Rady Children's Health Network

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Claims

The Rady Children’s Health Network (RCHN) Claims Department is here to help you with any claim inquiries, including questions about initial claims, resubmissions, and denials. We can be reached at 1 (877) 276-4543.

Network providers must submit claims and encounters to Rady Children’s Health Network (RCHN) for ALL services.

Timely Filing

File a claim on an electronic or paper form within 90 calendar days of the date of service, unless otherwise specified by your contract. Failure to follow these guidelines may result in denial and nonpayment. (Non-contracted providers are subject to regulatory billing guidelines for Commercial and Medi-Cal lines of business)

Electronic Claim Submission

Submitting claims electronically is safe, faster, and easier to track than paper claims. If you are not already using an electronic billing system, Office Ally is our clearinghouse, you may contact Office Ally to enroll at 866-575-4120. If you are already enrolled in Office Ally, please submit claims to the following payer IDs.

Office Ally
Payer ID: For professional risk claims, please use payer ID RCHN1
For facility risk claims, please submit to payer ID RCHSD
www.officeally.com

Submitting paper claims

If you cannot submit claims electronically, please mail paper claims to the address below. Remember to include supporting medical documentation when necessary.

Via Mail:
Rady Children’s Health Network
3020 Childrens Way MC 5077
San Diego, CA 92123

Via Physical Delivery:
Rady Children’s Health Network
5898 Copley Dr., Suite 300
San Diego, CA 92111

Processing Time

The standard processing time for a claim is 30 calendar days from the date Rady Children’s Health Network (RCHN) receives the claim (effective January 1, 2026).

Status Updates

To check claim status:

  • Online: EZ-Net (call your RCHN Account Executive for complete enrollment form to access the claim status website)
  • Phone: Claims Department at (877) 276-4543

Corrected Claims

A resubmission of an existing claim. The corrected claim tells Rady Children’s Health Network (RCHN) that you are rebilling a previously submitted claim with the correct codes and/or modifiers, with the goal of payment.

Corrected paper claim submission

  1. Make the changes to the CPT, ICD-10, modifiers, etc. on a new paper form.
  2. Stamp “corrected claim” in box 22 of the CMS-1500 form.
  3. Send the corrected claim to:

Via Mail:
Rady Children’s Health Network
3020 Childrens Way MC 5077
San Diego, CA 92123

Via Physical Delivery:
Rady Children’s Health Network
5898 Copley Dr., Suite 300
San Diego, CA 92111

Corrected claims submitted electronically through Office Ally

When submitting electronically, frequency code 7 must be used for corrected claims.

Coordination of Benefits (COB)

Coordination of Benefits is required when a member is covered by one or more health insurers in addition to RCHN. RCHN is the payer of last resort and should be billed after all others.

Billing Rady Children’s Health Network (RCHN) and other Health Coverage

  • File a claim, with the primary insurer.
  • If the primary insurer issues a partial payment or denial, submit a claim with a copy of the Explanation of Benefits (EOB), including payment details, to RCHN.
  • If appropriate, RCHN will pay the remaining balance up to the Medi-Cal allowable amount.