Comprehensive Provider Services

With flexible contracting and 24/7 online claim status access, HealthSmart Network Solutions helps make participation simpler, more transparent, and more valuable—so together, we can improve access, support healthier communities, and create a better experience for everyone.

Our online services enable you to:

  • View eligibility status of patients
  • Determine status of claims
  • Confirm payment of claims
  • And much more


To request a client list please Contact Us

For questions about benefits, eligibility or claims, please contact the number on the member’s ID card.

Quick Links

Fast, Accurate Claims Processing that You can Count On

Our partnerships with our network providers is a testament to our mission and our values. Every provider who joins our network(s) can expect an increase in patient volume, a stable member base and an expedited claim turnaround time. When you become a HealthSmart Network Solutions provider, we provide an array of seamless services to help you.

EDI Overview

HealthSmart Network Solutions offers a full-service healthcare EDI Clearinghouse, which is open to all providers in the healthcare community. Our goal is to give our network providers the highest level of service possible. Engineered with the latest cutting-edge technology, we are committed to meeting all HIPAA requirements and leading the way in EDI services.

EDI Services Include:
  • Commercial claims (Aetna, CIGNA, Humana, etc…) to providers
  • Free government claims to participating carriers
  • Eligibility verifications
  • Claim status inquiry
  • Electronic remittance advice (ERA) for auto payment posting
  • Referral and authorization requests
  • e-Paper (Print-Mail Services)
  • Patient statements
EDI Benefits:
  • Faster reimbursement
  • Reduce rejected claims (Clean Claims)
  • Decrease time-intensive manual tasks
  • Increase productivity and efficiency
  • Improve cash flow

Online Claim Status

Contracted network providers can use our free Online Claim Status tool to quickly check the status of their claims. For more information, please contact Customer Service at (800) 687-0500.

Online Credentialing and Recredentialing

We are pleased to participate in the Universal Credentialing DataSource, a project of the Council for Affordable Quality Healthcare (CAQH). This web-based solution allows you to store and manage your credentialing information online and share it with insurance carriers electronically.

Fraud, Waste & Abuse

By reporting suspected fraud, waste, or abuse (FWA), you help protect patients, reduce health care costs, and prevent financial harm to others. Submitting a report is an important first step. Once received, HealthSmart Network Solutions works to detect, correct, and prevent FWA across the health care system.