Payer Enrollment Forms – Claims and ERAs
(Government forms by State)
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Payers by Name Government by State	Professional Claims & ERA		Institutional Claims & ERA
052 Franciscan HMND (FRN01) 374 Franciscan CNPT (FRN02)	Franciscan Payers ERA Request
1199 National Benefit Fund (13162)	1199 National Benefit Fund ERA Request
AARP United Healthcare (36273)	AARP United Healthcare ERA Request
Absolute Total Care SC (68069)	Absolute Total Care EFT/ERA Request (via PaySpan Health)
Ace American Insurance Company (All States) (WC Only) (J4717)	Ace American Insurance Company ERA Request
Access Community Health Network (ACCOM)	Access Community Health Network ERA Request
Access IPA (ACC01)	Access IPA ERA Request
Advocate Health Partners (65093)	Advocate Health Partners ERA Request
Aetna (60054)	Aetna ERA Request
Aetna Better Health of California (128CA) Aetna Better Health of Florida (128FL) Aetna Better Health of Illinois (68024) Aetna Better Health of Kentucky (128KY) Aetna Better Health of Louisiana (128LA) Aetna Better Health of Maryland (128MD) Aetna Better Health of Michigan (128MI) Aetna Better Health of New Jersey (46320) Aetna Better Health of New York (34734) Aetna Better Health of Ohio (50023) Aetna Better Health of PA (23228) Aetna Better Health of Texas (38692) Aetna Better Health of Virginia (128VA) Aetna Better Health of West Virginia (128WV)	Aetna Better Health of CA ERA Request Aetna Better Health of FL ERA Request Aetna Better Health of IL ERA Request Aetna Better Health of KY ERA Request Aetna Better Health of LA ERA Request Aetna Better Health of MD ERA Request Aetna Better Health of MI ERA Request Aetna Better Health of NJ ERA Request Aetna Better Health of NY ERA Request Aetna Better Health of OH ERA Request Aetna Better Health of PA ERA Request Aetna Better Health of TX ERA Request Aetna Better Health of VA ERA Request Aetna Better Health of WV ERA Request
Aetna Senior Supplemental Insurance (62118)	Aetna Senior Supplemental Insurance (62118)
AG Administrators (11370)	AG Administrators ERA Request
Affinity Health Plan (13333, 13334)	Affinity Health Plan ERA Request
Alabama	Alabama BCBS ERA Request Alabama Medicaid Alabama Medicare Part B	Alabama Medicare Part A
Aither Health (64884)	Aither Health ERA Request
Alameda Alliance (95327)	Alameda Alliance Claims Request Alameda Alliance ERA Request
Alaska	Alaska BCBS Premera ERA only Alaska Medicaid Alaska Medicare Part B	Alaska BCBS Premera ERA only (same as prof) Alaska Medicaid (same as prof)
Aliera Healthcare (ALH01)	Aliera Healthcare ERA Request
Align Senior Care (CA, FL, MI, VA) (ASCA1, ASFL1, ASMI1, ASVA1)	Align Senior Care ERA Request
Alignment Health Care (CCHPC)	Alignment Health Care ERA Request
Allcare Advantage (MRCHP) Allcare Health CCO (MRIPA) Allcare PEBB (MRPEBB)	Allcare Advantage, Allcare Health CCO, Allcare PEBB ERA Request
Alliance Behavioral Health (23071)	Alliance Behavioral Health (Claims and ERAs)
Alliance Physicians High Desert	Alliance Physicians High Desert ERA Request
Alliant Health Plans of Georgia (58234)	Alliant Health Plans of Georgia ERA Request
Allied Benefit Systems (37308)	Allied Benefit Systems ERA Request
All United Medical Group (AUMG1)	All United Medical Group ERA Request
Allways Health Partners (04293) FKA Neighborhood Health Plan MA	Allways Health Partners ERA Request
Alohacare Quest (ALQST), Alohacare Medicare Advantage (ALOHA)	Alohacare Quest and Alohacare Medicare Advantage Claims Alohacare ERA Request
Alpha Care Medical Group (NMM04)	Alpha Care Medical Group ERA Request
AltaMed (ALTAM)	AltaMed ERA Request
American Family Insurance (56071)	American Family Insurance ERA Request
American Health Advantage of Indiana (RP115)	American Health Advantage of Indiana ERA Request
American Health Plans (Remits Only) (R2644)	American Health Plans (Remits Only) ERA Request
American Income Life Insurance (60577)	American Income Life Insurance ERA Request
American Insurance Administrators (26119)	American Insurance Administrators ERA Request
American Medical Security (81400)	American Medical Security ERA Request
American Postal Workers Union Health Plan (44444)	American Postal Workers Union Health Plan ERA Request
American Republic Insurance (42011)	American Republic Insurance ERA Request
American Specialty Health (ASH01)	American Specialty Health ERA Request
America’s 1ST Choice SC-GA (20553)	America’s 1ST Choice SC-GA ERA Request
Americhoice (03432, 86047, and 86049 - UHC of PA, pka Americhoice PA)	Americhoice ERA Request
Amerigroup (26375, 27514, 28804, 28809)	Amerigroup Multi State ERA Request
Amerigroup – Wellpoint (WLPNT)	Amerigroup – Wellpoint ERA Request
AmeriHealth (multi-state)	Amerihealth Administrators (54763) EFT/ERA Amerihealth Caritas Delaware (77799) Amerihealth Caritas Florida (77003) Amerihealth Caritas Iowa (77075) Amerihealth Caritas Louisiana (27357) AmeriHealth Caritas VIP Care - Michigan HIDE SNP (90689) Amerihealth Caritas New Hampshire (87716) Amerihealth Caritas Pennsylvania (22248) Amerihealth Caritas PA Community HealthChoices (77062) Amerihealth Caritas VIP Care Michigan (77013) Amerihealth DE-NJ HMO (95044) Amerihealth Delaware PPO (93688) Amerihealth New Jersey PPO (60061)	Amerihealth HMO (95044) Inst Amerihealth New Jersey PPO (60061) Inst
AmeriHealth Mercy Care (22248)	AmeriHealth Mercy Care ERA Request (AKA Amerihealth Caritas Pennsylvania)
Amtrust North America (All States) (WC Only) (J1868)	Amtrust North America ERA Request
Ancillary Care Services (A2004)	Ancillary Care Services ERA/EFT Request
Angle Insurance Company of Utah (39856)	Angle Insurance Company of Utah ERA Request
Anthem Dental (Remits and Eligibility Only) (84105)	Anthem Dental (Remits and Eligibility Only) ERA Request
APS Healthcare of Puerto Rico (66056)	APS Healthcare of Puerto Rico Clm Request
Apex Benefit Servcs (34196)	Apex Benefit Services ERA Request
AppleCare Medical Management (APP01)	AppleCare Medical Management ERA Request
Arcadia Healthcare Solutions - IPG	Arcadia Healthcare Solutions – IPG ERA Request
Arizona	Arizona BCBS ERA Request BCBS of AZ Advantage (Medisun) ERA Request Arizona Medicaid Arizona Medicare Part B
Arizona Priority Care Plus (AZPCP)	Arizona PCP ERA Request
Arkansas	Arkansas BCBS Arkansas Medicaid Arkansas Medicare Part B	Arkansas Medicaid Inst Arkansas Medicare Part A
Arkansas Superior Select (61184)	Arkansas Superior Select ERA Request
Aspirus Health Plan (Medicare Advantage) (36483)	Aspirus Health Plan ERA Request
Associated Hispanic Physicians of Southern CA IPA (AHPSC)	Associated Hispanic Physicians of Southern CA IPA ERA Request
Assurant Health (75068)	Assurant Health ERA Request
Asuris Northwest Health (93221)	Asuris Northwest Health ERA Request
Atrio Health Plan (ATRIO)	Atrio Health Plan ERA Request
Aultcare (AULTC) Includes Primetime Health (PTIME) and Aultra (37242)	AultCare, Primetime Health, Aultra
Automated Group Administrators (37280)	Automated Group Administrators ERA Request
Auxiant (AUX01)	Auxiant ERA Setup Request
Avera Health Plan (46045)	Avera ERA Request
Avesis Third Party Admin- Medical (87098)	Avesis EFT/ERA Request
Avmed (59274)	Avmed ERA Request
Bakersfield Family Medical Center (BKRFM)	Bakersfield Family Medical Center ERA Request
Bankers Fidelity Life Assurance Co (30152)	Bankers Fidelity Life Assurance Co ERA Request
Bankers Life (61263)	Bankers Life ERA Request
Banner Health- Arizona (12X42)	Banner Health Arizona ERA Request
Baptist Health Plan (PKA Bluegrass Family Health) (61124)	Baptist Health Plan ERA Request
Bay Bridge Administrators (06941)	Bay Bridge Administrators ERA Request
BayCare Select Health Plans Inc (81079)	BayCare Select Health Plans Inc ERA Request
Beacon Health Options (FKA Value Options)	Beacon Health Options (FKA Value Options) ERA Request
Beaver Medical Group (45967)	Beaver Medical Group ERA Request
Bella Vista Medical Group (MPM10)	Bella Vista Medical Group ERA Request
Benefit and Risk Management Services (99320)	Benefit and Risk Management Services ERA Request
Bind Insurance (25463)	Bind Insurance ERA Request
Blackhawk (CB987)	Blackhawk ERA Request
