Office Ally may, at its sole option, add or remove Payers to the Services at any time. Office ally will use commercially reasonable efforts to provide Customer with written notice of such removals.
NOTICE: The Payer List page is currently unavailable due to scheduled maintanance
Payer Name
Payer ID
Transaction
Available
Non Par
Enrollment
Secondary
attachment
WC / Auto
NOTES
Medicare North Carolina
Payer ID
11502
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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Medicare North Carolina 11502 837P
Medicare North Carolina
Payer ID
11502
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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Medicare North Carolina 11502 837I
Medicare North Dakota
Payer ID
MR083
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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Medicare North Dakota MR083 837P
Medicare Northern Virginia
Payer ID
12202
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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Includes Arlington and Fairfax Counties in Northern Virginia and the city of Alexandria.
Medicare Northern Virginia 12202 837P
Medicare Ohio
Payer ID
15202
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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Medicare Ohio 15202 837P
Medicare Oklahoma
Payer ID
04312
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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Medicare Oklahoma 04312 837P
Medicare Oklahoma
Payer ID
04312
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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Medicare Oklahoma 04312 837I
Medicare Oregon
Payer ID
MR011
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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Medicare Oregon MR011 837P
Medicare Pennsylvania
Payer ID
12502
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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Medicare Pennsylvania 12502 837P
Medicare Pennsylvania
Payer ID
12502
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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Medicare Pennsylvania 12502 837I
Medicare Puerto Rico
Payer ID
09202
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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Medicare Puerto Rico 09202 837P
Medicare Railroad
Payer ID
MR018
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 listed under Payer Enrollment Forms - All or Multiple States. ERA activation can be found within the EDI enrollment form.
Medicare Railroad MR018 837P
Medicare Rhode Island
Payer ID
14412
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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Medicare Rhode Island 14412 837P
Medicare South Carolina
Payer ID
11202
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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Medicare South Carolina 11202 837P
Medicare South Carolina
Payer ID
11001
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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Medicare South Carolina 11001 837I
Medicare South Dakota
Payer ID
MR084
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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Medicare South Dakota MR084 837P
Medicare Tennessee
Payer ID
MR034
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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Medicare Tennessee MR034 837P
Medicare Tennessee
Payer ID
10301
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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Medicare Tennessee 10301 837I
Medicare Texas
Payer ID
MR085
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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Medicare Texas MR085 837P
Medicare Texas
Payer ID
MR085
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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Medicare Texas MR085 837I
Medicare Utah
Payer ID
MR046
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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Medicare Utah MR046 837P
Medicare Vermont
Payer ID
14512
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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Medicare Vermont 14512 837P
Medicare Virginia (Palmetto)
Payer ID
11302
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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Includes all cities/counties except Alexandria, Arlington & Fairfax.
Medicare Virginia (Palmetto) 11302 837P
Medicare Virgin Islands
Payer ID
09302
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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Medicare Virgin Islands 09302 837P
Medicare Washington
Payer ID
MR006
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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Medicare Washington MR006 837P
Medicare Washington
Payer ID
MR006
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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Medicare Washington MR006 837I
Medicare Washington DC
Payer ID
00903
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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Medicare Washington DC 00903 837P
Medicare Washington DC
Payer ID
00903
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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Medicare Washington DC 00903 837I
Medicare West Virginia
Payer ID
11402
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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Medicare West Virginia 11402 837P
Medicare Wisconsin
Payer ID
06302
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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Medicare Wisconsin 06302 837P
Medicare Wisconsin
Payer ID
06302
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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Medicare Wisconsin 06302 837I
Medicare Wyoming
Payer ID
MR074
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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Medicare Wyoming MR074 837P
MediChoice IPA
Payer ID
AMM11
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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MediChoice IPA AMM11 837P
MediChoice IPA
Payer ID
AMM11
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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MediChoice IPA AMM11 837I
Medicina Familiar Medical Group
Payer ID
CAPMN
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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Medicina Familiar Medical Group CAPMN 837P
Medicina Familiar Medical Group
Payer ID
CAPMN
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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Medicina Familiar Medical Group CAPMN 837I
Medico Insurance
Payer ID
23160
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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PO Box 21660 Eagan MN 55121
Medico Insurance 23160 837P
Medico Insurance
Payer ID
23160
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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PO Box 21660 Eagan MN 55121
Medico Insurance 23160 837I
Medico Insurance
Payer ID
23160
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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PO Box 21660 Eagan MN 55121
Medico Insurance 23160 837D
Medigold
Payer ID
95655
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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Medigold 95655 837P
Medigold
Payer ID
95655
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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Medigold 95655 837I
Medigold PPO
Payer ID
13123
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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Medigold PPO 13123 837P
Medigold PPO
Payer ID
13123
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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Medigold PPO 13123 837I
MediShare (Christian Care Ministries)
Payer ID
59355
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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Providers should check the member ID card and use the Household ID value as the member ID when submitting claims electronically.
