Claims & Appeals


  • Submitting Claims

     As a participating provider with Passport, you have established a contractual agreement to provide physical, behavioral and/or other long-term support services to our members. The arrangement is fee-for-service for the provision of covered healthcare services unless otherwise specified under your Participating Agreement. The rates established in your Participating Agreement are considered full payment for covered services provided. Accordingly, Passport members may not be balance billed for any remaining amounts and/or difference between what is billed, and your negotiated reimbursement rates defined in the rate exhibit of your Participating Provider Agreement.

    Passport pays clean claims submitted for covered services provided to eligible members. In most cases, we pay clean claims within 30 days.

    How do I submit my claims to Passport?

    We recommend that you submit claims through the Electronic Data Interchange (EDI) for efficient processing and payment. We work with Change Healthcare for all EDI transactions. Use EDI Payer ID number: 66008

    Learn more about EDI

    Submitting electronic claims

    Passport offers a direct submit/web-based claims option through Availity Essentials. This functionality is available via the provider portal on our website. There is no charge to participating providers for submitting claims through the Availity tools. Availity supports keyed entry of claims on the portal and supports secure transfer/upload of batch claim files from most practice management systems. You must register with Availity to use the service and add Passport as one of your payers. If you are not currently registered with Availity please visit to get connected.

    Submitting paper claims

    To submit paper claims, please mail to:

    Passport Advantage (Claims)
    PO Box 3805
    Scranton, PA 18505

    If you have question, contact the claims department at (844) 859-6152.

    Processing and payment of claims for covered services are generally made within 30 calendar days of receipt of a clean claim. For more information on claims submission and payment, please refer to the Passport provider manual.