Blue Medicare Advantage- IL, MT, NM, OK, TX (66006)	Blue Medicare Advantage- IL ERA Request Blue Medicare Advantage- MT ERA Request Blue Medicare Advantage- NM ERA Request Blue Medicare Advantage- OK ERA Request Blue Medicare Advantage- TX ERA Request
BoldAge Pace (BOLD1)	BoldAge Pace ERA Request
Boncura Health Solutions (66727)	Boncura Health Solutions ERA Request
Boon Group (BOONG)	Boon Group ERA Request
Boston Medical Center HealthNet Plan (13337)	BMC HealthNet Plan ERA Request
Braven Health (84367)	Braven Health Request
Bravo-Cigna Healthspring (52192)	Bravo-Cigna Healthspring ERA Request
Bridgespan Health (BRIDG)	Bridgespan Health ERA Request
Bridgeway Health Solutions AZ (68069)	Bridgeway Health Solutions AZ EFT/ERA Request
Bright Health (CB186)	Bright Health ERA Request
Bristol Park Medical Group & MemorialCare Medical Foundation (MMFMC) and Edinger Medical Group & Greater Newport Physicians (GNPMG)	Bristol Park Medical Group & MemorialCare Medical Foundation (MMFMC) and Edinger Medical Group & Greater Newport Physicians (GNPMG) ERA Request
Brown & Toland (94316)	Brown & Toland ERA/EFT Request
Brown and Toland Health Services (BTHS1)	Brown and Toland Health Services ERA/EFT Request
BSI (25916)	BSI ERA Request
Brown and Toland Sutter (BTSS1)	Brown and Tola nd Sutter ERA Request
Buckeye Community Health Plan(68069)	Buckeye Community Health Plan OH EFT/ERA Request
Business Administration & Consultation (49984)	BA Consult ERA Request
California	California BC- Anthem ERA request California Blue Shield (94036) and CA Promise Health Plan (C1SCA) ERA request California Medicaid Claims and ERA Request Northern California Medicare Part B Southern California Medicare Part B	California Blue Cross (see prof.) California Blue Shield (see prof.) California Medicaid Inst. Claims and ERA Request California Medicare Part A
California Medical Center (MPM28)	California Medical Center ERA Request
Capital District PHP (CDPHP)	Capital District PHP ERA request
Capital Health Plan (95112)	Capital Health Plan ERA Request
Care Improvement Plus (77082) Enroll for ERAS under UHC (87726)	United Healthcare Multipayer ERA Setup Request
CareCentrix (11345)	CareCentrix Claims’ and ERA Request
CareFirst Administrators/NCAS – Charlotte (75191)	CareFirst Administrators ERA Request
CareMore Health Plan (CARMO, AKA IP128,CM001)	CareMore Health Plan ERA Request
CareOregon (93975)	CareOregon ERA Request
CarePartners of CT (16307)	CarePartners of CT ERA Request
CarePlus Health Plan (65031)	CarePlus Health Plan ERA Request
CareSource OH (31114), CareSource IN (INCS1), CareSource KY (KYCS1), CareSource WV (WVCS1), CareSource AR (ARCS1), CareSource North Carolina (NCCS1)	CareSource OH, IN, KY, WV, AR, NC ERA/EFT Request
CareSource of Michigan Medicaid (MIMD1)	CareSource of Michigan Medicaid ERA Request
CareSource of Nevada Marketplace (NVCS1)	CareSource of Neveda Marketplace ERA Request
CareSource of Nevada Medicaid (NVMD1)	Caresource of Nevada Medicaid ERA Request
Cascade Comprehensive Care (CHA01)	Cascade Comprehensive Care ERA Request
CBNHP Healthchoices (65391)	CBNHP Healthchoices ERA Request
Cedars-Sinai Medical Network Services (95166)	Cedars-Sinai Medical Network Services ERA Request
Cedar Valley Community Healthcare (42558)	Cedar Valley Community Healthcare ERA Request
Celticare Health Plan MA (68069)	Celticare Health Plan MA ERA ONLY Request Celticare EFT/ERA Request (via PaySpan Health)
Cenpatico Behavioral Health (68068)	Cenpatico EFT/ERA Request (via PaySpan Health)
CenCal Health (95386, 99111)	CenCal Health ERA Request
Centene Payers	Centene Multipayer List for ERA Requests
Central California Alliance for Health (CCA01)	Central California Alliance for Health Claims and ERA Request
Centurion (42140)	Centurion ERA Request
Champ VA (84146) and Champ VA Crossover (80214)	Champ VA and ChampVA Crossover ERA Request
Champion Payer Solutions (CPS01)	Champion Payer Solutions ERA Request
CHCS Services (75895)	CHCS Services ERA Request
Childrens Medical Center Health Plan (CMCHP)	Childrens Medical Center Health Plan ERA Request
Chinatown Service Center (R3478)	Chinatown Service Center ERA Request
Chiropractic Care of MN AKA Landmark Healthcare (LNDMK)	Chiropractic Care of MN ERA Request
Christian Brothers Services (38308)	Christian Brothers Services ERA Request
Christian Care Ministries (59355)	Christian Care Ministries ERA Request
Christus Health Medicare Advantage (10629)	Christus Health Medicare Advantage ERA Request
Christus Health Plan Medicaid (45210)	Christus Health Plan Medicaid ERA Request
Christus Health Plan of Texas and Louisiana (52106)	Christus Health Plan of Texas and Louisiana ERA Request
Choice Medical Group (CMG01)	Choice Medical Group ERA Request
Chorus Community Health Plans (WI Medicaid) (29123)	Chorus Community Health Plans ERA Request
Cigna Healthcare (62308) Great West (80705) Cigna Medicare Advantage (86033)	Cigna, Cigna Medicare and Great West ERA Request (ERA setup can be for both Medical and Dental)
Cigna Medicare Supplemental (13193)	Cigna Medicare Supplemental Benefits ERA Request
Clever Care Health Plan Inc (84227)	Clever Care Health Plan ERA Request
Clinicas Del Camino Real (CDCR1)	Clinicas Del Camino Real ERA Request
Clover Health (13285)	Clover Health ERA Request
CNIC Health Solutions (37227)	CNIC Health Solutions ERA Request
CoachellaMed (COMG1)	CoachellaMed ERA Request
Coastal Administrative Services (77052)	Coastal Administrative Services ERA request
Coastal Communities Physician Network (CCPN1) (Z1391)	Coastal Communities Physician Network ERA Request
Collective Health (36481)	Collective Health ERA Request
Colonial Penn Life Insurance (Remits and Eligibility Only) (62065)	Colonial Penn Life Insurance (Remits and Eligibility Only) ERA Request
Colorado	Colorado BCBS- Anthem ERA request Colorado Medicaid Colorado Medicare Part B	Colorado BCBS- Anthem ERA request Colorado Medicaid Colorado Medicare Part A
Colorado Access (COACC)	Colorado Access ERA Request
Colorado Community Health Alliance (COCHA)	Colorado Community Health Alliance ERA Request
Common Ground Healthcare (77170)	Common Ground Healthcare ERA/EFT Request
Commonwealth Care Alliance (A2793)	Commonwealth Care Alliance ERA Request
CommuniCare Advantage (34525)	CommuniCare Advantage ERA Request
Community Care Behavioral Health (23282)	Community Care Behavioral Health ERA Request
Community Behavioral Health (00CBH/CBH)	Community Behavioral Health Claims’ Request
Community Care Managed Healthcare Plans of OK (73143)	Community Care Managed Health Care Plans ERA Request
Community Care Organization (39126)	Community Care Organization ERA Request
Community Care Plan (Florida Healthy Kids) (FHKC1)	Community Care Plan ERA Request
Community Care Plan (Palm Beach District) (PBHD1)	Community Care Plan (Palm Beach District) ERA Request
Community Family Care (NMM05)	Community Family Care ERA Request
Community First Health Plan (42723)	Community First Health Plan ERA Request
Community Health Choice Medicaid (48145)	Community Health Choice- ERA Request
Community Health Group of San Diego (66170)	Community Health Group of San Diego ERA Request
Community Health Plan of WA (CHPWA)	Community Health Plan of WA ERA Request
Companion Life Insurance Company (01361)	Companion Life Insurance Company ERA Request
Compsych (37363)	Compsych ERA Request
Concierge HMO IPA (CHHMO)	Concierge HMO IPA ERA Request
Conifer Health Solutions (CAPMN)	Conifer Health Solutions ERA Request
Connecticare (06105) Connecticare VIP Mcr Adv (78375) Connecticare MCD (MLNCT)	Connecticare ERA Request Connecticare VIP Mcr Adv EFT-ERA Request Connecticare MCD ERA Request
Connecticut	Connecticut BCBS- Anthem ERA request Connecticut Medicaid Connecticut Medicare Part B
Constitution State Services (WC Only) J4180	Constitution State Services ERA Request
Contessa Health (CH201)	Contessa Health ERA Request
Continental General Insurance (71404)	Continental General Insurance ERA Request
Contra Costa Health Plan (CCHP)	Contra Costa Health Plan ERA Request
Cook Children’s Health Plan	Cook Children’s Health Plan (CCHP1) (CCHP9) ERA Request
COPC – Senior Care Advantage (AGL02)	COPC-Senior Care Advantage ERA Request
CoreSource (35182, 35183, 48117, 75136)	CoreSource ERA request
Corporate Benefits Service Inc (56116)	Corporate Benefits Service Inc ERA request
