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.
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Payer Name
Payer ID
Transaction
Available
Non Par
Enrollment
Secondary
attachment
WC / Auto
NOTES
Medicaid Utah
Payer ID
SKUT0
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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A UHIN pass through few applies to this transaction. Secondary claims: If Medicare is the primary, please use payer ID U4005.
Medicaid Utah SKUT0 835
Medicaid Utah Crossovers
Payer ID
U4005
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 few applies to this transaction.
Medicaid Utah Crossovers U4005 837P
Medicaid Vermont
Payer ID
10846
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medicaid Vermont 10846 270 / 271
Medicaid Vermont
Payer ID
MCDVT
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medicaid Vermont MCDVT 835
Medicaid Vermont
Payer ID
MCDVT
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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Medicaid Vermont MCDVT 837P
Medicaid Virginia
Payer ID
MCDVA
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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Medicaid Virginia MCDVA 837I
Medicaid Virginia
Payer ID
MCDVA
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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Medicaid Virginia MCDVA 837P
Medicaid Virginia
Payer ID
MCDVA
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medicaid Virginia MCDVA 835
Medicaid Virginia
Payer ID
VAMCD
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medicaid Virginia VAMCD 270 / 271
Medicaid Virginia - HealthKeepers Plus
Payer ID
CX014
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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Medicaid Virginia - HealthKeepers Plus CX014 837D
Medicaid Washington
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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Medicaid Washington MC006 837I
Medicaid Washington
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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Medicaid Washington MC006 837P
Medicaid Washington
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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Medicaid Washington MC006 837D
Medicaid Washington
Payer ID
MC006
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medicaid Washington MC006 835
Medicaid Washington
Payer ID
WAMCD
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medicaid Washington WAMCD 270 / 271
Medicaid Washington DC
Payer ID
77033
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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Medicaid Washington DC 77033 837P
Medicaid Washington DC
Payer ID
77033
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medicaid Washington DC 77033 835
Medicaid West Virginia
Payer ID
MCDWV
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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Medicaid West Virginia MCDWV 837P
Medicaid West Virginia
Payer ID
MCDWV
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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Medicaid West Virginia MCDWV 837I
Medicaid West Virginia
Payer ID
MCDWV
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medicaid West Virginia MCDWV 835
Medicaid West Virginia
Payer ID
WVMCD
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medicaid West Virginia WVMCD 270 / 271
Medicaid Wisconsin
Payer ID
MCDWI
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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Medicaid Wisconsin MCDWI 837P
Medicaid Wisconsin
Payer ID
MCDWI
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medicaid Wisconsin MCDWI 835
Medicaid Wisconsin
Payer ID
WIMCD
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medicaid Wisconsin WIMCD 270 / 271
Medicaid Wisconsin (Administered by Doral Dental of Wisconsin)
Payer ID
CX014
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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Medicaid Wisconsin (Administered by Doral Dental of Wisconsin) CX014 837D
Medicaid Wisconsin - Humana / TDC
Payer ID
CX014
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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Medicaid Wisconsin - Humana / TDC CX014 837D
Medicaid Wisconsin - PrimeCare
Payer ID
CX014
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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Medicaid Wisconsin - PrimeCare CX014 837D
Medicaid Wyoming
Payer ID
10892
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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A pass through few of $0.0325 applies to this transaction
Medicaid Wyoming 10892 270 / 271
Medicaid Wyoming
Payer ID
77046
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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Medicaid Wyoming 77046 837P
Medicaid Wyoming
Payer ID
77046
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medicaid Wyoming 77046 835
Medical Associates Health Plan
Payer ID
MAHC1
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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Medical Associates Health Plan MAHC1 837P
Medical Associates Health Plan
Payer ID
MAHC1
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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Medical Associates Health Plan MAHC1 837I
Medical Associates Health Plan
Payer ID
MAHP
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medical Associates Health Plan MAHP 270 / 271
Medical Benefits Administrators, Inc.
Payer ID
74323
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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ERA Enrollment form is under the name "Medical Benefits Mutual"
Medical Benefits Administrators, Inc. 74323 835
Medical Benefits Administrators, Inc.
Payer ID
74323
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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Medical Benefits Administrators, Inc. 74323 837P
Medical Benefits Administrators, Inc.
Payer ID
74323
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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Medical Benefits Administrators, Inc. 74323 837I
Medical Benefits Companies
Payer ID
74323
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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ERA Enrollment form is under the name "Medical Benefits Mutual"
Medical Benefits Companies 74323 835
Medical Benefits Companies
Payer ID
74323
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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Medical Benefits Companies 74323 837P
Medical Benefits Companies
Payer ID
74323
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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Medical Benefits Companies 74323 837I
Medical Benefits Mutual
Payer ID
74323
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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Medical Benefits Mutual 74323 837P
Medical Benefits Mutual
Payer ID
74323
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medical Benefits Mutual 74323 835
Medical Benefits Mutual
Payer ID
74323
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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Medical Benefits Mutual 74323 837I
Medical Benefits Mutual Life Insurance Co.
Payer ID
74323
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Medical Benefits Mutual Life Insurance Co. 74323 835
Medical Benefits Mutual Life Insurance Co.
Payer ID
74323
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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Medical Benefits Mutual Life Insurance Co. 74323 837P
Medical Benefits Mutual Life Insurance Co.
Payer ID
74323
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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Medical Benefits Mutual Life Insurance Co. 74323 837I