MediShare (Christian Care Ministries) 59355 837P
MediShare (Christian Care Ministries)
Payer ID
59355
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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Providers should check the member ID card and use the Household ID value as the member ID when submitting claims electronically.
MediShare (Christian Care Ministries) 59355 837I
Mediview Sendero CHIP & STAR
Payer ID
SCS17
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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Mediview Sendero CHIP & STAR SCS17 837P
Mediview Sendero CHIP & STAR
Payer ID
SCS17
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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Mediview Sendero CHIP & STAR SCS17 837I
Mediview UTMB3
Payer ID
UTMB3
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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Mediview UTMB3 UTMB3 837P
Mediview UTMB3
Payer ID
UTMB3
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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Mediview UTMB3 UTMB3 837I
Mediview UTMB Care UB
Payer ID
RUTMH
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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Mediview UTMB Care UB RUTMH 837I
Mediview Vista 360 Health
Payer ID
V360H
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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Mediview Vista 360 Health V360H 837P
Mediview Vista 360 Health
Payer ID
V360H
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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Mediview Vista 360 Health V360H 837I
MedLogix MSO - Allied Health Solutions
Payer ID
MLAHS
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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MedLogix MSO - Allied Health Solutions MLAHS 837P
MedLogix MSO - Allied Health Solutions
Payer ID
MLAHS
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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MedLogix MSO - Allied Health Solutions MLAHS 837I
Medlytix LLC
Payer ID
MEDLX
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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Medlytix LLC MEDLX 837I
Medlytix, LLC
Payer ID
MEDLX
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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Medlytix, LLC MEDLX 837P
MedMgr MSO, Inc.
Payer ID
MMM88
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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MedMgr MSO, Inc. MMM88 837P
MedMgr MSO, Inc.
Payer ID
MMM88
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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MedMgr MSO, Inc. MMM88 837I
MedPartners Administrative Services
Payer ID
412MP
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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MedPartners Administrative Services 412MP 837P
MedPartners Administrative Services
Payer ID
412MP
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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MedPartners Administrative Services 412MP 837I
MedPay Assurance
Payer ID
MP001
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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MedPay Assurance MP001 837I
MedRisk
Payer ID
J1956
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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Workers Comp Only. At this time, only Professional (HCFA) claims are accepted.
Payer returns ERAs automatically once electronic claim submission begins. No enrollment needed.
MedRisk J1956 837P
MedSolutions, Inc
Payer ID
62160
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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MedSolutions, Inc 62160 837P
MedSolutions, Inc
Payer ID
62160
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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MedSolutions, Inc 62160 837I
MedStar Family Choice DC
Payer ID
RP062
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 1/1/23 and after
MedStar Family Choice DC RP062 837P
MedStar Family Choice DC
Payer ID
RP062
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 1/1/23 and after
MedStar Family Choice DC RP062 837I
MedStar Family Choice MD
Payer ID
RP063
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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MedStar Family Choice MD RP063 837P
MedStar Family Choice MD
Payer ID
RP063
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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MedStar Family Choice MD RP063 837I
MedStar Family Choice of DC
Payer ID
39190
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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MedStar Family Choice of DC 39190 837P
MedStar Family Choice of DC
Payer ID
39190
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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MedStar Family Choice of DC 39190 837I
MedStar Family Choice of Maryland
Payer ID
00243
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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MedStar Family Choice of Maryland 00243 837P
Mega Life and Health (Frisco, TX)
Payer ID
60601
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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Mega Life and Health (Frisco, TX) 60601 837D
Meijer Stores
Payer ID
J1930
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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Workers Comp Only. At this time, only Professional (HCFA) claims are accepted.
Meijer Stores J1930 837P
MEMIC Casualty Company
Payer ID
14164
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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Workers Comp and Liability. At this time, only Professional (HCFA) claims are accepted.
Payer returns ERAs automatically once electronic claim submission begins. No enrollment needed.
MEMIC Casualty Company 14164 837P
MEMIC Indemnity Company
Payer ID
11030
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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Workers Comp Only. At this time, only Professional (HCFA) claims are accepted.
Payer returns ERAs automatically once electronic claim submission begins. No enrollment needed.