CountyCare (06541)	CountyCare ERA request
Covenant Mngmt Systems Employee Benefit Plan (CMSEB)	Covenant Mngmt Systems Employee Benefit Plan ERA Request
Coventry Healthcare (25133) includes: Advantra Freedom (25152), Altius (SX113), Diamond State Health Plan (25131), Health America (25126) and Mailhandlers Benefit Plan (62413)	Coventry ERA Request For Coventry Health Care of Florida SEE Aetna Better Health of FL ERA Request
Cox Health Plan (00019)	Cox Health Plan ERA Request
Culinary Health Plan (59144)	Culinary Health Plan ERA Request
Davis Vision (00157)	Davis Vision Claims
Dean Health Plan (39113)	Dean Health Plan ERA Request
Delaware	Delaware BCBS Claims’ Request Delaware BCBS ERA Request Delaware Medicaid Delaware Medicare Part B
Delaware Health First (68069)	Delaware Health First ERA Request
Dell Childrens Health Plan (38261)	Dell Childrens Health Plan ERA Request
Delta Health Systems (DHS01)	Delta Health Systems ERA Request
Desert Oasis Healthcare (44066)	Desert Oasis Healthcare ERA Request
Devoted Health (DEVOT)	Devoted Health ERA Request
District of Columbia (DCMA)	Carefirst BCBS DC ERA request DC Medicaid DC Medicare Part B	Carefirst BCBS DC ERA request
DMBA –Deseret Mutual Benefits Assn (SX105)	UHIN Multipayer ERA Request Form
DMERC	DMERC Region A DMERC Region B DMERC Region C DMERC Region D
Doctors Healthcare Plans (DRHCP)	Doctors Healthcare Plans ERA Request
Driscoll Health Plan (74284)	Driscoll Health Plan ERA only
East Carolina Behavioral Health- Trillium	Trillium ERA Setup Request
ECHO Healthcare Multipayers	ECHO Healthcare Multipayer ERA Request
EDS Admin Services AKA Health Choice OK (22521)	EDS Admin Services ERA request
Elderplan (31625)	Elderplan ERA Request
Elder Service Plan of the North Shore (04326)	Elder Service Plan NS ERA Request
El Camino Health Alliance (ECL01)	El Camino Health Alliance ERA Request
El Paso First Health Plans (EPF02, EPF03, EPF10, EPF37)	El Paso First Health Plans (Claims and ERA)
El Proyecto De Barrio (MPM04)	El Proyecto De Barrio ERA Request
EMIA Educators Mutual Insurane (SX110)	UHIN Multipayer ERA Request Form
Employee Benefit Admin (95288)	Employee Benefit Admin ERA Request
Employee Benefit Management Corp (31074)	Employee Benefit Management Corp ERA Request
Employee Benefit Services (37216)	Employee Benefit Services ERA Request (EFT required)
EON Health (66011)	EON Health ERA Request
Equian (All States) (WC Only) (J2090)	Equian ERA Request
Equitable Life & Casualty (75091)	UHIN Multipayer ERA Request Form
Essential Health Partners (EHPSC)	Essential Health Partners ERA Request
Essence Healthcare (20818)	Essence Healthcare ERA request
Excellus Blue Cross Blue Shield (12837)	Excellus Blue Cross Blue Shield ERA/EFT Request
EyeMed (31165)	EyeMed ERA Request
Fallon Community Health Plan (22254)	Fallon Community Health Plan ERA only
Family Care Specialists IPA (FCS01)	Family Care Specialists IPA ERA Request
Family Choice Medical Services (FCMS2)	Family Choice Medical Services ERA Request
Family Health Partners (31472, 43173)	Family Health Partners ERA only
Farm Bureau Health Plans (62045)	Farm Bureau Health Plans ERA request
Fidelis Care New York (11315)	Fidelis Care NY ERA request
First Choice Health Network (91131)	First Choice Health Network ERA Request
First Choice Next (57103)	First Choice Next ERA Request
First Choice VIP Care Plus (77009)	First Choice VIP Care Plus ERA Request
First Medical (66053)	First Medical ERA request
First Priority Health- FPLIC (23241)	First Priority Health ERA only
Florida	Florida BCBS ERA request Florida Medicaid Florida Medicare Part B	BCBS--See professional form Medicaid--See professional form Florida Medicare Part A Florida Blue Medicare (FBM01)
Florida Community Care (FLCCR)	Florida Community Care ERA request
Florida Complete Care (FLCPC)	Florida Complete Care ERA Request
Florida Health Care Plan (59322)	FHCP ERA Request
Freedom Health Medicare Adv (41212)	Freedom Health Mcr Adv ERA only
Fresno Pace For Seniors (99660)	Fresno Pace For Seniors ERA Request
Friday Health Plans (H0657)	Friday Health Plans ERA Request
Gallagher Bassett (Auto Only) (TP057)	Gallagher Bassett ERA Request
Gateway Health Plan- Medicaid (25169) Gateway Health Plan- Medicare (60550) Gateway Health Plan- Medicare Assured OH (91741)	Gateway Health Plan- Medicaid ERA Request (25169) Gateway Health Plan- Medicare ERA Request (60550) Gateway Health Plan- Medicare Assured ERA Request (91741)
Geisinger Health Plan (75273)	Geisinger Health Plan ERA/EFT Request
Georgia	Georgia BCBS- Anthem ERA Request Georgia Medicaid Georgia Medicare Part B	Georgia BCBS- Anthem ERA request– Inst. Georgia Medicaid Inst Georgia Medicare Part A
GHI Group Health Inc (13551) GHI HMO (25531)	GHI Group Health Inc EFT-ERA request GHI HMO EFT-ERA request
Gold Coast Health Plan (77160)	Gold Coast Health Plan ERA Request
Golden Physicians Medical Group (GPMG2)	Golden Physicians Medical Group ERA Request
Golden Rule (37602)	Golden Rule ERA Request see professional ERA form
Gravie Administrative Services (GRV01)	Gravie Administrative Services ERA Request
Great West (80705) and Cigna (62308)	Great West and Cigna ERA request see professional ERA form
Greater NY Insurance Co and Chubb Corvel (J4323)	Greater NY Insurance Co ERA Request
Group and Pension Administrators (48143)	Group and Pension Administrators ERA Request
Group Health Coop Eau Claire (95192)	Group Health Coop Eau Claire ERA Request
Group Health Coop So Central Wisconsin (39167)	Group Health Coop So Central Wisconsin ERA Request
Group Health Coop Pacific Northwest (91051)	Group Health Coop Pacific Northwest ERA/EFT Request
Guardian Life Insurance Co (64246)	Guardian Life Insurance Co ERA Request
Guarantee Trust Life Insurance Company (Remits Only) (06684)	Guarantee Trust Life Insurance Company ERA Request
Hamaspik Choice (47738)	Hamaspik Choice ERA Request
HAP Caresource MI Health Link (MIMR1)	HAP Caresource MI Health Link ERA Request
Harbor Health (HARBR)	Harbor Health ERA Request (Zelis)
Harmony Health Plan of IL-IN	Harmony Health Plan of IL-IN ERA Request
Harvard Pilgrim Healthcare (04271)	Harvard Pilgrim Healthcare ERA Request Harvard Pilgrim EFT/ERA Request (via PaySpan Health)
Hawaii	Hawaii BCBS – HMSA Hawaii Medicaid Hawaii Medicare Part B
Health Alliance Plan of IL (77950)	Health Alliance Plan of IL ERA Request
Health Alliance Plan of MI (38224)	Health Alliance Plan of MI ERA Request
Health Care District Palm Beach County (HCDPB)	Health Care District Palm Beach County Claims Request
Healthcare Strategic Initiatives (HSICS)	Healthcare Strategic Initiatives ERA Request
Health Choice Integrated (22100) Steward Health Choice Arizona (62179)	Health Choice Integrated ERA Request Steward Health Choice Arizona ERA Request
Health Choice Utah (45399) Health Choice Generations Utah (13054)	Health Choice Utah ERA Request
Healthcomp Inc (85729)	Healthcomp Inc ERA Request
Healthequity Inc (Remits Only) (43700)	Healthequity Inc (Remits Only) ERA Request
HealthEZ (41178)	HealthEZ ERA Request
Health First Health Plans (95019)	Health First Health Plans ERA Request
Health First Health Plans (RP039)	Health First Health Plans ERA Request
Health Net CA, OR (95567)	Health Net of California Oregon ERA Request
Health Net Encounters – Capitated (HN007) Health Net Encounters- FFS (95570)	Health Net Encounters- Capitated (HN007) Claims Request Health Net Encounters- FFS (95570) Instructions for Claims
Health Network One (65062)	Health Network One ERA Request
Health New England (04286)	Health New England ERA Request
Health Options (47181)	Health Options ERA Request
Health Plan of San Joaquin (68035)	Health Plan of San Joaquin ERA Request
Health Plan of San Mateo (HPSM1)	Health Plan of San Mateo EFT-ERA Request
Health Plan Upper Ohio Valley (HPOUV)	Health Plan Upper Ohio Valley ERA Request
HealthPlus Managed Long Term Care (Z3001)	HealthPlus Managed Long Term Care ERA Request
Health Partners of Philadelphia (80142)	Health Partners of Philadelphia ERA/EFT Request
Healthcare Partners (HCP01)	See Optum Care Network
Healthcare Partners IPA- NY (11328)	HealthCare Partners IPA NY ERA Request
HealthCare Partners of Nevada (20501)	HealthCare Partners of Nevada ERA Request
