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Payer Name
Payer ID
Transaction
Available
Non Par
Enrollment
Secondary
attachment
WC / Auto
NOTES
Denver Health and Hospital Authority
Payer ID
84133
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Denver Health and Hospital Authority 84133 837I
Denver Health and Hospital Authority Indigent Care
Payer ID
84134
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Denver Health and Hospital Authority Indigent Care 84134 837P
Denver Health and Hospital Authority Indigent Care
Payer ID
84134
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Denver Health and Hospital Authority Indigent Care 84134 837I
Denver Health Medical Plan
Payer ID
84135
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Denver Health Medical Plan 84135 837P
Denver Health Medical Plan
Payer ID
84135
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Denver Health Medical Plan 84135 837I
Denver Health Medical Plan Inc.
Payer ID
65456
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Denver Health Medical Plan Inc. 65456 837P
Denver Health Medical Plan Inc.
Payer ID
65456
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Denver Health Medical Plan Inc. 65456 837I
Denver Health Medical Plan, In. - Medicare Choice
Payer ID
84131
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Denver Health Medical Plan, In. - Medicare Choice 84131 837P
Denver Health Medical Plan, In. - Medicare Choice
Payer ID
84131
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Denver Health Medical Plan, In. - Medicare Choice 84131 837I
Department of Corrections - Oklahoma
Payer ID
71065
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Effective 1/1/18.
Department of Corrections - Oklahoma 71065 837P
Department of Corrections - Oklahoma
Payer ID
71065
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Effective 1/1/18.
Department of Corrections - Oklahoma 71065 837I
Department of Social and Health Services (DSHS)
Payer ID
MC006
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Department of Social and Health Services (DSHS) MC006 837P
Department of Social and Health Services (DSHS)
Payer ID
MC006
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Department of Social and Health Services (DSHS) MC006 837I
Department of Social and Health Services (DSHS)
Payer ID
MC006
Payer ID
Transaction
All
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Department of Social and Health Services (DSHS) MC006 837D
Department Rehabilitative Services - Oklahoma
Payer ID
71065
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Effective 1/1/18.
Department Rehabilitative Services - Oklahoma 71065 837P
Department Rehabilitative Services - Oklahoma
Payer ID
71065
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Effective 1/1/18.
Department Rehabilitative Services - Oklahoma 71065 837I
Desco Corporation
Payer ID
J2636
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Desco Corporation J2636 837P
Desco Corporation
Payer ID
J2636
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Desco Corporation J2636 837I
Deseret Mutual Benefit Administrators
Payer ID
SX105
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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A UHIN pass through fee applies to this transaction.
Deseret Mutual Benefit Administrators SX105 837P
Desert Medical Group (Regal)
Payer ID
DESRT
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Desert Medical Group (Regal) DESRT 837P
Desert Medical Group (Regal)
Payer ID
DESRT
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Desert Medical Group (Regal) DESRT 837I
Desert Oasis Healthcare (DOHC) (Regal)
Payer ID
DESRT
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Desert Oasis Healthcare (DOHC) (Regal) DESRT 837P
Desert Oasis Healthcare (DOHC) (Regal)
Payer ID
DESRT
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Desert Oasis Healthcare (DOHC) (Regal) DESRT 837I
Desert Valley Medical Group
Payer ID
DVMC1
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Desert Valley Medical Group DVMC1 837P
Desert Valley Medical Group
Payer ID
DVMC1
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Desert Valley Medical Group DVMC1 837I
Detego Health
Payer ID
62599
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Detego Health 62599 837P
Detego Health
Payer ID
62599
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Detego Health 62599 837I
Devoted Health
Payer ID
DEVOT
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Devoted Health DEVOT 837P
Devoted Health
Payer ID
DEVOT
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Devoted Health DEVOT 837I
DHMN - Preferred IPA Hospital Risk
Payer ID
DHM02
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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DHMN - Preferred IPA Hospital Risk DHM02 837P
DHMN - Preferred IPA Hospital Risk
Payer ID
DHM02
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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DHMN - Preferred IPA Hospital Risk DHM02 837I
DHMN Santa Cruz
Payer ID
DHM01
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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DHMN Santa Cruz DHM01 837P
DHMN Santa Cruz
Payer ID
DHM01
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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DHMN Santa Cruz DHM01 837I
DHR Provider Management
Payer ID
DHRPM
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Please contact Debra (949-635-0434) to become approved for electronic submissions.
