How To Submit Claims To Moda Health Plan,

For Moda Health Plan,, the practical claims workflow usually starts with electronic submission guidance and only falls back to paper instructions when the payer documents a mailing address for specific claim types or exceptions. The details below keep the workflow broad instead of reducing it to a single address.

At a glance

• Moda supports electronic and paper claim workflows. Official provider materials identify electronic claim submission through direct EDI connections and clearinghouses, including Availity, Change Healthcare/Emdeon, MCPS, and MD On-Line for the Idaho provider channel, with payor ID 13350 shown for several connections. Moda also accepts mailed claims/correspondence at its Portland P.O. Box address. Specific corrected-claim instructions are not fully standardized in the retrieved official sources, but commercial timely filing guidance ties corrected/reconsideration claims, disputes, and appeals to the Moda EOP date.

Submission channels

• Electronic claim submission via direct EDI
• Electronic submission via clearinghouses
• Paper/mail submission

Electronic claims payer IDs

• 13350

Paper claims addresses

• Moda Health, P.O. Box 40384, Portland, OR 97240-0384

Corrected claims and follow-up

• Commercial provider manual: corrected/reconsideration claims, claim disputes, and appeals are measured from the date of the Moda EOP to the date received by Moda Health.

• Provider materials indicate providers should preserve mailing logs or other proof of submission when filing by mail.

• Claims status resource 1

Caveats

• Electronic submission details vary by product/channel; the clearest payer ID evidence found is in the Idaho provider billing page and EOCCO materials.
• A comprehensive, product-neutral claim submission manual was not located in the retrieved sources.
• Paper claim addresses may vary by line of business; the Portland P.O. Box 40384 address is confirmed for Moda Health correspondence and Medicare Advantage mail claims.

Provider resources

• Medical provider contact us (official)
• Referral and Authorization Guidelines (official)
• Commercial Provider Manual (PDF) (official)
• Medicare Advantage Provider Manual (PDF) (official)
• Provider billing and claims | Moda Health Idaho (official)

Sources