Healthease Florida (59608)	Healthease Florida ERA Request
HealthFirst, Inc of NY (80141)	HealthFirst, Inc of NY ERA Request
Healthgram (56144)	Healthgram ERA Request
Healthlink PPO/National Capital Preferred Provider Organization (NCPPO) (90001)	Healthlink PPO/National Capital Preferred Provider Organization ERA Request
HealthNet of California (95567)	HealthNet of California ERA request
HealthNow New York (55204)	HealthNow New York ERA request
Healthpartners MN (HPAMN)	Healthpartners MN ERA request
Health Plan of San Joaquin (68035)	Health Plan of San Joaquin ERA Request
Health Plus PHSP (81237, PKA 11324)	Health Plus ERA Request (now part of Amerigroup Multi-State)
Healthscope (40026)	Healthscope ERA Request
HealthSmart Benefit Solutions (87815)	HealthSmart Benefit Solutions ERA Request
Healthy Blue Louisiana (00661) Healthy Plus Dual Advantage (00551)	Healthy Blue Louisiana ERA Request Healthy Blue Dual Advantage ERA Request
Healthy Blue Kansas (Medicaid and Medicare DSNP) (00047)	Healthy Blue Kansas ERA Request
Healthy Blue Missouri (00541) Healthy Blue North Carolina (00602)	Healthy Blue- Missouri, North Carolina ERA Request
Healthy Medical Group (HMG01)	Healthy Medical Group ERA Request
Hennepin Health Plan (60058)	Hennepin Health ERA Request
High Desert PACE (HDP01)	High Desert PACE ERA Request
Highmark BCBS DE Health Options (47181)	Highmark BCBS DE Health Options ERA Request
Highmark Gateway BCBS PA (54771) Highmark Senior Health PA –Medicare Adv (15460)	Highmark Gateway PA ERA Request Highmark Gateway BCBS PA ERA Request
Highmark Health Options Duals WV (88831)	Highmark Health Options Duals WV ERA Request
Highview National Insurance Company (WC Only) (J4589)	Highview National Insurance Company ERA Request
Hill Physicians Medical Group (HIL01)	Hill Physicians Medical Group ERA Request
HIP Health Insurance Plan of Greater NY (55247)	HIP of Greater NY ERA request
HMA Inc- Hawaii (86066)	HMA Inc Hawaii ERA Request
Home Health Hospice Medicare CGS- Medicare Juris 15 (15004) Palmetto – Medicare Juris 11 (11001)		Home Health Hospice-CGS Juris 15 Home Health Hospice-Palmetto Juris 11
Hometown Health Plan (88023)	Hometown Health Plan ERA/EFT Request
Honest Medical Group (HONMG)	Honest Medical Group ERA Request
Horizon Mercy NJ Health (22326)	Horizon NJ Health ERA Request
Horizon Valley Medical Group (HVMG1)	Horizon Valley ERA Request
HRSA COVID-19 Coverage Assistance Fund	HRSA COV-19 Coverage Fund 837-Claims’ Request
Humana (61101)	Humana EFT/ERA Request
iCare Health Options (FL Optometric Phys) (26054)	iCare Health Options ERA Request
iCare Independent Care Health Plan (11695)	iCare Independent Care Health Plan ERA Request
IBC Personal Choice (54704)	IBC Personal Choice	IBC Personal Choice (Inst)
Idaho	Idaho Blue Cross Idaho Regence Blue Shield ERA Idaho Medicaid Claims and ERAs Idaho Medicare Part B	Idaho Regence Blue Shield ERA Idaho Medicaid Inst ERA Idaho Medicare Part A
IlliniCare Health Plan (68069)	IlliniCare Health Plan ERA Request
Illinois	Illinois BCBS ERA request (Includes Blue Medicare Advantage) Illinois Medicaid ERA Request Illinois Medicare Part B BCBS IL Community Health Plans	Illinois BCBS ERA request Illinois Medicaid inst ERA. Illinois Medicare Part A
IMCare, Itasca Medical Center (41600)	IMCare, Itasca Medical Center ERA Request
Independence Administrators (TA720)	Independence Administrators ERA Request
HRSA COVID-19 Coverage Assistance Fund (90AQS)	HRSA COV-19 Coverage Assistance Fund Claims’ Request
Independent Health NY (95308)	Independent Health Clms and ERA
Indiana	Indiana BCBS – Anthem ERA Request Indiana Medicaid ERA request Indiana Medicare Part B	Indiana BCBS- Anthem ERA request– Inst. Indiana Medicaid ERA request Indiana Medicare Part A
Indiana University Health Plan (Commercial IUHPLNS) (26212)	Indiana University Health Plan (Commercial IUHPLNS) ERA Request
Indiana University Health Plan (Medicare) (95444)	Indiana University Health Plan (Medicare) ERA Request
InnovAge (31182)	InnovAge ERA/EFT Request
Inland Empire Health Plan (IEHP1)	Inland Empire Health Plan ERA request
Inland Faculty Medical Group (MVMM1)	Inland Faculty Medical Group ERA request
Instamed Healthcare Payment Systems	Instamed Multipayer ERA/EFT Request
Insurance Management Services (IMSMS)	Insurance Management Services ERA Request
Integrated Behavioral Health DBA Uprise Health (63103)	Integrated Behavioral Health DBA Uprise Health ERA Request
International Benefit Administrator (11329)	International Benefit Administrator ERA Request
Iowa	Iowa Blue Cross Blue Shield Iowa Medicaid Iowa Medicare Part B Medicaid Iowa Safety Net Management Information Systems	Iowa Medicaid Inst.
IQVIA (15060)	IQVIA ERA Request
John Alden Life Insurance Co (41099)	John Alden Life Insurance Co ERA Request
Johns Hopkins US Family Health Plan (52123) Johns Hopkins EHP Priority Partners (52189) Johns Hopkins Medicare Advantage (66003)	Johns Hopkins US Family Health Plan Johns Hopkins EHP Priority Partners ERA Request Hopkins Health Advantage ERA Request
John Muir/Tapestry (78036)	John Muir/Tapestry ERA Request
Jopari Auto Payers	Allstate – Except NJ (Auto) ERA Request Auto-Owners Life Ins Co (Auto Only) ERA Request CIM Ins Corp (MN, NJ) (Auto) ERA Request Contra Costa County Risk Management (Auto) ERA Request Encompass (Subsidiary of Allstate) (Auto) ERA Request GMAC Ins Co Online (MN, NJ) (Auto) ERA Request Progressive (Auto) ERA Request Selective – MN NJ Only (Auto) ERA Request
JVHL Blue Care Network (JJJVH) JVHL Blue Care Network (JQJVH) JVHL Blue Care Network (J9JVH) JVHL McLaren Health Plan (K7JVH) JVHL Molina Healthcare of Michigan (JVJVH) JVHL Priority Health (JZJVH)	JVHL Multipayer List for Claims and ERAs
Kaiser Foundation GA (21313 / RH008)	Kaiser Foundation Georgia ERA Request
Kaiser Foundation CO (91617/00277)	Kaiser Foundation Colorado ERA Request
Kaiser Foundation HI (94123)	Kaiser Foundation Hawaii ERA Request
Kaiser Foundation Mid-Atlantic States (52095)	Kaiser Foundation Mid-Atlantic States ERA Request
Kaiser Foundation Northwest (93079/KS007)	Kaiser Foundation Northwest ERA Request
Kaiser Foundation No CA (94135/KS003)	Kaiser Foundation Northern CA ERA Request
Kaiser Foundation So CA (94134/KS001)	Kaiser Foundation Southern CA ERA Request
Kaiser – Self Funded (94320)	Kaiser – Self Funded ERA Request
Kansas	Kansas BCBS ERA Request Kansas City BCBS ERA Request Kansas Medicaid ERA Request Kansas Medicare Part B	Kansas BCBS Inst. Kansas City BCBS Inst. Kansas Medicaid Inst. Kansas Medicare Part A
Keenan and Assocs Commercial (KEE01)	Keenan and Assocs Commercial ERA Request
Kelsey-Seybold (KELSE)	Kelsey-Seybold ERA Request
Kentucky	Kentucky BCBS - Anthem ERA Request Kentucky Medicaid Kentucky Medicare Part B	Kentucky BCBS- Anthem ERA request– Inst. Kentucky Medicare Part A
Kern Health Systems (KERN1)	Kern Health Systems ERA Request
Key Benefit Administrator (37217)	Key Benefit Administrator ERA Request
Key Medical Group (IP082, IP083, IP084)	Key Medical Group ERA Request
Key Solutions (37323)	Key Solutions ERA Request
KeyCare Advantage (KCMD1)	KeyCare Advantage ERA Request Eff 01/12/2024- ERA setup for this payer has been temporarily disabled.
Keystone First – CHIP (30070)	Keystone First – CHIP ERA Request
Keystone First Community Healthchoices (42344)	Keystone First Comm Healthchoices ERA
Keystone Health Plan East (95056)	Keystone Health Plan East	Keystone Health Plan East Inst
Keystone First (aka Keystone Mercy Health Plan)(23284)	Keystone Mercy Health Plan ERA Request
Keystone VIP Choice (77741)	Keystone VIP Choice ERA Request
LA Care Health Plan (LACAR)	LA Care Health Plan ERA Request
Land of Lincoln Health (90096)	Land of Lincoln Health ERA Request
Landmark Healthcare Aka Chiro Care of MN (LNDMK)	Landmark Healthcare-Chiropractic Care of MN ERA request
Lagniappe Advantage (LALA1)	Lagniappe Advantage ERA Request
LaSalle Medical Associates (NMM02)	LaSalle Medical Associates ERA Request
Leon Health Plans (A3565)	Leon Health Plans ERA Request
Liberty Advantage (LIB01)	Liberty Advantage ERA Request Eff 1/31/2021- ERA setup for this payer has been temporarily suspended. ERA setup to be available in a few months. In the meantime, billing providers can contact the payer at 1-844-854-6884.
