How to Submit a Claim

Claims can be submitted via paper or electronically, although processing and payment of electronically submitted claims will be quicker.

Paper Claims

Must be on either the CMS HCFA-1500 or UB-04 forms and submitted to:

RiverSpring FIDA Plan
c/o Relay Health
1564 Northeast Expressway
Mail Stop HQ-2361
Atlanta, GA 30329

Electronic Claims

Must use the HIPAA 5010 compliant 837 format.

Provider Application

To request a provider application, please email:

Provider Manual (pending)

Provider Training (pending)

Last updated on June 27, 2019