DHR Provider Management DHRPM 837P
Diabetes Heart Care CSNP
Payer ID
HCS01
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Diabetes Heart Care CSNP HCS01 837P
Diamond Bar Medical Group
Payer ID
NMM01
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Diamond Bar Medical Group NMM01 837P
Diamond Bar Medical Group
Payer ID
NMM01
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Diamond Bar Medical Group NMM01 837I
Diamond Insurance Group, LTD
Payer ID
J2140
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Diamond Insurance Group, LTD J2140 837P
Diamond Insurance Group, LTD
Payer ID
J2140
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Diamond Insurance Group, LTD J2140 837I
Diamond Resorts International
Payer ID
J2637
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Diamond Resorts International J2637 837P
Diamond Resorts International
Payer ID
J2637
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Diamond Resorts International J2637 837I
Dignity Global
Payer ID
MPM27
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Effective January 1, 2017.
Dignity Global MPM27 837P
Dignity Global
Payer ID
MPM27
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Effective January 1, 2017.
Dignity Global MPM27 837I
Dignity HCLA
Payer ID
MPM28
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Effective January 1, 2017.
Dignity HCLA MPM28 837P
Dignity HCLA
Payer ID
MPM28
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Effective January 1, 2017.
Dignity HCLA MPM28 837I
Dignity Health Chw
Payer ID
J2298
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Dignity Health Chw J2298 837P
Dignity Health Chw
Payer ID
J2298
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Dignity Health Chw J2298 837I
Dignity Health Medical Group - Inland Empire
Payer ID
PROH4
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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For claims with DOS on or after 7/1/14.
Dignity Health Medical Group - Inland Empire PROH4 837P
Dignity Health Medical Group - Inland Empire
Payer ID
PROH4
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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For claims with DOS on or after 7/1/14.
Dignity Health Medical Group - Inland Empire PROH4 837I
Dignity Health Medical Network – Central California
Payer ID
MCS03
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dignity Health Medical Network – Central California MCS03 837P
Dignity Health Medical Network – Central California
Payer ID
MCS03
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dignity Health Medical Network – Central California MCS03 837I
Dignity Health Medical Network – Santa Cruz
Payer ID
MCS03
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dignity Health Medical Network – Santa Cruz MCS03 837P
Dignity Health Medical Network – Santa Cruz
Payer ID
MCS03
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dignity Health Medical Network – Santa Cruz MCS03 837I
Dignity Health - Mercy Medical Group / Woodland Clinic
Payer ID
PROH1
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dignity Health - Mercy Medical Group / Woodland Clinic PROH1 837P
Dignity Health - Mercy Medical Group / Woodland Clinic
Payer ID
PROH1
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dignity Health - Mercy Medical Group / Woodland Clinic PROH1 837I
Dignity Health MSO
Payer ID
MCS03
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dignity Health MSO MCS03 837P
Dignity Health MSO
Payer ID
MCS03
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dignity Health MSO MCS03 837I
Dignity Health Plan
Payer ID
83247
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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For Claim DOS after 12/31/2022
Dignity Health Plan 83247 837P
Dignity Health Plan
Payer ID
83247
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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For Claim DOS after 12/31/2022
Dignity Health Plan 83247 837I
Dignity Health Sacramento Hosp SHO
Payer ID
HOSH1
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dignity Health Sacramento Hosp SHO HOSH1 837P
Dignity Health Sacramento Hosp SHO
Payer ID
HOSH1
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dignity Health Sacramento Hosp SHO HOSH1 837I
Dignity Health - Sequoia Physicians Network
Payer ID
PROH2
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dignity Health - Sequoia Physicians Network PROH2 837P