LifeCircles PACE (71498)	LifeCircles PACE ERA Request
Life Pittsburgh (25181)	Life Pittsburgh ERA Request
Lifewise Health Plan Oregon (93093 Lifewise Health Plan Washington (91049)	Lifewise Health Plan of Oregon ERA request Lifewise Health Plan of Washington ERA request
LifeWorks Advantage (LWA01)	LifeWorks Advantage ERA Request
Little Company of Mary (LCM10)	Little Company of Mary ERA Request
Live Well IPA (LWIPA)	Live Well IPA ERA Request
Longevity Health Plan of CO (LCO01) Longevity Health Plan of FL (LFL01) Longevity Health Plan of IL (LIL01) Longevity Health Plan of MI (LMI01) Longevity Health Plan of NJ (LNJ01) Longevity Health Plan of NY (LNY01) Longevity Health Plan of NC (LNC01) Longevity Health Plan of OK (LOK01)	Longevity Health Plan of CO, MI, NC ERA Request Longevity Health Plan of FL, IL, NJ, OK, NY ERA Request
Louisiana	Healthy Blue Louisiana (00661) HMO Louisiana (84555) ERA Request Louisiana BCBS (53120) Louisiana Medicaid, KidMed LA, Community Health Solutions of Louisiana Louisiana Medicare Part B	Louisiana BCBS Louisiana Medicare Part A
Lutheran Services Carolinas (LSC01)	Lutheran Services Carolinas ERA Request
Maestro (56139), Secure Health (28530)	Maestro, Secure Health ERA Request
Magellan Behavioral Health (01260)	Magellan Behavioral Health ERA request
Magellan Complete Care of Arizona (MCCAZ, MCC01)	Magellan Complete Care of Arizona (MCC01) ERA Request
Magellan Complete Care of Virginia DSNP (MCC02)	Magellan Complete Care of Virginia DNSP (MCC02) ERA Request
Magnacare (11303)	Magnacare ERA Request
Magnolia Health Plan MS (68069)	Magnolia Health Plan ERA request
Maine	Maine BCBS-Anthem ERA request Maine Medicaid Maine Medicare Part B	Maine BCBS- Anthem ERA request– Inst. Maine Medicaid Inst.
MAMSI (52148)	MAMSI ERA Request
Managed Care Systems (MCS01, MCS03)	Managed Care Systems EFT-ERA Request
Managed Health Services – Indiana (68069), Wisconsin (68069)	Managed Health Services IN ERA ONLY Managed Health Services WI ERA ONLY Managed Health Services EFT/ERA Request (via PaySpan Health)
Manhattan Life Assurance Company of America (Remits Only) (86253)	Manhattan Life Assurance Company ERA Request
MAPFRE Life Puerto Rico (5251)	MAPFRE Life ERA Request
Martin’s Point (MPHC2/53275)	Martins Point ERA Request
Maryland	Carefirst BCBS MD ERA request Maryland Medicaid Maryland Medicare Part B See also Dist. of Columbia as necessary for Montgomery co. and Prince Georges co.	Carefirst BCBS MD ERA request Maryland Medicare Part A
Maryland Public Behavioral Health (BHOMD)	Maryland Behavioral Health ERA Request
Maryland Physicians Care (00247)	Maryland Physicians Care ERA Request
Mary Washington Health Plan (83269)	Mary Washington Health Plan ERA Request
Massachusetts	Massachusetts BCBS prof clms/era Massachusetts Medicaid Massachusetts Medicare Part B	Massachusetts BCBS Inst clms/era Massachusetts Medicaid Inst Massachusetts Medicare Part A
McLaren Health Plan (38338) McLaren Health Plan Medicaid (3833C)	McLaren Health Plan ERA Request
MDWise Healthy Indiana (3135M)	MDWise Healthy Indiana ERA Request
MDwise Medicare Advantage (MDADV)	MDwise Medicare Advantage ERA Request
Med3000 CMS Title 19 (M3F12 aka EM843)	Med3000 CMS Title 19 ERA Request (also known as Childrens Managed Medical Assist. Plan)
Med3000 CMS Title 21 (M3F14 aka EM205)	Med3000 CMS Title 21 ERA Request
MedBen (74323)	MedBen ERA Request
MedCost / Liberty Health Share (90753)	MedCost / Liberty Health Share ERA Request
Medica (94265)	Medica (94265) ERA Request
Medica2 (IFB) (12422)	Medica2 (12422) ERA Request
Medica Health Plan Solutions (71890)	Medica Health Plan ERA Request
Medicare Part A Legacy LOB	**If RH/FQHC provider/clinic is credentialed within their own state for Part A claims, use the enrollment form for that state.	Palmetto GBA Medicare (10311) (TN) NGS (UGS) Medicare Legacy (06001) (WI) Novitas Medicare JH Part A (04911) Novitas Medicare JL Part A (12901) WPS Medicare J5 National Part A (05901)
Medical Associates Health Plan (MAHC1)	Medical Associates Health Plan ERA Request
Medical Mutual of Ohio (29076)	Medical Mutual of Ohio ERA Request
Medico (23160)	Medico ERA Request
MediGold (95655)	MediGold ERA Request
Medisun / BCBS of Arizona Advantage (77078)	Medisun / BCBS of Arizona Advantage ERA request
Mediview Curative (CURTV)	Mediview Curative ERA Request
MedPoint Management Payers (MPM03, MPM05, MPM06, MPM22, MPM26, MPM62)	MedPoint Management ERA Request
MedPartners Admin Service (412MP)	MedPartners Admin Service ERA Request
eviCore fka MedSolutions (62160)	eviCore fka MedSolutions ERA Request
Medstar DC (RP062) MedStar Family Choice (RP063)	Medstar DC, MedStar Family Choice ERA Request
Medstar Select / Medicare Choice (251MS)	Medstar Select / Medicare Choice ERA Request
MemorialCare Select Health Plan	MemorialCare Select ERA Request
Mental Health Network (74289)	Mental Health Network ERA Request
Mercy Care Plan Arizona (86052)	Mercy Care Plan Arizona ERA Request
Mercy Maricopa Integrated Health Plan (33628)	Mercy Maricopa Integrated Health Plan ERA Request
Meritain Health (41124), (64157)	Meritain Health EFT-ERA Request
Methodist First Choice (23550)	Methodist First Choice ERA Request
Metro Plus Health Plan (13265)	Metro Plus Health Plan ERA Request
MHNet (Mental Health Network) (74289)	MHNet ERA Request
Miami Childrens Health Plan (82832)	Miami Childrens Health Plan ERA Request
Michigan	Michigan BCBS ERA Request Blue Cross Complete of MI ERA Request Michigan Medicaid Michigan Medicare Part B	Michigan BCBS Inst ERA Request Michigan Medicare Part A Michigan Medicaid Inst
Midwest Health Partners (76079)	Midwest Health Partners ERA Request
Minnesota	BCBS MN Blue Plus Medicaid (00726) Minnesota BCBS ERA request Minnesota Medicaid MHCP Minnesota Medicare Part B	BCBS - see professional form Minnesota Medicaid MHCP
Mississippi	Mississippi BCBS Mississippi Medicaid Mississippi Medicare Part B	Mississippi BCBS Inst. Mississippi Medicaid Inst. Mississippi Medicare Part A
Missouri	Missouri BCBS - Anthem ERA Request Missouri Medicaid ERA request Missouri Medicare Part B	Missouri BCBS- Anthem ERA request– Inst. Missouri Medicaid ERA request Missouri Medicare Part A
Missouri Medicare Select (MMS01)	Missouri Medicare Select ERA Request
MMO Health (SX1093)	MMO Health ERA Request
MN Dept of Health (MNDH1)	MN Dept of Health ERA Request
Moda Health Plan FKA ODS (13350)	Moda Health Plan ERA/EFT Request
Molina Healthcare (Includes these states: CA, FL, IA, IL, KY, MI, MO, OH, Puerto Rico, SC, TX, UT, WA, WI)	Molina Healthcare ERA Request
Momentum TPA (MOMTM)	Momentum TPA ERA Request
Montana	Montana BCBS (includes Blue Medicare Advantage, Montana Medicaid HELP Plan) Montana Medicaid ERA request Montana Medicare Part B
Montana State Fund (All States) (WC Only) (J2893)	Montana State Fund ERA Request
Monitor Life Insurance (16098)	Monitor Life Insurance ERA Request
MPower FFS (MPWR01)	MPower FFS ERA Request
Mountain Health CO-OP (MHC01)	Mountain Health CO-OP ERA Request
Municipal Health Benefit Fund (81883)	Municipal Health Benefit Fund ERA Request
Mutual Health Services (34192)	Mutual Health Services ERA Request
Mutual of Omaha (71412)	Mutual of Omaha ERA Request
Mutual of Omaha Medicare Advantage (82275)	Mutual of Omaha Medicare Advantage ERA Request
MVP Health Plan New York (14165)	MVP Health Plan NY ERA Request (0nly provider does NOT want EFT setup.) MVP Health Plan NY EFT and ERA Request (via PaySpan)
NALC Health Plan (53011)	NALC Health Plan ERA Request
NAMM North American Medical Management AKA PrimeCare Medical Network (IP079)	NAMM / Primecare Medical Network ERA Request
NAMM-IL - Sr Care Partners (NANPR)	NAMM-IL Sr Care Partners ERA/EFT Request
Native Care Health LLC (19191)	Native Care Health EFT-ERA Request
Nebraska	Nebraska BCBS Nebraska Medicaid Nebraska Medicare Part B	Nebraska Medicaid Nebraska Medicare Part A
Neighborhood Health Partnership of FL (96107) EFF 06/01/2016—This payer moved to payer 87726.	Neighborhood Health Partnership of FL ERA Request. See UHC ERA request form.
