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Claims

How to File a Claim

It is your responsibility to ensure that a claim is submitted to Aspirus Arise. You may request the provider of services file the claim on your behalf. Claims should be itemized and state the provider of the service, diagnosis, date of service, services provided, and amount charged for the services.

Submit claims to:

  Aspirus Arise

  P.O. Box 21684

  Eagan, MN 55121

 

Corrected Claims

The Corrected Claims Form must be completed and attached to your corrected claim. Claim requests submitted without this form will be returned.

Claim Denials

If a claim is denied, in whole or in part, you will receive written notice of the denial and the reason(s) for denial. The notice will also inform you of the right to file a grievance and the procedure to follow. Prior authorization denials will be considered claim denials and will follow the same notification process.

If you have a complaint or would like to file a grievance, please contact us at 920-490-6969.

Provider Appeal Form

Provider Appeal Form

Provider Offsets: Provider Remittance Advice

Provider Offsets: Provider Remittance Advice

Reimbursement Policies

Anesthesia Reimbursement Policy
Bilateral Procedures
Increased Procedural Services Policy
Itemized Bill Review for Inpatient Hospital Claims
Modifier Policy
NCCI Reimbursement Policy
NCCI Shoulder Policy
Reduced and Discontinued Procedures
Separate Procedure Policy
Status B Policy
Surgical Assist. Co Surgeon, Surgical Teams
Venipuncture Policy


Refund Form

Refund Form