengine.com\/wp-content\/uploads\/NEMS-icon.png\" width=\"60\" height=\"60\" alt=\"\" \/><\/div><h3 class=\"content-box-heading\" style=\"font-size:24px;line-height:29px;\">Reclamaciones de NEMS MSO<\/h3><\/div><div class=\"fusion-clearfix\"><\/div><div class=\"content-container\" style=\"color:var(--awb-color7);\">\n<p>APARTADO DE CORREOS 1548<br \/>\nSan Leandro, CA 94577<\/p>\n<\/div><\/div><\/div><style type=\"text\/css\">\n\t\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .heading-link:hover .icon i.circle-yes,\n\t\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-box:hover .heading-link .icon i.circle-yes,\n\t\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-link-icon-hover .heading .icon i.circle-yes,\n\t\t\t\t\t\t.fusion-content-boxes-1 .fusion-content-box-hover .link-area-box-hover .heading .icon i.circle-yes {\n\t\t\t\t\t\t\tbackground-color: transparent !important;\n\t\t\t\t\t\t\tborder-color: var(--awb-color7) !important;\n\t\t\t\t\t\t}<\/style><div class=\"fusion-clearfix\"><\/div><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-nested-column-3{width:33.3333333333% !important;margin-top : 0px;margin-bottom : 0px;}.fusion-builder-nested-column-3 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 5.76%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 5.76%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-nested-column-3{width:33.3333333333% !important;order : 0;}.fusion-builder-nested-column-3 > .fusion-column-wrapper {margin-right : 5.76%;margin-left : 5.76%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-nested-column-3{width:100% !important;order : 0;}.fusion-builder-nested-column-3 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-4 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-nested-column-4{width:33.3333333333% !important;margin-top : 0px;margin-bottom : 0px;}.fusion-builder-nested-column-4 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 5.76%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 5.76%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-nested-column-4{width:33.3333333333% !important;order : 0;}.fusion-builder-nested-column-4 > .fusion-column-wrapper {margin-right : 5.76%;margin-left : 5.76%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-nested-column-4{width:100% !important;order : 0;}.fusion-builder-nested-column-4 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-5 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-nested-column-5{width:33.3333333333% !important;margin-top : 0px;margin-bottom : 0px;}.fusion-builder-nested-column-5 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 5.76%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 5.76%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-nested-column-5{width:33.3333333333% !important;order : 0;}.fusion-builder-nested-column-5 > .fusion-column-wrapper {margin-right : 5.76%;margin-left : 5.76%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-nested-column-5{width:100% !important;order : 0;}.fusion-builder-nested-column-5 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><\/div><div class=\"fusion-text fusion-text-3 fusion-text-no-margin\" style=\"margin-top:0px;margin-bottom:0px;\"><p>Para obtener m\u00e1s informaci\u00f3n, visite el sitio <a href=\"https:\/\/www.nemsmso.org\/claims-pdr\/\" target=\"_blank\" rel=\"noopener\"><strong>Sitio web de NEMS MSO<\/strong><\/a>.<\/p>\n<\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-0{width:100% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-0 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 1.92%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 1.92%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-0{width:100% !important;order : 0;}.fusion-builder-column-0 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-column-0{width:100% !important;order : 0;}.fusion-builder-column-0 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-flex-container.fusion-builder-row-1{ padding-top : 0px;margin-top : 0px;padding-right : 0px;padding-bottom : 0px;margin-bottom : 0px;padding-left : 0px;}<\/style><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":70,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-189","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/pages\/189","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/comments?post=189"}],"version-history":[{"count":0,"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/pages\/189\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/pages\/70"}],"wp:attachment":[{"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/media?parent=189"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}