Paper Claim Filing

All claims for Community Link services that are not submitted electronically (using EDI or Excel spreadsheet via Move-IT) must be mailed directly to WPS*. (Click here to learn more about electronic claim filing options.)
  • There is no fax option for claim submission. Any paper or fax claims that are received at Community Link offices will be returned to the provider.
  • Third-party payer claims must be submitted via mailed paper claims (see below).

All paper claims should be mailed to:

Family Care
c/o WPS Health Insurance
PO Box 211595
Eagan, MN  55121

*Note: Claims for Physical, Occupational, and Speech therapy services for dates of service prior to 01/01/2017 should be mailed to: Community Link, Inc., attn: Claims Dept., 28526 US Hwy 14, Lone Rock, WI 53556.

Paper Form Options

Providers can submit paper claims using the standard HCFA 1500, UB04, or the Community Link paper claim  form. WPS will not accept any other type of paper claim form. Unacceptable claim forms will be returned to the provider to submit on the appropriate claim form.

Click the button below for the Community Link claim form. Line-by-line instructions are included with the form. This form should be used for dates of service on or after January 1, 2017.

Community Link Claim Form

 

For dates of service prior to January 1, 2017, please use the ContinuUs paper claim form. Claims for Physical, Occupational, and Speech therapy services for dates of service prior to 01/01/2017 should be mailed to: Community Link, Inc., attn: Claims Dept., 28526 US Hwy 14, Lone Rock, WI 53556.

ContinuUs Claim Form

 

Third-Party Payer Claims

All claims previously billed to a third-party payer must be submitted to WPS on a paper claim form with a copy of the Remittance Advice/Explanation of Benefits (EOB) or Explanation of Medicare Benefits (EOMB) attached. If there is an EOB/EOMB that has multiple members on it, each claim submitted needs a copy of the EOB/EOMB attached.

See Third-Party Payer Claims and Disclaimer Codes for more detail.