It is Network Health’s goal to process all claims at initial submission. Before we can process a claim, it must be a “clean” or complete claim submission. If any of the necessary information is missing from the claim, we will be unable to process your claim in a timely fashion.
To facilitate the timely processing of your claims, please review Network Health’s Claim Submission Policy.
Providers are strongly encouraged to submit claims electronically for claims processing. For those that do not have the ability to submit electronically, Network Health has partnered with ConnectCenter, which offers participating providers the ability to submit claims electronically at no charge. Please contact Member Experience or your Provider Operations Manager to learn more.
PO Box 568 Menasha, WI 54952
View the benefits for our Medicare Advantage plans from the current and previous plan year.
2025 Benefits at a Glance - Medicare Advantage Benefits for Providers
2024 Benefits at a Glance - Medicare Advantage Benefits for Providers
Use these documents to understand basic benefits information needed when discharging our members from skilled nursing facilities.
Individual Medicare Advantage Discharge Resource
Group Medicare Advantage Discharge Resource
Provider Payment Options and Electronic Remittance Advice (ERA)
Network Health partnered with ECHO Health, Inc to provide the following payment options for our providers.
Electronic Fund Transfer (EFT) – receive EFT from all payers. A fee for this service may be required.
EFT payments for Network Health only - no fee is required. Click here to enroll.
Medical Payment Exchange (MPX) – the provider receives an email or fax notifying them they have a payment waiting. If no action is taken within 3 business days, the payment is released to a paper check.
Virtual Credit Card (VCC) - including the explanation of payment (EOP). The step for processing payments is similar to how providers manually input patient payments today.
Please note: If the provider wishes to receive paper checks, they must opt out of VCC and MPX by visiting echovcards.com or calling 800-339-4718. The ECHO EPC Draft Number located on your provider remittance advice is required to opt out.
The frequently asked questions document is available for questions related to EFT and ERA registration.
You may contact ECHO Health directly at 888-834-3511 for questions related to your electronic payments or ERAs.
Visit ECHO Health at www.providerpayments.com to view detailed explanations of payment (EOP).
Network Health partnered with Zelis to offer various payment enrollment options, including ACH+ which streamlines the claims payment process and enables your RCM teams to swiftly navigate claim payment and remittance transactions.
Zelis ACH+ deposits your payment directly into your account which is faster than checks by 16 days on average.
Real-time access to payment and remittance data from over 550+ payers in one intuitive portal.
Detailed insights into your claim payments with Zelis CAQH Core III certified Electronic Remittance Advice (ERA) or 835s.
Dedicated support team to contact for payment or remittance questions for all 550+ payers partnered with Zelis.
Information and payments are protected thanks to a multi-layered security approach, backed by HITRUST certification.
To enroll, call 855-496-1571 or click here to have a Zelis enrollment advisor reach out to you.
The Zelis frequently asked questions document is available for questions related to provider electronic payments,
For all other inquiries, contact Zelis at 877-828-8770.
Check status of claims by logging into the Provider Portal. Select the Claims tab (located on the navigation bar to the right), then select View Claims from the drop-down selection.
To see if your claim has been rejected due to missing or inaccurate information, log into the provider portal to access your claims rejection report.
If you receive a denied claim from Network Health, please review the denial message printed on your provider remittance advice. If you have questions regarding the denial, please contact the member experience team. You may dispute the denial by completing the provider dispute form located on Network Health’s Provider Portal.
Per our provider dispute policy, all provider disputes and appeals must be submitted via our provider portal.
| Medicare | Commercial Group | Individual and Family |
| 800-378-5234 or 920-720-1345 |
800-826-0940 or 920-720-1300 |
855-275-1400 or 920-720-1400 |
Participating and Non-Participating providers have 120 days to submit a payment dispute.
Participating providers have 120 days to submit a dispute. Non-Participating providers have 60 days to file an appeal.
All timeframes start with the original remittance advice date. All payment dispute decisions are final.
Please ensure that you review Network Health's Claims Submission Policy prior to submitting your dispute. You can find this policy as well as all payment policies here: https://networkhealth.com/provider-resources/policies-and-forms
To submit a payment dispute: Log into the Provider Portal, select the Claims tab (located on the navigation bar to the right), then from the drop down select Claims Dispute Form.
Network Health has various options for you to check eligibility and benefits.
If you utilize a clearinghouse for real-time eligibilty and benefits, you can use this functionality for all Network Health members
You can call our member experience teams at the following numbers.
Commercial members (excluding Medicare Advantage) - 800-826-0940
State of WI (ETF) - 844-625-2208
Individual and Family plans (including those on the Federal Health Insurance Exchange) - 855-275-1400
Medicare Advantage - 855-580-9935
TPA - 262-523-5240
Use the Network Health Provider Portal