Claims

Before submitting any claims, all participating providers must report their National Provider Indicator (NPI) number using our Provider Change Form. The form may be faxed to 1-207-828-7870, emailed to ProviderChanges@MartinsPoint.org, or mailed to: Martin's Point Health Care Network Management Department, PO Box 9746, Portland, ME 04104-9882.

Generations Advantage payment policies are generally consistent with Medicare. For more information about Medicare coverage and reimbursement rules, please visit the Medicare Learning Network.

US Family Health plan payment policies are generally consistent with TRICARE®. For more information, please visit the Code of Federal Regulations

Electronic Claims

Electronic claim submission allows for quicker processing and payments. We offer three Electronic Data Interchange (EDI) options. Contact them directly to register for Martin's Point electronic claims submission and electronic remittance advices (ERAs/835s):

Emdeon Business Services: 1-800-845-6592, Martin's Point Payor ID: 53275

Office Ally: 1-866-575-4120, Martin's Point Payor ID: MPHC1

Relay Health, a division of McKesson Technologies: New users call 1-866-735-2963. Current users call 1-800-527-8133. Martin's Point Payor ID: MPHC2

Electronic Funds Transfer /Direct Deposit

Electronic funds transfer (EFT) service, also known as “Direct Deposit,” is available to providers who have first signed up to receive Martin’s Point ERAs/835s. To request EFT service, please complete and submit our EFT/Direct Deposit Authorization Form.

Electronic Remittance Advice (835) Provider Guide 
Our Electronic Remittance Advice (835) Provider Guide should make it easier for you to understand Martin’s Point 835 files. It is a searchable PDF that maps industry-standard adjustment reason codes to the corresponding Martin’s Point claims editing rules and remarks on our 835 files.

Paper Claims

Paper claims may be mailed to:

Martin’s Point US Family Health Plan Claims Department
PO Box 11410
Portland, Maine 04104-7410

Martin’s Point Generations Advantage Claims Department
PO Box 11410
Portland, Maine 04104-7410 

Check Claim Status (Sign-In Required)

Already registered?  Sign in to check claim status  

Not yet registered? Martin's Point offers a web-based portal for providers to check the status of claims, preauthorization requests and member eligibilitly. To use this tool, you must first obtain a username for the Martin's Point single sign-on system. For more information, please view our Registration Instructions PDF.

Provider Manual: Claims

For more information on claims policies and procedures, please review that section of our Provider Manual.

Claims Contact Information
Questions? Please call 1-888-732-7364.