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Last Update Payer ID Payer Name Availity's Electronic Data Interchange (EDI) Health Plan Partners Government Payer* Claim Enroll Required Remit (835) NPI Option Professional Claim (837) Institutional Claim (837) Eligibility & Benefits (270) Claim Status (276) Auth & Referral (278) Additional Information VPA18 VARIABLE PROTECTION ADMINISTRATORS (VPA) 2 x x 60054 VARIAN HEALTH CARE PLAN 2 x x GASA1 VERITY NATIONAL GROUP, INC. 2 x x 75256 VERITY NATIONAL GROUP, INC. 2 x x VFP11 VILLAGE FAMILY PRATICE x 4 x x For 835, 270 and 276 transactions please use Payer ID: HPN11 BV001 VIPA 2 x GEN02 VIRGINIA SURETY COMPANY 2 x x 37297 VISION CARE INCORPORATED 2 x 55248 VISTA HEALTH PLAN 2 x x 63114 VIVA HEALTH PLAN 2 x 77073 VNS CHOICE MEDICARE 2 x x 22264 VYTRA HEALTHCARE 2 x x 62111 W.C. BEELER & COMPANY 2 x 85256 WABASH MEMORIAL HOSPITAL ASSOCIATION 2 x x 84980 WAL-MART (BLUE CARD CARRIERS) 4 x x GEN02 WASHINGTON NATIONAL INSURANCE CO 2 x x 73155 WATERSTONE BENEFIT ADMINISTRATORS 4 x x 39151 WEA TRUST 3 x x 75261 WEBTPA 2 x x 36337 WEISS HEALTH PROVIDERS 2 x 25133 WELL PATH OF CAROLINA 2 x x Enrollment Contact - (866) 703-1444 WELM2 WELLMED (CLAIMS) 4 x x WELMD WELLMED (ENCOUNTERS) 4 x WELM2 WELLMED/SECURE HORIZONS 4 x x 91064 WENATCHEE VALLEY MEDICAL CENTER 2 x x 91136 WEST COAST STATIONARY ENGINEERS HEALTH & SECURITY TRUST FUND 2 x x 80942 WEST SUBURBAN HEALTH PROVIDERS 2 x x 70408 WESTERN CARE 2 x x 24735 WESTERN GROWER'S INS. CO. 3 x x 37247 WESTERN MUTUAL INSURANCE 2 x x 31048 WESTERN SOUTHERN FINANCIAL GROUP (CINCINNATI, OH) 2 x x 38232 WEYCO 2 x x 93050 WILLIAM C. EARHART, CO., INC. 2 x x 98010 WILLIAM J. SUTTON & COMPANY 2 x x 62153 WINDSOR MEDICARE EXTRA 2 x x 27327 WINHEALTH PARTNERS 2 x Formerly payer ID WNHLT 39200 WISCONSIN AUTO & TRUCK DEALERS INSURANCE PLAN 2 x x WPS01 WISCONSIN COMMERCIAL 3 x SX022 WISCONSIN PHYSICIANS SERVICE GROUP HEALTH (WPS) 2 x 13413 WOMEN'S INTEGRATED NETWORK, INC (WIN FERTILITY) 2 x 81949 WOODMAN ACCIDENT AND LIFE COMPANY 4 x VARIOUS WORKERS' COMPENSATION x 2 x x 20333 WORKSITE BENEFIT SERVICES, LLC. 2 x x 75276 WORLD INSURANCE COMPANY 2 x x 77080 WPP - ELDERCARE WISCONSIN 2 x x 10159 WPS PREVEA HEALTH PLAN 4 x x 25133 WRITERS GUILD 2 x x 23710 WRITERS’ GUILD INDUSTRY HEALTH PLAN 2 x x 62153 XANTUS HEALTHPLAN OF TENNESSEE 2 x x 06121 YALE NEW HAVEN HEALTH - MSO INC 3 x x 60646 YALE UNIVERSITY HEALTH PLAN 2 x 88858 ZEBRAHEALTH 2 x x 28 of 124 Visit our web site: www.availity.com Availity® Health Information Network Electronic Data Interchange (EDI) & Web Solutions Companion Guides Please see Availity's Workers' Compensation Companion Guide for more details: (https://apps.availity.com/availity/documents/AvailityWorkersCompensationCompanionGuide.pdf )
Availity's Electronic Remittance Advice (ERA) Health Plan Partners Availity® Health Information Network Electronic Data Interchange (EDI) & Web Solutions Companion Guides Payer Name Payer ID Additional Information Please complete the Availity Multi-payer Form prior to the Centene ERA form. Option available for ERA only providers. EFT providers must contact Availity Required Forms (links) Payer Specific Forms (links) ABSOLUTE TOTAL CARE 68069 Centene for further instructions. When enrolling for