Contact Information

ESP Resources, Inc.
PO Box 3256
Morganton, NC 28680-3256

Phone: 828.438.8383
Fax: 828.438.3801

Email: info@espresourcesinc.com

Claims Processing

Required Client Demographic Information

  • Client LME Affiliation (Example: Foothills, Neuse, Wake, Etc.)
  • Client LME Medical Record Number
  • Client Provider Medical Record Number
  • Client First, Middle, Maiden & Last Name
  • Client Date of Birth
  • Gender (Male/Female)
  • Client Street Address
  • Client City , State & Zip Code
  • Client Diagnosis Information
  • Primary Diagnosis 1
  • Primary Diagnosis 2
  • Primary Diagnosis 3
  • Primary Diagnosis 4
  • Start/End Date of Above Diagnosis
  • Client Funding Sources
    • Medicaid
    • Medicare
    • IPRS
    • Primary Insurance
  • Client Funding Source Information (Information required for each funding source)
    • Client Eligibility Identification Number
    • Funding Source Effective/Lapse Dates
    • Funding Source Plan Name

    (Examples: Medicaid, Medicare, Blue Cross, CIGNA, etc.)

  • Funding Source Policy Holder Information
    • First, Middle Initial & Last Name
    • Street Address, City, State & Zip Code
    • Telephone Number including Area Code
    • Policyholder Relation to Client
    • Policyholder Date of Birth
    • Policyholder Gender

Required Staff/Attending Provider Information

  • Staff/Attending Provider Status (Profit/Non-Profit)
  • Staff/Attending Provider Last Name
  • Staff/Attending Provider First Name
  • Staff/Attending Provider Middle Name
  • Staff/Attending Provider Maiden Name
  • Staff/Attending Provider Credentials (if applicable)
  • Staff/Attending Provider Location/Facility
  • Staff/Attending Provider Location/Facility Street Address
  • Staff/Attending Provider Location/Facility City, State & Zip Code
  • Federal ID#
  • Staff/Attending Provider Billing Number
  • Staff/Attending Provider IPRS Enrollment Number
  • Endorsed Provider (Yes/No)
  • Provisional Endorsement (Yes/No)
  • Endorsement Effective/Lapse Dates
  • Endorsed Services