WellSpan EAP Home
Contact Us
Eap Header 5

Affiliate Providers

Affiliate Providers

Billing Information

We have the capability to accept claims electronically.  Our electronic payor number is CB457.  If you choose to send claims electronically, please use the below CPT-4 codes. To see a sample HCFA 1500 form or for a WellSpan EAP referral and invoice form please click below. 

Sample HCFA 1500 Claim Form 
WellSpan Referral and Invoice Form

WellSpan EAP Billing Information
Claims Address: WellSpan EAP prefers claims to be electronically submitted, emailed securely (wellspaneap@wellspan.org) or faxed.
Customer Service #: 1-800-673-2514
FAX: 717-755-7190 claims only
Electronic Payor #: CB457
Initial Visit Code: 90791
Subsequent Visit: 90834
Subsequent Visit: 90837

If you have any questions, please call WellSpan EAP customer service at 1-800-673-2514.


Are you sure you would like to cancel?

All information will be lost.

Yes No ×