Medical Claims Mailing Address:

Health First Health Plans
PO Box 219454
Kansas City, MO 64121-9454
Payer ID: 95019

The most current forms for your use are below.
 

Claim Forms

• Dispute Process
• Provider Claim Dispute Request
• Provider Claim Dispute Request – Second Level
• Provider Claim Inquiry 
• Corrected Claim Flyer
• Medical Reimbursement Form
• Timely Filing Guidance
• Waiver of Liability
• Claim Submission for Unlisted Procedure
• Electronic Fund Transfer (EFT) Claim Submission through Zelis

Provider Billing Guidelines

As a private payer processing claims under Medicare and Commercial lines of business, Health First Health Plans adopts standard billing practices, but may also have unique billing requirements to facilitate accurate payment. This site contains information about any unique billing requirements that may be in place for provider claims.

In general:

Health First Health Plans is a covered entity under HIPAA and requires claims transactions to be conducted in standard formats using standard code sets such as ICD, CPT, and HCPCS.

Unless indicated otherwise, we require claims to comply with AMA coding guidelines and any specific billing guidelines established by Medicare and its contractors. Medicare guidelines include, but are not limited to, Correct Coding Initiative (CCI) policies, Local Coverage Determinations (LCDs), and any associated articles or transmittals.

In the absence of specific billing guidelines of the AMA or Medicare contractors, Health First Health Plans reserves the right to establish custom billing guidelines. Guidelines will be developed as needed and published on this website.

• Bilateral Procedure Guidelines 

• Clinical Trial Billing Guidelines

• Co-Surgeons, Team Surgeons, and Assistant Surgeons Billing Guidelines 

• Drug HCPCS Codes No Longer Requiring a Paper Invoice (JN) Billing Guidelines

• Home Health Notice of Admission Billing Guidelines 

• Inpatient Hospital Readmission Guidelines

• Modifiers 26, TC, and Global Services Billing Guidelines 

• Modifier Billing Guidelines

• Multiple Surgery Guidelines 

• Oxygen Reimbursement Table 

• Telehealth Billing Guidelines

• Unlisted Codes and Carrier Discretion Code Guidelines

Last updated 1/21/2025