Forms & Documents for Providers

Electronic payments via Virtual Card starting in November 2025

Electronic claims payment through electronic funds transfer (EFT) is the fastest and most secure way to receive payment. The EFT deposit is assigned a trace number matched to the 835 electronic remittance advice (ERA) for simple payment reconciliation. Visit EnrollSafe at https://enrollsafe.payeehub.org to enroll in or disenroll from EFT. If you need EFT help, email Support@payeehub.org.

Care providers not enrolled in EFT may receive payments via a virtual credit card (VCC) in lieu of paper checks. VCCs allow care providers to process payments as credit card transactions. Credit card processing fees may apply. Contact your merchant processor or financial institution for specific costs.

Depending on the electronic payment method, HealthSun Health Plans, Inc. may receive some form of compensation. Signing up for EFT automatically opts care providers out of VCCs.

If you still need a check payment, call Comdata at 800-833-7130 and provide them with the TINs of your organization that you do not want to receive VCCs.

Thank you for your support as we transition to more electronic payment options. Through our efforts, we are committed to reducing administrative burden and ensuring active involvement with you — our care provider partners.

For more information, please click on Frequently Asked Questions.

New: Inpatient Readmissions Reimbursement Policy

Effective July 1, 2025, separate reimbursement may not be used for claims that have been identified as readmission to the same hospital within 30 days of discharge for the same, similar, or related condition unless provider, federal, or CMS contracts and/or requirements indicate otherwise.

This policy only affects facilities reimbursed for inpatient services by a diagnosis related group methodology.

 Policy exclusions:

• Admissions for the medical treatment of:  Cancer, Neonatal/newborn, Obstetrical deliveries, Behavioral health, Rehabilitation care,  Sickle cell anemia, Transplants

• Transfers from one acute care hospital to another
• Member discharge from the hospital against medical advice

For policy details, refer to the Provider Manual 2025.

Social Services Announcement

This is a reminder about the invaluable support available through our Social Services Department. The department is dedicated to assisting members in addressing non-medical needs that impact well-being and care outcomes.

Services Provided Include:

• Telephonic assessments: To evaluate member’s needs and strengths. It aims to identify resources and support systems.
• Community Resources: Help connecting members to housing, food assistance, financial aid, and other local resources.
• Behavioral Health Support: Referrals for counseling or mental health services.
• Member Education: Resources to promote self-sufficiency and empower individuals.

Social Services Bulletin

Social Services Referral Form

Special supplemental benefits for the chronically ill (SSBCI) Eligibility Changes

Effective January 1, 2025, HealthSun Health Plans, Inc. (HealthSun) will change its process for approving members for special supplemental benefits for the chronically ill (SSBCI), such as groceries, utilities, chronic meals (for more than 90 days), and nonemergency transportation to non-health-related destinations.

Special Supplemental Benefits for the Chronically Ill (SSBCI) Eligibility Changes Bulletin 2026

Special Supplemental Benefits for the Chronically Ill (SSBCI) HealthSun Provider Form 2026

Special Supplemental Benefits for the Chronically Ill (SSBCI) Eligibility Changes Bulletin 2025

Special Supplemental Benefits for the Chronically Ill (SSBCI) HealthSun Provider Form 2025