To view claims information for your patient, please login to your provider portal.
To submit a claim:
All medical claims must be either be sent to:
Luminare Health Benefits, Inc.
P. O. Box 4278
Clinton, IA 52733-4278
Or submitted online using the following Payer ID: 35182.
Claims must be submitted within twelve (12) months of the date of service. Non-electronic claims may be submitted on any approved claim form, available from the provider. The claim must be completed in full, with all the requested information. A complete claim must include the following:
- Name of patient
- Patient’s date of birth
- Name of employee
- Address of employee
- Name of employer and group number
- Name, address and tax identification number of provider
- Employee Member Identification Number
- Date of service
- Diagnosis and diagnosis code
- Description of service and procedure number
- Charge for service
- The nature of the accident, injury or illness being treated.
- Sufficient documentation, in the sole determination of the Plan Administrator, to support the Medical Necessity of the treatment or service being provided to enable the Plan Supervisor to adjudicate the claim pursuant to the terms and conditions of the Plan.
CLAIMS WILL NOT BE DEEMED SUBMITTED UNTIL ALL REQUIRED INFORMATION IS RECEIVED BY PROMISE HEALTH PLAN.
Claims will be paid within 30 days from when Promise Health Plan receives all the information necessary.