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Claims submission and disputes


Simply Healthcare Plans, Inc. uses the Availity Portal, a secure, full-service web portal that offers a claims clearinghouse and real-time transactions at no charge to health care professionals. Use Availity to submit claims, check claims status, dispute a claim decision and much more.

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Overpayment Refund/Remittance Payment should be mailed to the address listed below. Please include the project number and letter ID on your check.

Simply Healthcare Plans, Inc.
P.O. Box 933657
Atlanta, GA 31193-3657

If you believe an overpayment has been identified in error, you may submit your dispute by fax to 1-866-920-1874 or mail to:

Simply Healthcare Plans, Inc.
Cost Containment Unit — Disputes
P.O. Box 62427
Virginia Beach, VA 23466-2437

If we do not receive payment or a dispute within 60 days, we will begin the process to offset the identified overpayment against future claims where contract terms and state law allow.

Finding claims tools on Availity:


Submit claims:

  1. From the Availity homepage, choose Claims & Payments from the top navigation.
  2. Select Type of Claim from the drop-down menu.

Claims status inquiry:

  1. From the Availity homepage, select Claims & Payments from the top navigation.
  2. Select Claims Status Inquiry from the drop-down menu.

Claims dispute:

To check claims status or dispute a claim:

  1. From the Availity homepage, select Claims & Payments from the top navigation.
  2. Select Claim Status Inquiry from the drop-down menu.
  3. Submit an inquiry and review the Claims Status Detail page.
  4. If the claim is denied or final, there will be an option to dispute the claim. Select Dispute the Claim to begin the process. You’ll be redirected to the Payer site to complete the submission.

Clear Claims Connection:

To use Clear Claims Connection:

  1. From the Availity homepage, select Payer Spaces from the top navigation.
  2. Select the appropriate health plan.
  3. From the Payer Spaces homepage, select the Applications tab.
  4. Select the Clear Claims Connection tile.

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