Neighborhood Health Plan of MA (04293)	Neighborhood Health Plan - MA ERA Request
Neighborhood Health Plan of RI (05047)	Neighborhood Health Plan – RI ERA Request
Network Health Plan (39144) Network Health Plan Platinum Plus (77076)	Network Health Plan ERA Request Network Health Plan Platinum Plus ERA Request
Network Medical Management (NMM01)	Network Medical Management ERA Request
NEUEH Health	NEUEH Health ERA Request
Nevada	Nevada BCBS-Anthem ERA request Nevada Medicaid Nevada Medicare Part B	Nevada Medicare Part A
New ERA Life Employee Benefit Plans (96396)	New ERA Life Employee Benefit Plans ERA Request
New Hampshire	New Hampshire BCBS-Anthem ERA Request New Hampshire Medicaid New Hampshire Medicare Part B	New Hampshire Medicare Part A
New Jersey School Insurance Group (J4534)	New Jersey School Ins Group ERA Request
New Jersey	New Jersey Horizon BCBS ERA New Jersey Medicaid Prof New Jersey Medicare Part B	New Jersey Horizon BCBS Claims. New Jersey Medicaid Inst New Jersey Medicare Part A
New Mexico	New Mexico BCBS ERA request (Includes Blue Medicare Advantage) New Mexico Medicaid New Mexico Medicare Part B	New Mexico BCBS ERA request
New Mexico Health Connections (45129)	New Mexico Health Connections ERA Request
New West Health Plan (84141)	Trizetto Multi-Payer ERA Request
New York	New York BCBS Empire- Anthem ERA request NY BCBS Central Excellus- ERA/EFT request NY BCBS Rochester Excellus- ERA/EFT request NY BCBS Utica Excellus- ERA/EFT request New York BCBS Northeastern ERA request New York BCBS Western ERA request New York Medicaid New York Medicaid-For Rendering Providers New York Mcr Part B- Downstate, pka Empire New York Mcr Part B- Queens New York Mcr Part B- Upstate	New York BCBS- Empire Inst – ERA request New York Medicaid Inst. New York Mcr Part A Inst.
New York Hotel Fund (Z4410)	New York Hotel Fund Claims Request
New York Network Management (11334)	New York Network Management ERA Request
New York Workers’ Comp Board (All NY WC Payers)	New York Workers’ Comp Board Claims Request
NextBlue of North Dakota (55892)	NextBlue of North Dakota ERA Request
Next Level Health Partners (69821)	Next Level Health Plan ERA Request
NHC Advantage (NHC01)	NHC Advantage ERA Request
Nippon Life Insurance (81264)	Nippon Life Insurance EFT-ERA Request
Nivano (aka Med Ben Admin) (68041)	Nivano ERA Request
North American Life Insurance AKA Oxford Life (76112)	North American Life Insurance AKA Oxford Life ERA Request
North American Medical Management –NAMM (IP079 AKA PrimeCare Medical Network	NAMM- North American Medical Mgmt ERA Request
North East Medical Services (NEMS)	North East Medical Services ERA Request
North Carolina	North Carolina BCBS and Blue Medicare PPO/HMO North Carolina Medicaid North Carolina Medicare Part B	North Carolina Medicare Part A
North Dakota	North Dakota BCBS (55891) ERA Request North Dakota Medicaid ERA only North Dakota Medicare Part B North Dakota Workforce Safety
Northwood (NWood)	Northwood ERA Request
NEUEHealth (NEUEH)	NEUEHealth ERA Request
Ohana Health Plan (14163)	Ohana Health Plan ERA Request
Ohio	Ohio BCBS - Anthem ERA Request Ohio Medicaid ERA Request Ohio Medicare Part B	Ohio BCBS- Anthem ERA Request Ohio Medicaid Inst Ohio Medicare Part A
Oklahoma	Oklahoma BCBS ERA request (Includes Blue Medicare Advantage) Blue Medicare Advantage-OK ERA Request Oklahoma Medicaid ERA request Oklahoma Medicare Part B	Oklahoma BCBS ERA request Oklahoma Medicaid Oklahoma Medicare Part A
Old Surety Life Insurance Company (29237)	Old Surety Life Insurance Company ERA Request
Opticare Eye Health Network (56190)	Opticare Vision ERA request
Optimum Health Care (20133) AKA Global TPA LLC	Optimum Health Care ERA Request
Optima Health Plan (54154)	Optima Health Plan ERA request
OptumCare (LIFE1)	OptumCare ERA Request
Optum Care Network (OCN01)	Optum Care Network ERA request
Optum Care Network – Inland Faculty Medical Group (MPM70)	Optum Care Network – Inland Faculty Medical Group ERA Request
OptumHealth– Complex Medical Conditions (41194) OptumHealth- Physical Health (41161) OptumHealth – Salt Lake County (U6885)	OptumHealth- Complex Medical Conditions ERA Request OptumHealth- Physical Health ERA Request OptumHealth- Salt Lake County Claims and ERA Request
Oregon	Oregon Regence Blue Shield ERA request Oregon Medicaid (Prof. Claims and ERAs) Oregon Medicare Part B	Oregon Medicaid (Inst Claims)
Oscar Health (OSCAR)	Oscar Health ERA Request
OSU Sooner Care (76619) OSU Aetna Better Health (OSUAE) OSU Centene Oklahoma Complete Health (OSUCE) OSU Humana Healthy Horizons (OSUHU)	OSU MultiPayer Clms Request
Oxford (06111)	Oxford ERA Request
Oxford Life AKA North American Life Insurance (76112)	Oxford Life AKA North American Life Insurance (76112)
PACE Southwest Michigan (R3460)	PACE Southwest Michigan ERA Request
PacificCare UHC West (95959)	UHC West ERA Request
PacificSource (93029, 20377)	PacificSource ERA-EFT Request
Paragon Benefits (58174)	Paragon Benefits ERA Request
Paramount Health Care (PARHC)	Paramount Health Care ERA Request
Parkland Community Health Plan (66917)	Parkland Community Health Plan ERA Request
Partners Behavioral Health (13141)	Partners Behavioral Health Claims and ERA Request
Partnership Health Plan (PHP02)	Partnership Health Plan Clms and ERA Request
Passport Advantage (66008)	Passport Advantage ERA Request
Passport Health (61325) See Molina Healthcare payers.	Passport Health ERA Request
Pay-Plus Solutions, Inc. (Multipayer)	Pay-Plus Solutions, Inc Multipayer ERA Request -- See Zelis Payments
Payspan Health – 3^rd Party ERA/EFT	Payspan Multipayer ERA request
Peach State Health Plan (68069)	Peach State Health Plan EFT/ERA request (via PaySpan Health)
Peak Health (Peak0)	Peak Health ERA Request
Peak Pace Solutions (27034)	Peak Pace Solutions ERA Request
Pennsylvania	Capital Blue Cross (CAPBC), Keystone Health Plan Central (23045) PA BCBS (Highmark) Claims’ Request (Includes BC NE PA) BCBS PA (54771) (Highmark) ERA Request (Includes all Highmark Payers) Highmark Senior Health PA-Medicare Advantage Claims’ Request (15460) Pennsylvania Medicaid Pennsylvania Medicare Part B	Capital Blue Cross (CAPBC) Inst. PA BCBS (Highmark) Inst. Claims’ Request (Includes BC NE PA) PA BCBS (Highmark) Inst. ERA Request PA Medicare Adv – Highmark Sr Health - Inst Pennsylvania Medicaid Inst. Pennsylvania Medicare Part A
Peoples Health (72126)	Peoples Health ERA Request
Pennsylvania Health Care Plan (VALHLTH)	Pennsylvania Health Care Plan ERA/EFT Request
Perennial Advantage of Colorado (PACO1) Perennial Advantage of Ohio (PAOH1)	Perennial Advantage of Colorado ERA Request Perennial Advantage of Ohio ERA Request
PHCS Savility Payers (13306)	PHCS Savility Payers ERA/EFT Request
Philadelphia American Life (NWERA)	Philadelphia American Life ERA Request
Physicians Health Plan of Medicare Michigan (83276) Physicians Health Plan of Mid-Michigan (37330)	Physicians Health Plan of Medicare Michigan ERA Request PHP Mid-Michigan ERA Request
Physicians Hlth Plan of Northern Indiana (12399)	Phys Health Plan of IN ERA/EFT Request
Physicians of Southwest Washington (91171)	Physicians of Southwest Washington ERA Request
Physicians Medical Group of San Jose (PMGSJ)	Physicians Medical Group of San Jose ERA Request
Physicians Mutual Insurance Co (47027)	Physicians Mutual Insurance Co ERA Request
Piedmont Community Health Plan (55768)	Piedmont Community Health Plan ERA Request
Piedmont Wellstar Health Plan (251PD)	Piedmont Wellstar Health Plan ERA Request
PIH Health (PIH01)	PIH Health ERA/EFT Request
Pinnacle Medical Group (95271)	Pinnacle Medical Group ERA Request
Planstin Administration (65241)	Planstin Administration ERA Request
PMCS (Preferred Medical Claim Solutions) (21524)	PMCS ERA Request
PNC Bank Multipayers	PNC Bank Multipayers ERA Request
Pomco (16111)	Pomco ERA Request
Preferred Care NY Rochester (PCNY0)	Preferred Care NY ERA Request (Only for ERA, and if provider does NOT want EFT.
