In order for Office of Developmental Programs (ODP) direct service providers to receive payment for Waiver-Funded services rendered, they are required to submit their claim transactions through PROMISe (Provider Reimbursement and Operations Management Information System in electronic format). PROMISe is Pennsylvania's dedicated claims processing system. PROMISe interfaces with the Home and Community Services Information System (HCSIS) to process Home and Community Based Service (HCBS) claim invoices for ODP.
The term claims processing is generally used to describe the series of activities and processes that occur systematically, based on claim criteria, to facilitate the accurate adjudication of claim data received by PROMISe. Claim payments are dependent on the providers ability to submit a claim successfully in order to ensure payments occur in a timely manner. In order for a provider to submit a claim successfully and be approved for payment, it is important that the provider understands the ODP billing process and rules surrounding it. The Provider Billing and Payment section contains billing, payment, and claims resolution resources specific to ODP. These resources support independent self-resolution activities by the provider. ODP strongly encourages direct service providers to attempt self-resolution of their claim errors.
Please visit the Provider Billing and Payment section often to obtain the latest version of provider billing resources and to view new resources currently under development. For assistance regarding claim issues, please contact the ODP Claims Resolution Section:
Toll Free Number: (866) 386-8880
Business Hours: Monday through Thursday 8:30am to 12:00pm and 1:00pm to 3:30pm
E-mail Address: email@example.com
For more information and resources please visit the MyODP Provider Billing and Payment webpage. You may login as a guest.