State Farm Frequently Asked Questions

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PURPOSE: This document contains helpful information and frequently asked questions (FAQs) related to sending electronic State Farm claims.

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Contents

About Property and Casualty Claims

About State Farm Health/Medical Claims

Connection Options

Setting Up Electronic Funds Transfer (EFT) Payments

Minnesota Pharmacy Claims

Best Practices for Successful Claims

Rejections

Invalid Subscriber ID

Invalid Claim ID

Sending SOAP Notes

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About Property and Casualty Claims

  • Property and Casualty (P & C) is a broad term given to lines of business like Auto, Auto Personal Injury Protection (PIP), Fire, Homeowners, Workers Compensation, Boat, RV, ATV, etc. Most P & C policies carry a Medical Benefit as part of the liability coverage.
  • A Property and Casualty CLAIM Number is assigned by State Farm to identify a specific claim in their system. This number is always required for electronic bills to State Farm’s Property and Casualty lines of coverage.
    • A Property and Casualty claim number will be 9 characters in length. Older numbers may have 6 characters.
      • Positions 1 and 2 will always be numeric.
      • Position 3 may be either numeric or alphabetic.
      • Positions 4-9 will be numeric.

Example:  44A123456

  • Do not enter dashes, spaces, or special characters in the claim number.
  • A Property and Casualty claim number should not be sent with claims related to a State Farm Health/Medical line of coverage.
  • Do you have a Practice Management system that creates your claims? Tell your Practice Management vendor that the Property and Casualty claim number will need to populate in the 2010BA loop in a REF segment with a Y4 qualifier.
  • A Property and Casualty POLICY Number acts like a medical policy number for Property and Casualty claims.
    • Property and Casualty policy numbers will be either:
      • 6-9 characters in length
      • 12-13 characters in length
    • Property and Casualty policy numbers may be entered in the field for the Subscriber or Member ID.
      • If you do not have the Property and Casualty policy number, you may enter unknown.

About State Farm Health/Medical Claims

  • State Farm’s Health line of business provides medical insurance to subscribers.
  • Claims to the Health line of business must include a valid Policy number, also known as a Subscriber or Member ID.
    • Health/Medical Policy numbers are typically 12 characters long.
      • Position 1 will be H or C.
      • Position 2 may be either numeric or alphabetic.
      • Positions 3 – 12 will be numeric.
    • If you find a policy number beginning with a 3-character prefix like SFZ or XON followed by 9 digits, this is a Regence Blue Cross Blue Shield claim and must be submitted to Regence instead of State Farm.
  • Do NOT include a Property and Casualty claim number on a Health/Medical claim.

Connection Options

  • Become a UHIN member to connect directly to State Farm. See https://uhin.org/join/ for details.
  • UHIN connects to clearinghouses across the nation. Ask your clearinghouse whether they can send your State Farm claims via UHIN.
  • There are no enrollment or testing requirements to send to State Farm. As soon as you have a connection, you may begin sending.

Setting Up Electronic Funds Transfer (EFT) Payments

To set up EFTs, contact State Farm using the information below.

              PACNW PIP MPC EFT Team

              866-841-0666

Minnesota Pharmacy Claims

Pharmacy claims from MN should be sent to AutoRX. AutoRX will convert NCPDP transactions into electronic claims. For more details, contact AutoRX Customer Service at 866-752-0415.

Best Practices for Successful Claims

  • For Property and Casualty claims, ensure that the claim number is in the Property and Casualty Claim Number field in your electronic claim.
    • The claim number should be either 6 or 9 characters.
    • Type only the ID into the claim. Do not add additional words or punctuation.
  • Ensure that the Subscriber Policy Number has been entered as the Subscriber Member ID or Insurance ID.
    • In rare cases, when you are unable to obtain the policy number from the patient or subscriber, you may enter unknown in this field. However, this may delay the processing of your claims.

Rejections

Invalid Subscriber ID

When a rejection states that the subscriber ID is invalid:

  • Check the subscriber ID for errors. If the ID appears to be correct, proceed to the next step.
  • You may have sent the claim to the wrong line of business.
    • For example, sending Property and Casualty claims, including Auto and Worker’s Comp, to Payer ID 31053 results in an “invalid subscriber ID” rejection. The 31053 Payer ID is used exclusively for State Farm Health Insurance claims, which means that other claim types will fail to process.
    • Payer ID 31059 is used primarily for Property and Casualty claims, including Auto and Worker’s Comp. Although Health Insurance claims may be sent to this Payer ID, this ID is considered “non-participating.”
  • Check whether your subscriber ID is in the right field.

Invalid Claim ID

When a rejection states that the claim ID is invalid or includes the phrase "the claim/encounter has invalid information as specified in the status details:"

  • Check the claim ID for errors. If the ID appears to be correct, proceed to the next step.
  • Was the claim ID entered in the Property and Casualty Claim Number field? If not, re-send the claim with the claim ID in this field.

Sending SOAP Notes

SOAP notes may be faxed to State Farm:

  • Write the claim number at the top of your notes. This will allow State Farm to match your notes to your electronic claim.
    • State Farm Fire or Auto: Fax to 800-324-0645
    • State Farm Medical: Fax to 800-811-2358

 

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