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Community First Health Plans (Community First) is happy to announce a new partnership with RJ Health Systems (RJ Health) to roll out the RC Claim Assist tool for use by Participating Providers. RC Claim Assist gives Providers the actionable coding and units needed to accurately bill for drugs administered against the medical benefit. Community First utilizes RJ Health in processing claims including validating that appropriate coding is submitted and determining correct reimbursement.

RJ Health is a specialty drug data company launched in January of 2000 with a mission to simplify medical drug information and its flagship product, Reimbursement Codes, have become the industry’s trusted standard for reimbursement of specialty drugs. Healthcare organizations such as Health Plans, PBMs, Providers and Service organizations, partner with RJ Health as the industry’s leading independent resource for determining the correct price and appropriate coding of physician-administered drugs. As a Provider, once registered with this site, you will be able to convert correctly HCPCPS/CPT units to NDC units.

RC Claim Assist is a standalone provider-facing website, securely accessible through Community First’s provider/network portal. RC Claim Assist helps providers convert HCPCS/CPT® drug code units to NDC drug code units easily. A step-by-step intuitive process allows for HCPCS/CPT, NDC or Drug Name search of the entire RC Claim Assist database in 3 easy steps. Providers only need to supply HCPCS/CPT code, HCPCS/CPT Code units and NDC code in order to convert to NDC units.

Using RC Claim Assist will help ensure the correct submission of claims – related to the drug coding and NDC units – which will help reduce denials, reprocessing and incorrect payments. Community First will help you get enrolled so that you can start utilizing this tool.

In order to begin the enrollment process, please contact Network Management at nmcfhp@cfhp.com.

Already enrolled with one of our Provider Representatives? Login Here.

To start registration, insert a NPI using this form:
https://rcclaimassist.com/pre-registration-form-rcca-npi-cfhp-white-label/

If you forgot your password, click here:
https://rcclaimassist.com/cfhp-white-label-forgot-password/​

To see a demo of the NEW RJ Health Systems Claim Assist Tool for Providers, log in to your Provider Portal to watch a demo video.

Beginning September 1, 2024 Community First Health Plans, Inc. will be adding STAR+PLUS to its line of health care products.

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