MEMIC Indemnity Company 11030 837P
MemorialCare Independent Physicians (formerly known as Greater Newport Physicians)
Payer ID
GNPMG
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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The ERA enrollment form will be listed under "MemorialCare".
MemorialCare Independent Physicians (formerly known as Greater Newport Physicians) GNPMG 837P
MemorialCare Independent Physicians (formerly known as Greater Newport Physicians)
Payer ID
GNPMG
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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The ERA enrollment form will be listed under "MemorialCare".
MemorialCare Independent Physicians (formerly known as Greater Newport Physicians) GNPMG 837I
MemorialCare Medical Foundation
Payer ID
MMFMC
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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The ERA enrollment form will be listed under "MemorialCare".
MemorialCare Medical Foundation MMFMC 837P
MemorialCare Medical Foundation
Payer ID
MMFMC
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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The ERA enrollment form will be listed under "MemorialCare".
MemorialCare Medical Foundation MMFMC 837I
MemorialCare Medical Foundation Cap Services
Payer ID
MMFCS
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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The ERA enrollment form will be listed under "MemorialCare".
MemorialCare Medical Foundation Cap Services MMFCS 837P
MemorialCare Medical Foundation Cap Services
Payer ID
MMFCS
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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The ERA enrollment form will be listed under "MemorialCare".
MemorialCare Medical Foundation Cap Services MMFCS 837I
MemorialCare Medical Foundation UCI
Payer ID
MMFUC
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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The ERA enrollment form will be listed under "MemorialCare".
MemorialCare Medical Foundation UCI MMFUC 837P
MemorialCare Medical Foundation UCI
Payer ID
MMFUC
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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The ERA enrollment form will be listed under "MemorialCare".
MemorialCare Medical Foundation UCI MMFUC 837I
MemorialCare Select Health Plan
Payer ID
46187
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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(formerly known Seaside Health Plan). The ERA enrollment form will be listed under "MemorialCare".
MemorialCare Select Health Plan 46187 837P
MemorialCare Select Health Plan
Payer ID
46187
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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(formerly known Seaside Health Plan). The ERA enrollment form will be listed under "MemorialCare".
MemorialCare Select Health Plan 46187 837I
MemorialCare Select Health Plan Encounters
Payer ID
E4618
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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(formerly known Seaside Health Plan)
MemorialCare Select Health Plan Encounters E4618 837P
MemorialCare Select Health Plan Encounters
Payer ID
E4618
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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(formerly known Seaside Health Plan)
MemorialCare Select Health Plan Encounters E4618 837I
Memorial Healthcare IPA
Payer ID
IP095
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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Memorial Healthcare IPA IP095 837P
Memorial Healthcare IPA
Payer ID
IP095
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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Memorial Healthcare IPA IP095 837I
Memorial Hermann Health Network (MHHN)
Payer ID
MHHNP
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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Memorial Hermann Health Network (MHHN) MHHNP 837P
Memorial Hermann Health Network (MHHN)
Payer ID
MHHNP
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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Memorial Hermann Health Network (MHHN) MHHNP 837I
Memorial Integrated Healthcare (Commercial)
Payer ID
59064
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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Now known as Community Care Plan (CCP).
Memorial Integrated Healthcare (Commercial) 59064 837P
Memorial Integrated Healthcare (Commercial)
Payer ID
59064
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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Now known as Community Care Plan (CCP).
Memorial Integrated Healthcare (Commercial) 59064 837I
Memorial Integrated Healthcare (Medicaid)
Payer ID
59065
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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Now known as Community Care Plan (CCP).
Memorial Integrated Healthcare (Medicaid) 59065 837P
Memorial Integrated Healthcare (Medicaid)
Payer ID
59065
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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Now known as Community Care Plan (CCP).
Memorial Integrated Healthcare (Medicaid) 59065 837I
Memorial Medical Center - Non Sutter
Payer ID
SC054
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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Memorial Medical Center - Non Sutter SC054 837P
Memorial Medical Center - Non Sutter
Payer ID
SC054
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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Memorial Medical Center - Non Sutter SC054 837I
Mendota Insurance Company
Payer ID
33650
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Auto
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Auto Only. At this time, only Professional (HCFA) claims are accepted.
Payer returns ERAs automatically once electronic claim submission begins. No enrollment needed.
Mendota Insurance Company 33650 837P
Menifee Valley Community Medical Group
Payer ID
HCMG1
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 the payer (951-791-1111) prior to submitting claims electronically.
Menifee Valley Community Medical Group HCMG1 837P
Menifee Valley Community Medical Group
Payer ID
HCMG1
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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Please contact the payer (951-791-1111) prior to submitting claims electronically.