Advocate Health ERAs, please be sure to enroll for both Advocate Health Centers Availity Multi-payer Form Centene_ERA_835_enrollment ADVOCATE MEDICAL GROUP 36320 and Advocate Health Partners When enrolling for Advocate Health ERAs, please be sure to enroll for both Advocate Health Centers Availity Multi-payer Form ADVOCATE HEALTH PARTNERS 65093 and Advocate Health Partners Availity Multi-payer Form Electronic Remittance Advice and Electronic AETNA INSURANCE COMPANY 60054 NPI number is required on the Multi-payer Form for Funds Transfer Enrollment AMERICAN COMMERCIAL BARGE LINES 87726 processing. Please complete the Availity Multi-payer Form prior Availity Multi-payer Form AMERIGROUP OF VIRGINIA IHP001 to the Amerigroup ERA form. Availity Multi-payer Form Electronic Remittance Advice (835) Amerigroup EDI 835 ERA Enrollment Form ASURIS NORTHWEST HEALTH 93221 Enrollment Form ATRIO HEALTH PLAN ATRIO Availity Multi-payer Form NPI number is required on the Multi-payer Form for Electronic Remittance Advice (835) BLUECROSS BLUESHIELD (BCBS) ID REGENCE 00611 processing. Electronic Remittance Advice (ERA) files for BCBS providers in IL, NM, OK and TX are excluded from the Availity 835 aggregation/version processing. Enrollment Form They will not be combined with other payers’ ERA Electronic Remittance Advice (ERA) files. You must contact BCBS to request v5010 ERA Enrollment Form (HCSC ERA Enrollment BLUECROSS BLUESHIELD (BCBS) IL HCSC 00621 files Form) BLUECROSS BLUESHIELD (BCBS) MN 00220/00720 Electronic Remittance Advice (ERA) files for BCBS providers in IL, NM, OK and TX are excluded from the Availity 835 aggregation/version processing. BCBSMN ERA Enrollment They will not be combined with other payers’ ERA Electronic Remittance Advice (ERA) files. You must contact BCBS to request v5010 ERA Enrollment Form (HCSC ERA Enrollment BLUECROSS BLUESHIELD (BCBS) NM HCSC 00790 files Electronic Remittance Advice (ERA) files for BCBS providers in IL, NM, OK and TX are excluded from the Availity 835 aggregation/version processing. Form) They will not be combined with other payers’ ERA Electronic Remittance Advice (ERA) files. You must contact BCBS to request v5010 ERA Enrollment Form (HCSC ERA Enrollment BLUECROSS BLUESHIELD (BCBS) OK HCSC 00840 files Form) NPI number is required on the Multi-payer Form for Electronic Remittance Advice (835) BLUECROSS BLUESHIELD (BCBS) OR REGENCE 00851 processing. Electronic Remittance Advice (ERA) files for BCBS providers in IL, NM, OK and TX are excluded from the Availity 835 aggregation/version processing. Enrollment Form They will not be combined with other payers’ ERA Electronic Remittance Advice (ERA) files. You must contact BCBS to request v5010 ERA Enrollment Form (HCSC ERA Enrollment BLUECROSS BLUESHIELD (BCBS) TX HCSC 84980 files Form) NPI number is required on the Multi-payer Form for Electronic Remittance Advice (835) BLUECROSS BLUESHIELD (BCBS) UT REGENCE 00910 processing. Enrollment Form NPI number is required on the Multi-payer Form for Electronic Remittance Advice (835) BLUECROSS BLUESHIELD (BCBS) WA REGENCE 00932 processing. Enrollment Form BLUESHIELD (BC) CA 87726 Availity Multi-payer Form 29 of 124 Visit our web site: www.availity.com
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