Availity® Health Information Network
Availity® Health Information Network
Availity® Health Information Network
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Payer Name Payer ID<br />
Enrollment<br />
Required<br />
Prof<br />
Claims<br />
(837)<br />
Inst Claims<br />
(837)<br />
Claim<br />
Status<br />
Inquiry<br />
(276/277)<br />
Eligibility &<br />
Benefits<br />
Inquiry<br />
(270/271)<br />
MEDICARE PART B INDIANA 00630 X IN<br />
MEDICARE PART B KANSAS 05202 X KS<br />
MEDICARE PART B KENTUCKY 15201 X KY<br />
MEDICARE PART B MAINE 14102 X ME<br />
MEDICARE PART B MINNESOTA 00954 X MN<br />
MEDICARE PART B MISSOURI 05302 X MO<br />
MEDICARE PART B NEW HAMPSHIRE 14302 X NH<br />
MEDICARE PART B NEW MEXICO 04202 X NM<br />
MEDICARE PART B OHIO 15202 X OH<br />
MEDICARE PART B OKLAHOMA 04301 X OK<br />
MEDICARE PART B OREGON 02302 X OR<br />
MEDICARE PART B TEXAS 04412 X TX<br />
MEDICARE PART B VIRGINIA 11302 X VA<br />
MEDICARE PART B WISCONSIN 00951 X WI<br />
MEMORIAL CLINICAL ASSOCIATES MCA11 TX TX<br />
NOVASYS HEALTH 71080 AR<br />
NW DIAGNOSTIC CLINIC (SELECTCARE TX) NWDC1 TX TX<br />
OPTIMUM HEALTHCARE INC. (OPT) OPT01 FL<br />
OTHER BLUE PLANS<br />
FL, IL, IN,<br />
FL, IL, IN, KY,<br />
KY, MO,<br />
MO, NM, OH,<br />
NM, OH,<br />
OK, TX, WI<br />
OK, TX, WI<br />
PEACH STATE HEALTH PLAN 68069 GA GA GA<br />
PEDICARE TITLE 19 M3FL8 ALL ALL<br />
PEDICARE TITLE 21 M3FL6 ALL ALL<br />
PHYSICIANS UNITED PLAN 10775 FL FL<br />
PINNACLE PHYS MGT (SELECTCARE TX) PPMO1 TX TX<br />
PODIATRYFIRST POD1ST FL FL<br />
SELECT SENIOR CARE (SELECTCARE TX) SSC11 TX TX<br />
SELECTCARE OF TEXAS (GTPA) GTPA1 TX TX<br />
SELECTCARE OF TEXAS (HPN) HPN11 TX TX<br />
SELECTCARE OF TEXAS (MCA) MCA11 TX TX<br />
SENIOR CARE IPA (SELECTCARE TX) CIPA1 TX TX<br />
SUNFLOWER STATE HEALTH PLAN 68069 KS<br />
SUNSHINE STATE HEALTH PLAN 68057 FL FL FL<br />
SUPERIOR HEALTH PLAN SHP11 TX TX TX<br />
TEXAN PLUS (SOUTHEAST TEXAS AREA) HPN11 TX TX TX<br />
TEXAS FIRST HEALTH PLANS (NORTH TEXAS) TX1ST TX TX TX<br />
TEXAS FIRST HEALTH PLANS (TIOPA) TIOPA1 TX TX<br />
TODAYS HEALTH WITH1 WI WI WI<br />
TRIBUTE (SELECTCARE OK) SCOK1 OK OK OK<br />
TRICARE SOUTH 38520 X FL, OK, TX FL, OK, TX<br />
Availity's Web Portal <strong>Health</strong> Plan Partners<br />
Online<br />
Remittance<br />
Advice (835)<br />
Remit<br />
Reader<br />
Claim<br />
Reconcillation/Re<br />
search<br />
Authorization &<br />
Referral<br />
Submission (278)<br />
FL<br />
Authorization &<br />
Referral Inquiry<br />
(278)<br />
Authorization &<br />
Referral Update<br />
(278)<br />
CareCost Estimator<br />
(Patient Financial<br />
Responsibility)<br />
UNITED HEALTHCARE 87726<br />
FL, OH,<br />
VA<br />
FL, OH, VA FL, OH, VA FL, OH, VA<br />
US FAMILY HEALTH PLANS USFHP TX, LA ALL ALL<br />
VILLAGE FAMILY PRAC (SELECTCARE TX) VFP11 TX TX<br />
WELLCARE - HARMONY HEALTH PLAN 14163 IL, IN, MO IL, IN, MO<br />
WELLCARE - HEALTHEASE 14163 FL FL<br />
WELLCARE - HEALTHEASE KIDS 14163 FL FL<br />
WELLCARE - OHANA HEALTH PLAN 14163 HI HI<br />
WELLCARE - STAYWELL 14163 FL FL<br />
WELLCARE - STAYWELL KIDS 14163 FL FL<br />
WELLCARE HEALTH PLANS 14163<br />
WORKERS' COMPENSATION VARIOUS ALL ALL<br />
CT, FL, GA,<br />
LA, NJ, NY,<br />
OH, & TX<br />
CT, FL, GA,<br />
LA, NJ, NY,<br />
OH, & TX<br />
46 of 124 Visit our web site: www.availity.com<br />
<strong>Availity®</strong> <strong>Health</strong> <strong>Information</strong> <strong>Network</strong><br />
Electronic Data Interchange (EDI) & Web Solutions Companion Guides<br />
CareRead<br />
(ID Card<br />
Swipe)<br />
CareProfile<br />
(<strong>Health</strong><br />
Records)<br />
Clinical<br />
Messaging via<br />
CareProfile &<br />
Eligibility &<br />
Benefits Inquiry<br />
CareCollect<br />
(Payment<br />
Collection)<br />
Additional <strong>Information</strong><br />
In the regions where Other Blue<br />
Plans is available as a payer,<br />
select this option to transact with<br />
all out of state Blue Plans. In<br />
regions where this is not an<br />
option, select the local Blue Plan<br />
to transact with all out of state<br />
Blue Plans.”<br />
If you are a new E&B submitter,<br />
please contact 877.978.7776 to<br />
enroll.<br />
Contact (800)-325-5920 to<br />
enroll. Provider Enrollment Form<br />
may be obtained at<br />
www.mytricare.com. The 270 &<br />
276 WEB transactions are for<br />
TRICARE South Region Only.<br />
Please see Availity's Workers'<br />
Compensation Guide for more<br />
details
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