Dignity Health - Sequoia Physicians Network
Payer ID
PROH2
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dignity Health - Sequoia Physicians Network PROH2 837I
Dimension Benefit Management
Payer ID
Z1412
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dimension Benefit Management Z1412 837P
Dimension Development Two, LLC
Payer ID
J2639
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Dimension Development Two, LLC J2639 837P
Dimension Development Two, LLC
Payer ID
J2639
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Dimension Development Two, LLC J2639 837I
Diocese Of San Jose
Payer ID
J2241
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Diocese Of San Jose J2241 837P
Diocese Of San Jose
Payer ID
J2241
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Diocese Of San Jose J2241 837I
Diploma Joint Insurance Fund (SEL)
Payer ID
J3934
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp
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Diploma Joint Insurance Fund (SEL) J3934 837P
Diploma Joint Insurance Fund (SEL)
Payer ID
J3934
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp
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Diploma Joint Insurance Fund (SEL) J3934 837I
DirectCARE
Payer ID
55731
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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DirectCARE 55731 837P
DirectCARE
Payer ID
55731
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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DirectCARE 55731 837I
Direct Care Administrators
Payer ID
DCA62
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Direct Care Administrators DCA62 837P
Direct Care Administrators
Payer ID
DCA62
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Direct Care Administrators DCA62 837I
Direct Dental Administrators
Payer ID
DDA10
Payer ID
Transaction
All
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Direct Dental Administrators DDA10 837D
Director's Guild of America - Producer Health Plans
Payer ID
BC001
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Director's Guild of America - Producer Health Plans BC001 837P
Director's Guild of America - Producer Health Plans
Payer ID
BC001
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Director's Guild of America - Producer Health Plans BC001 837I
Direct Pay Provider Network
Payer ID
J4156
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp
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ERA returned automatically for rejected claims only.
Direct Pay Provider Network J4156 837P
Direct Pay Provider Network - Institutional
Payer ID
J4155
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp
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Direct Pay Provider Network - Institutional J4155 837I
EDI enrollment form under Payer Enrollment Forms - All or Multiple States. Coverage: CT, DE, District of Columbia, MA, ME, MD, NH, NJ, NY, PA, RI, and VT. Effective 6/30/16 (3pm EST), Jurisdiction A will transition from NGS to CGS (Contractor Code: 16013). Office Ally will handle all updates on the back end and no submitter action is required.
DMERC Region A Medicare 16003 837P
DMERC Region B Medicare
Payer ID
17003
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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EDI enrollment form under Payer Enrollment Forms - All or Multiple States. Coverage: IL, IN, KY, MI, MN, OH, and WI. Effective 6/30/16 (3pm EST), Jurisdiction B will transition from NGS to CGS (Contractor Code: 17013). Office Ally will handle all updates on the back end and no submitter action is required.
DMERC Region B Medicare 17003 837P
DMERC Region C Medicare
Payer ID
00885
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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EDI enrollment form under Payer Enrollment Forms - All or Multiple States. Coverage: AL, AR, CO, GA, FL, LA, MS, NC, NM, OK, SC, TN, TX, VA, WV, Puerto Rico, and US Virgin Islands. Contractor Code: 18003.
DMERC Region C Medicare 00885 837P
DMERC Region D Medicare
Payer ID
05655
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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EDI enrollment form under Payer Enrollment Forms - All or Multiple States. Coverage: AK, AZ, CA, HI, ID, IA, KS, MO, MT, NE, NV, ND, OR, SD, UT, WA, and WY. Contractor Code: 19003.