Preferred Care Partners (65088)	Preferred Care Partners ERA Request
Preferred IPA (PFIPA)	Preferred IPA ERA Request
PreferredOne (41147)	PreferredOne ERA Request
Premier Eye Care (65054)	Premier Eye Care ERA Request
Premier Health Plan- OH (251PR)	Premier Health Plan ERA Request
Presbyterian Health Plan (Z0003)	Presbyterian Health Plan ERA Request
Prestige Health Choice (77003)	Prestige Health Choice ERA Request
Prime West Health Plan (61604)	Prime West Health Plan ERA Request
PrimeCare Medical Network (IP079) AKA North American Medical Management	PrimeCare Medical Network ERA Request
Principal Life Insurance (61271)	Principal Life ERA request
Priority Health (38217)	Priority Health ERA Request
ProCare (TX) (PTX01)	ProCare (TX) ERA Request
Prospect Medical Group (PROSP)	Prospect Medical Group ERA Request
Providence Health Assurance Medicaid (77350)	Providence Health Assurance Medicaid ERA/EFT Request
Providence of Oregon Health Plan (SX133)	Providence of Oregon Health Plan (PHP01)
Provider Partners Health Plan IN (31407) Provider Partners Health Plan IL (31401) Provider Partners Health Plan MD (31118) Provider Partners Health Plan MO (31404) Provider Partners Health Plan PA (31400) Provider Partners Health Plan TX (31405)	Provider Partners Health Plan IN, IL, MD, OH, PA ERA Request Provider Partners Health Plan MO, TX ERA Request
Pruitt Health Premier (PH001) Pruitt Health Premier NC/SC (PHPC1)	Pruitt Health Premier ERA Request
PSKW Physician Reimbursement (PSKW0)	PSKW Physician Reimbursement ERA Request
Public Employees Health Plan PEHP (SX106)	Public Employees Health Plan PEHP Claims and ERA Request
Puerto Rico	Triple S – BCBS Puerto Rico (PR973) Triple S Medicare Advantage (973MA) Puerto Rico Medicare Part B (MBPR2 / 09202) BCBS Puerto Rico (Z0065)
Quality Care Partners (89461)	Quality Care Partners ERA Request
QuikTrip Corporation (73067)	QuikTrip Corporation ERA request
Railroad Medicare	Railroad Medicare Part B
REDCard Systems – 3^rd Party ERA/EFT Includes: Cigna Medicare Supplemental (13193), HealthCare Partners IPA-NY (11328)	REDCard Systems Multipayer ERA Request
Redlands- Yucaipa Medical Group (18247)	Redlands- Yucaipa Medical Group ERA Request
Renaissance Physicians Organization (76066)	Renaissance Physicians Organization ERA Request
Regency Employee Benefits (38221)	Regency Employee Benefits ERA Request
Reserve National Insurance (73066)	Reserve National Insurance ERA Request
ResourceOne Administrators (66456)	ResourceOne Administrators ERA Request
Resurrection Physician Providers Group (RPPG1)	Resurrection Physician Providers Group ERA Request
Rhode Island	Rhode Island BCBS Rhode Island Medicaid Rhode Island Medicare Part B
RIS Rx (RISRX)	RIS Rx ERA Request
Right Care from Scott and White (74205)	Right Care from Scott and White ERA Request
Rios Southwest Medical Group (RIOS1)	Rios Southwest Medical Group ERA Request
Rocky Mountain Pace (93142)	Rocky Mountain Pace ERA Request
Rockwood Casualty (J4412) (WC Payer)	Rockwood Casualty ERA Request
S and S Healthcare Strategies (31441)	S and S Healthcare Strategies ERA request
Samaritan Advantage (SAMAD) Samaritan Choice (SAM00) Samaritan Commercial (SAMCP) Intercommunity Health (INCHN)	Samaritan Health Multipayer ERA Request
Samaritan Health Plans (CP001)	Samaritan Health Plans ERA Request
Samba Federal Employee Benefit Assoc (37259)	Samba Federal Employee Benefit Assoc ERA request
Sana Benefits (50114)	Sana Benefits ERA Request
San Diego PACE SDPCS)	San Diego PACE ERA Request
San Francisco Health Plan (SFHP1)	San Francisco Health Plan ERA request
Sante Health (77038)	Sante Health ERA Request
Santa Clara Family Health Plan (24077)	Santa Clara Family Health Plan ERA Request
Sanford Health Plan (91184)	Sanford Health Plan ERA Request
Scan Health Plan- CA (SCAN1)	Scan Health Plan- CA ERA Request
Scott and White Health Plan (88030, TH002)	Scott and White Health Plan ERA Request
Scripps Health Plan (SHPM1)	Scripps Health Plan ERA Request
Scripps Health Plan Services (SHPS1)	Scripps Health Plan Services ERA Request
SECUR Health Plan (SECUR)	SECUR Health Plan ERA Request
Security Health Plan (39045)	Security Health Plan ERA Request
SelectCare of Texas	SEE Texan Plus Multipayer ERA Request form
SelectHealth (SX107)	Select Health ERA Request Form
Select Health of South Carolina (23285)	Select Health ERA Request
Selman and Company Tricare Supplemental 2019 (52214)	Selman and Company Tricare Supplemental ERA Request
Sendero Health (MV440)	Sendero Health ERA Request
Senior Whole Health (83035)	Senior Whole Health ERA Request
Sentinel Security Life Insurance (87020)	Sentinel Security Life Insurance ERA Request
Sequoia Health IPA (AGL01)	Sequoia Health Plan ERA Request
SFCCN Memorial Integrated (59064, 59065)	SFCCN Memorial Integrated ERA Request
Shared Health Mississippi (SHMS1)	Shared Health Mississippi ERA Request
Sharp Community Medical Group (SCMG1)	Sharp Community Medical Group ERA Request
Sharp Health Plan (SHP102)	Sharp Health Plan ERA Request
Sharp Rees Stealy Medical Group (SRS01, SCG01)	Sharp Rees Stealy Medical Group Claims and ERA Request
Sierra Health and Life (76342)	Sierra Health and Life ERA Request
Signature Advantage (SA001)	Signature Advantage ERA Request
Simply Healthcare (SMPLY)	Simply Healthcare ERA Request
SKAI Blue Cross Blue Shield (BSKAI)	SKAI Blue Cross Blue Shield ERA Request
Solidarity Healthshare (SH777)	Solidarity Healthshare ERA Request
South Atlantic Medical Group (SAMG1)	South Atlantic Medical Group ERA Request
South Carolina	South Carolina BCBS (SC400, SC401, SC402, SC481, SC403, SC922, SC498) South Carolina Blue Choice MCD (00403) South Carolina Medicaid (MCDSC) South Carolina Medicaid Inst South Carolina Medicare Part B	South Carolina Medicare Part A
South Country Health Alliance (81600)	South Country Health Alliance ERA Request
South Dakota	South Dakota BCBS South Dakota Medicaid South Dakota Medicare Part B
Southwest Service Administrators (CX100)	Southwest Service Administrators ERA Request
St Joseph Heritage Medical Group (IP106)	St Joseph Heritage Medical Group ERA Request
State Compensation Insurance Fund (35076)	State Compensation Insurance Fund ERA Request
State Farm (All States) (Auto Only) (J1548)	State Farm (All States) (Auto Only) ERA Request
State Farm Insurance Companies (31053)	State Farm Insurance Companies ERA Request
State Mutual (Z95722)	State Mutual ERA Request
Staywell Health Plan (14163)	Staywell Health Plan ERA Request
Stone Eagle V-Pay – Payment Vendor	Stone Eagle V-Pay Multipayer ERA Request Form (Includes: American Family Insurance, American Republic Insurance, Central Reserve Life, Consociate Group, Continental General Insurance, Employee Benefit Admin, Healthgram, Keenan and Assocs Commercial, Medical Insurance Co)
Streamline Imaging (J4481) (WC Payer)	Streamline Imaging ERA request with EchoHealth
Student Assurance Services (SAS01)	Student Assurance Services ERA/EFT Request
Student Resources International-UHC (74227)	Student Resources International-UHC ERA Request
Summacare (95202)	Summacare ERA Request
Summit Administration Services (86083)	Summit Administration Services ERA Request
Summit Community Care (PASSE)	Summit Community Care ERA Request
Sunshine State Health Plan (68069)	Sunshine State Health Plan EFT/ERA request (via PaySpan Health)
Superior Health Plan Texas (68069)	Superior Health Plan TX EFT/ERA request (via PaySpan Health)
Superior Vision (Block Vision) (13374)	Superior Vision EFT/ERA Request
Superior Vision Services (13305)	Trizetto Multi-Payer ERA Request
Sutter East Bay Medical Foundation (87160)	Sutter East Bay Medical Foundation ERA Request
Sutter Health (All States) (WC Only) (J1512)	Sutter Health (All States) (WC Only) ERA Request
Teamsters Medicare Trust for Retired Employees (43619)	Teamsters Medicare Trust for Retired Employees ERA Request
Tennessee	BS TN and MCD TN- Add Rendering Provider to Billing Grp for Elec Clms Tennessee BCBS an Medicaid Tennessee Medicare Part B	Tennessee BCBS inst Tennessee Medicaid inst Tennessee Medicare Part A
Texas	Texas BCBS ERA request (Includes Blue Medicare Advantage) Texas Medicaid ERA request (includes BCBS TX Medicaid STAR/CHIP) Texas Medicare Part B	Texas BCBS ERA request Texas Medicaid ERA request Texas Medicare Part A
The Cascade Pace Inc DBA Thome Pace (RP044)	The Cascade Pace Inc DBA Thome Pace ERA Request
The Macaluso Group (82694)	The Macaluso Group ERA Request
Todays Option (48055)	Todays Option (48055) ERA request
Thrivent Financial Aid Association for Lutheran Medicare (30167)	Thrivent Financial Aid Association for Lutheran Medicare ERA Request
Transamerica Life Insurance (TRP1E)	Transamerica Life Insurance ERA Request
Travis County Map Mediview (TCMAP)	Travis County Map Mediview ERA Request
Tribute Health Plan Oklahoma (31125)	Tribute Health Plan of Oklahoma ERA Request
