All Available Payers with Office Ally Payer List

Find the ERA Instructions under 'Banner University Care LTC' in the enrollment form library.

Former Payer IDs: 31107, 33108, 37237, 74214, 74223, 75196, and 75243.

EFT enrollment is required in order to activate ERAs. This payer also requires ERA enrollment in Payer ID 87726.

Former Payer IDs: 31107, 33108, 37237, 74214, 74223, 75196, and 75243.

Claims are submitted to 87726, and ERA enrollment completed under 95959.

Former Payer IDs: 25175, 86003, and 86049. Claims are submitted to 87726, and ERA enrollment completed under 04567.

Plan effective 5/1/17.

ERA Enrollment should be completed under Medicaid Ohio. If you are already approved to receive ERA for Medicaid of Ohio, you do not have to re-enroll.

Former Payer IDs: 31107, 33108, 37237, 74214, 74223, 75196, and 75243.

ERA enrollment must be completed under Quartz.

Find the ERA Instructions under 'Banner University Care LTC' in the enrollment form library.

Find the ERA Instructions under 'Banner University Care LTC' in the enrollment form library.

See University of Arizona Health Plans ERA enrollment form.

A UHIN pass through few applies to this transaction.

For DOS on or after 7/29/2019. Coverage: CT, DE, ME, MD, MA, NH, NJ, NY, NC, PA, RI, VT, VA, WV, DC.

For DOS on or After 10/8/2019. Coverage: ND, SD, NE, KS, MN, IA, MO, WI, IL,MI, IN, OH, KY.

For DOS on or after 1/08/2020. Coverage: FL, SC, GA, AL, TN,MS, LA, AR, OK

A UHIN pass through few applies to this transaction.

ERA's are activated as soon as the provider is approved for EDI submissions.

Effective 1/1/2024 -ERA starts automatically once a provider begins submitting electronically through OA.

Formerly HMA Hawaii

For claims with DOS before 1/1/2018. EDI Enrollment under Virginia Premier Health Plans.

EDI Enrollment under Virginia Premier Health Plans.

EDI Enrollment under Virginia Premier Health Plans.

EDI Enrollment under Virginia Premier Health Plans.

EDI Enrollment under Virginia Premier Health Plans.

EDI Enrollment under Virginia Premier Health Plans.

EDI Enrollment under Virginia Premier Health Plans.

Formerly known as River City Medical Group

Enrollment Forms are the same as those for BCBS TN. Typically if enrolled with BCBS TN, the provider will not need to enroll for Medicaid TN/TennCare. Contact the payer directly to confirm if pre-enrollment is required.

Payer returns ERA automatically. No enrollment required.

Formerly known as WPS Arise (Prevea). ERA Enrollment completed under WPS Health Insurance / Health Plan

Form listed under BMC HealthNet Plan.

Formerly under Payer ID TH023.

Enrollment listed under Wellnet Healthcare Administrators, payer ID: ZP1022

Payer returns ERAs automatically.