Carrier Documentation

Following are the answers to some of the frequently asked questions about electronic claims to insurance carriers, as well as the documentation that we have collected for each carrier. You may need either a word processing program, or Adobe Acrobat Reader to read some of these forms.

Please note that these forms are provided as a courtesy and convenience to our Validator users, and while we try to keep the forms as up to date as possible, carriers often change the forms without any notice, so it might not be a bad idea to contact the carrier before mailing your enrollment forms in to assure you have the correct form.

 

Blue Cross of California

Web Site Payer ID:
47198
EDI Contact
800-227-3983
State(s)
CA
Documentation:

Blue Shield of California

Web Site

http://www.blueshieldca.com/

Payer ID:
940360524
EDI Contact
800-480-1221
State(s)
CA
Documentation:

BCBS of Florida Medicare

Web Site

https://

Payer ID:
EDI Contact
909-791-8767
State(s)
Florida
Documentation:
Forms not available


Empire BCBS NEIC Quick Link

Web Site

https://

Payer ID:
NEIC
EDI Contact
315-488-0080
State(s)
New York
Documentation:
Forms not available

Empire Blue Cross Blue Shield

Web Site

https://www.empireblue.com/

Payer ID:
BS803
EDI Contact
315-488-0080
State(s)
New York
Documentation:
Forms not available

Empire Blue Cross Medicare

Web Site

https://www.empiremedicare.com/

Payer ID:
00803
EDI Contact
315-488-0080
State(s)

New York, District of Columbia and Delaware

Documentation:
Forms not available

GHI Medicare NY

Web Site

https://www.ghimedicare.com/

Payer ID:
14330
EDI Contact
646-458-6721
State(s)
New York
Documentation:
Forms not available

HGS Administrators Medicare

Web Site

https://

Payer ID:
00805
EDI Contact
717-763-6722
State(s)
New Jersey
Documentation:

HGS Administrators Medicare

Web Site

https://

Payer ID:
00865
EDI Contact
717-763-6722
State(s)
Pennsylvania
Documentation:

Medi-CAL: California Medicaid

Web Site

http://www.medi-cal.ca.gov/

Payer ID:
610442
Web Site Payer ID:
610442
EDI Contact
916-636-1100
State(s)
California
Documentation: Medi-Cal Telecommunications Provider and Biller Application

Medicaid : New York

Web Site

http://www.nyhipaadesk.com

Payer ID:
141797357
EDI Contact
518-447-9256
State(s)
New York
Documentation:
Forms not available

National Heritage Insurance Company

Web Site

http://www.nhicmedicare.com

Payer ID:
31140
EDI Contact
781-749-7745
State(s)
Massachusetts Maine, New Hampshire, and Vermont
Documentation:
Forms not available

NHIC Medicare (CAN)

Web Site

http://www.medicarenhic.com

Payer ID:
31140
EDI Contact
530-743-1587
State(s)
Northern CA, Riverside and San Berndandio Counties
Documentation:
Service Enrollment Form

NHIC Medicare (CAS)

Web Site

http://www.medicarenhic.com

Payer ID:
31146
EDI Contact
213-593-6950
State(s)
Southern CA, Imperial, LA, Orange, Santa Barbara, San Diego, San Luis Obispo and Ventura counties
Documentation:
Service Enrollment Form

Noridian Medicare

Web Site

http://www.noridianmedicare.com

Payer ID:
0011
EDI Contact
800-967-7902
State(s)
North Dakota, Sout Dakota, Colorado, and Wyoming
Documentation:
Forms not available

Noridian Medicare

Web Site http://www.noridianmedicare.com Payer ID:
0012
EDI Contact
800-967-7902
State(s)
Arkansas, Oregon, and Washington
Documentation:
Forms not available

Noridian Medicare

Web Site

http://www.noridianmedicare.com

Payer ID:
0016
EDI Contact
800-967-7902
State(s)
Arizona, Hawaii, and Nevada
Documentation:
Forms not available

Palmetto GBA Medicare

Web Site

www.

Payer ID:
00833
EDI Contact
614-249-0340
State(s)
Ohio and West Virginia
Documentation:
Forms not available

THIN - Commercial Claims

Web Site

http://www.thinedi.com

Payer ID:
See THIN list
EDI Contact
972-766-5480
State(s)
All
Documentation:

Tricare - Champus

Web Site

http://www.southcarolinablues.com

Payer ID:
571132733
EDI Contact
803-763-1459
State(s)
All
Documentation:
Forms not available

Wisconsin Physicians Services - Champus

Web Site

http://www.southcarolinablues.com

Payer ID:
WESTR
EDI Contact
803-763-1459
State(s)
All
Documentation:
Forms not available

 

 
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