How To Submit Claims To Sendero Health Plans,

For Sendero Health Plans,, 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

• Sendero accepts electronic and paper medical/behavioral health claims. Electronic claims use ANSI-837 through Cognizant/Trizetto with EDI Payor ID MV440. Paper claims go to Sendero Health Plans, Attn: Claims, P.O. Box 17307, Austin, TX 78760. The provider manual also notes requirements for taxonomy, member ID format, and billing location formatting on paper CMS-1500 claims.

Submission channels

• ANSI-837 electronic claims via Cognizant/Trizetto clearinghouse
• paper CMS-1500/CMS-1450 (UB04) claims mailed to Sendero

Electronic claims payer IDs

• MV440

Paper claims addresses

• Sendero Health Plans, Attn: Claims, P.O. Box 17307, Austin, TX 78760

Corrected claims and follow-up

• Corrected claims have a 120-day timely-filing window by claim type; the current manual excerpt reviewed does not provide a unique corrected-claim mailing address or EDI indicator beyond the manual’s corrected-claims timing rules.

• If an electronic claim is rejected, the provider must review acceptance/rejection reports and resubmit the initial claim within the applicable timely-filing window.

• Duplicate claims should not be submitted before 30 days for electronic claims or 45 days for paper claims.

• Claims status resource 1

• Claims status resource 2

Caveats

• The reviewed provider manual excerpt does not expose a dedicated claims portal or a unique corrected-claim form/instructions in-line; use the provider portal/user guide and current claims guidance for operational details.
• Paper CMS-1500 claims must include a physical billing address in Box 33; a P.O. Box there will be rejected.
• Coverage/claim requirements can vary by benefit type and effective date.

Provider resources

• Provider Portal Login (official)
• Provider Resources / Provider page (official)
• Provider Manual (rev. 11-26-24) (official)
• Provider Portal User Guide (official)
• Prior Authorization Process Description (official)
• Claim Reconsideration/Appeal Request Form (official)
• Preauthorization Code Interactive Lookup Tool (official)

Sources