Tricare	Tricare East (99727- DOS 1/1/2025 and after) Claims and ERA Request Tricare West (99726) Claims and ERA Request TriWest Healthcare Alliance VACCN Region 4 (previously VAPC3) TriWest Healthcare Alliance VACCN Region 5 (previously VAPC3)
Tricare For Life (TDFIC)	Tricare For Life Claims Request Tricare for Life ERA Request
Tricare Overseas (FOREN)	Tricare Overseas Claims Request Tricare Overseas ERA Request
TRU Community Care (TRUCO)	TRU Community Care ERA Request
Mercy Life (Trinity Health) (TRNPC)	Mercy Life ERA Request
TPA Private Healthcare (30031)	TPA Private Healthcare ERA Request
Trillium (East Carolina Behavioral Health) (56089)	Trillium ERA Setup Request
Tristate Benefit Solutions (31144)	Tristate Benefit Solutions ERA Request
Trizetto Vision Payers – Davis Vision (00157)	Davis Vision ERA Request
TrueCare Mississippi Medicaid (MSMCDCS1)	TrueCare Mississippi Medicaid ERA Request
Trustmark (61425)	Trustmark EFT-ERA Request
Tufts Health Plan (04298) (Includes previous TUFTS’ payer ID 04332)	Tufts Health Plan Claims/ERAs
TX Childrens’ Health Plan- CHIP (76048) TX Childrens’ Health Plan- Medicaid (75228)	TX Chidrens’ Health Plan- CHIP ERA Request TX Chidlrens’ Health Plan- Medicaid ERA Request
Tucker Admin (30799)	Tucker Admin ERA Request
UCare Minnesota- Prof (SX178) and UCare Minnesota- Inst (52629)	UCare Minnesota ERA Request
UCLA Medical Group (USMBP)	UCLA Medical Group ERA Request
UHA –University Health Alliance Hawaii (99026)	University Health Alliance Hawaii – Prof Claims/ERA University Health Alliance Hawaii – Institutional Claims/ERA
UHC Community Plan – DE, FL, HI, LA, MA, MD, NM, OH, PA, SC, VA, WA (04567) UHC Community Plan – KS (96385) UHC Community Plan – MI (95467) UHC Community Plan – MO (86050) UHC Community Plan – MS (95378) UHC Community Plan – NE (UFNEP) UHC Community Plan – NJ (86047) UHC Community Plan – NYU (NYU01) UHC Community Plan – TN (95378) UHC Community Plan – TX (TEX01) UHC Community Plan – WI (WID01)	United Healthcare Multipayer ERA Setup Request
UHC of River Valley (95378)	UHC of River Valley ERA Request
UHIN Multi-Payers Includes these payers: DMBA Deseret Mutual Benefits Assn (SX105) EMIA Educators Mutual Insurane (SX110) Equitable Life & Casualty Insurance Company (75091) State Farm Group and Individual Health (31053) University of Utah Health Plans (SX155)	UHIN Multipayer ERA Request Form
Ultimate Health Plan (77022)	Ultimate Health Plan ERA Request
UMR-Wausau (39026)	UMR-Wausau ERA Request
UMWA Health & Retirement Fund (52180)	UMWA Fund ERA Request
Unicare (80314)	Unicare ERA Request ERA change request for ALL states. NEW ERA SETUP for these states ONLY: IL, KS, MA, RI, TX VA & WV
Union Pacific Railroad Employees (87042)	Union Pacific Railroad Employees ERA Request
Union Security Insurance (70408)	Union Security Insurance ERA Request
Unison (25175)	Unison ERA Request
United American Insurance (55004)	United American Insurance ERA Request
United Healthcare (87726) And Care Improvement Plus (77082)	United Healthcare ERA Request
UnitedHealthcare StudentResources (74227)	UnitedHealthcare StudentResources ERA Request
United States Automobile Association (USAA) (74095)	United States Automobile Association (USAA) ERA Request
Unity Health Insurance (39180)	Unity Health Insurance ERA Request
Univera (12837, UNINW)	Univera ERA/EFT Request
University of Utah Health Plans (SX155)	University of Utah Health Plans ERA Request
UPMC Health Plan (23281)	UPMC Health Plan ERA Request
Upper Peninsula Health Group TPA (37324)	Upper Peninsula Health Group TPA ERA Request
Upper Peninsula Health Plan (38337)	Upper Peninsula Health Plan ERA Request
UCS Masonry Industry Trust (38221)	UCS Masonry Industry Trust ERA Request
UCSD Managed Care (UCSDH)	USCD Managed Care ERA Request
US Dept of Labor (77044)	US Dept of Labor
US Family Health Plan-Texas and Louisiana (USFHP)	US Family Health Plan ERA Request
USFHP Uniformed Services Family Health Plan (13407)	USFHP Uniformed Services Family Health Plan ERA Request
US Health (Remits Only) (USHA1)	US Health ERA Request
US Imaging (50383)	US Imaging ERA/EFT Request
Utah	Utah Regence BCBS ERA Request Utah Medicaid - FFS Utah Medicare Part B
VA Community Care Network (VACCN) VACCN Region 4 (VACCN4, TWVACCN4) VACCN Region 5 (VACCN5, TWVACCN5)	VA Community Care Network ERA Request VACCN Region 4 (VACCN4) ERA and Claims (previously VAPC3) VACCN Region 5 (VACCN5) ERA and Claims (previously VAPC3)
VA Fee Basis (12115)	VA Fee Basis ERA Request
Valir Pace Organization (R3463)	Valir Pace Organization ERA Request
Valley Health Plan (VHP01, VHP02)	Valley Health Plan ERA Request
Valley Health Plan (VHP02)	Valley Health Plan Professional Claims Request Valley Health Plan Institutional Claims Request
Value Options -- See Beacon Health Options
Van Lang IPA c/o TECQ Partners (77036)	Van Lang IPA c/o TECQ Partners ERA Request
Vault/AMPS Admin Services (VS402)	Vault/AMPS ERA Request
Vaya Health (13010)	Vaya Health PROF Claims Request Vaya Health INST Claims Request
Vermont	Vermont BCBS Vermont Medicaid Vermont Medicare Part B
Veterans Affairs PCCC Region 1-2-4 (68021) (aka Health Net VA)	Veterans Affairs VAPCCC Reg 1-2-4 ERA request
Veterans Affairs PCCC (WPS) VAPCCC3 (Includes Regions 3, 5A, 5B and 6)	VAPCCC3 Claims Request VAPCCC3 ERA Request -- VAPC3 no longer accepting new enrollments. VAPC3 is transitioning to VACCN. -- Scroll Up to See VACCN Region 4 and VACCN Region 5 -- For providers outside of Region 4 and 5- these regions are yet to be transitioned later this year. Providers can still submit through VAPCCC3, but cannot enroll new providers.
VGM Homelink (50701)	VGM Homelink ERA Request
VieCare Life Armstrong (25922)	VieCare Life Armstrong ERA Request
Village Care Max (26545)	Village Care Max ERA Request
VillageMD Multipayers VillageMD of Chicago (75838) VillageMD Of Western KY (43036) VillageMD of MI & NH (75545) Village MD of Northern IN (75836) QCPI VillageMD of GA (42636)	VillageMD Multipayer ERA Request Form
Virgin Islands (USVI)	Virgin Islands BCBS (Triple-S) Virgin Islands Medicare Part B
Virginia	Virginia BCBS Anthem ERA Request Virginia Medicaid Virginia Medicare Part B See also Dist. Of Columbia as necessary for city of Alexandria, Arlington and Fairfax co.	Virginia BCBS- Anthem ERA request– Inst. Virginia Medicare Part A
Vision Service Plan (94163)	VSP (Vision Service Plan) Claims and ERA Request
VitalCore Millette (MAI58)	VitalCore Millette ERA Request
Viva Health Plan (63114)	Viva Health Plan ERA Request
Vivant Health (RCMG1)	Vivant Health ERA Request
VNS Choice Medicare (77073)	VNS Choice ERA Request
Volunteers of America National Services (VNSPC)	Volunteers of America National Services ERA Request
Vytalize Health (RP042)	Vytalize Health ERA Request
Washington	Washington Blue Cross Premera ERA Washington Regence Blue Shield ERA Washington Medicaid Washington Medicare Part B	Washington Blue Cross Premera ERA Washington Regence Blue Shield ERA
Washington Labor & Industries (WC001)	Washington L&I (WC001) Claims and ERAs
WEB TPA (Aka Community Health Elec) (75261)	WEB TPA ERA Request
WelbeHealth (WBHCA)	WelbeHealth ERA Request
Welfare Pension Administration (91136)	Welfare Pension Administration ERA Request
Wellcare Health Plans (14163)	Wellcare Multi-State ERA Request
WellMed (WELM2)	WellMed ERA Request
WellNet Healthcare Administrators, Inc. (93669)	WellNet Healthcare Administrators, Inc. ERA Request
West Pace (aka Mary & West Pace) GMWP1	West Pace- GMWP1 ERA Request
West Virginia	West Virginia BCBS Claims’ Request (54828) West Virginia BCBS ERA Request (54828) WV Medicare Adv – Highmark Senior Health Claims’ Request (15459) WV Medicare Adv-Highmark Senior Health ERA Request West Virginia Medicaid ERA only West Virginia Medicare Part B	BCBS West Virginia Inst. Claims’ Request BCBS West Virginia Inst. ERA Request West Virginia Medicaid Inst. ERA only West Virginia Medicare Part A
West Virginia Family Health Plan (45276)	West Virginia Family Health Plan ERA Request
West Virginia Senior Choice (WVS01)	West Virginia Senior Choice ERA Request
Western Mutual Insurance / WMI-TPA (37247)	Western Mutual Insurance ERA Request
Western Oregon Advanced Health (DOCSO)	Western Oregon Advanced Health ERA Request
Western Southern Financial Group – Cincinnati (31048)	Western Southern Financial Group ERA Request
Western Teamster Welfare Trust (91068)	Western Teamster Welfare Trust ERA Request
Westfield Insurance (J1858)	Westfield Insurance ERA Request
Wisconsin	Wisconsin BCBS - Anthem ERA Request Wisconsin Medicaid Wisconsin Medicare Part B	Wisconsin BCBS- Anthem ERA Wisconsin Medicare Part A
World Trade Center (WTC) Health Program (WTC44)	World Trade Center (WTC) Health Program ERA Request
WPS Commercial (00235)	WPS Commercial ERA Request
WyoBlue Advantage (WYBA)	WyoBlue Advantage ERA Request
Wyoming	Wyoming BCBS (53767) ERA Request Wyoming Medicaid Wyoming Medicare Part B
YouthCare Healthchoice (68069)	YouthCare Healthchoice ERA Request
Zelis Payments – 3^rd Party ERA/EFT	Zelis Payments - Multipayer ERA Request