All Available Payers with Office Ally Payer List

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Payer Name
Payer ID
Transaction
Available
Non Par
Enrollment
Secondary
WC / Auto
NOTES
County Medical Services Program (CMSP)
Payer ID
AMM15
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Effective 4/1/15.
County Of San Diego
Payer ID
J1513
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp
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Workers Comp Only. At this time, only Professional (HCFA) claims are accepted.
County of Chesterfield, VA
Payer ID
J1525
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp
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Workers Comp Only. At this time, only Professional (HCFA) claims are accepted.
County of Fresno
Payer ID
AMM21
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Effective 7/1/18
County of Fresno
Payer ID
AMM21
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Effective 7/1/18
County of Kern - CORVEL
Payer ID
J1935
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp & Auto
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Workers Comp and Auto.
County of Kern POS
Payer ID
22149
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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For Dates of Service (DOS) 12/31/2015 and PRIOR. For DOS on/after 1/1/2016, the claims should be directed to Anthem Blue Cross (California).
County of Kern POS
Payer ID
22149
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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For Dates of Service (DOS) 12/31/2015 and PRIOR. For DOS on/after 1/1/2016, the claims should be directed to Anthem Blue Cross (California).
County of Los Angeles (1000)
Payer ID
J1625
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp & Auto
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Workers Comp and Auto. For claim numbers that start with '1000'. At this time, only Professional (HCFA) claims are accepted.
County of Los Angeles (2000)
Payer ID
J1722
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp
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Workers Comp Only. For claim numbers that start with '2000'. At this time, only Professional (HCFA) claims are accepted.
County of Los Angeles (3000)
Payer ID
J1967
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp & Auto
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Workers Comp and Auto. For claim numbers that start with '3000'. At this time, only Professional (HCFA) claims are accepted.
County of Los Angeles (4000/5000)
Payer ID
J1723
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp
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Workers Comp Only. For claim numbers that start with '4000' or '5000'. At this time, only Professional (HCFA) claims are accepted.
County of Sacramento - EMSF
Payer ID
AMM20
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Effective 6/1/18
County of Sacramento - EMSF
Payer ID
AMM20
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Effective 6/1/18
County of Sacramento - Healthy Partners
Payer ID
MBA01
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Payer returns ERA's automatically once electronic claim submission begins.
County of Sacramento - Healthy Partners
Payer ID
MBA01
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Payer returns ERA's automatically once electronic claim submission begins.
County of Shasta (CA)
Payer ID
J1616
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp & Auto
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Workers Comp and Auto. At this time, only Professional (HCFA) claims are accepted.
County of Tulare (CA) - CORVEL
Payer ID
J1666
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp & Auto
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Workers Comp and Auto.
Covenant Administrators Inc.
Payer ID
58102
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Atlanta, GA.
Covenant Administrators Inc.
Payer ID
58102
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Atlanta, GA.
Covenant Administrators Inc.
Payer ID
58102
Payer ID
Transaction
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Atlanta, GA.
Covenant Administrators Inc.
Payer ID
COV-ADMIN
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Covenant Management System Employee Benefit Plan
Payer ID
CMSEB
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Covenant Management System Employee Benefit Plan
Payer ID
CMSEB
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Covenant Management Systems
Payer ID
12T60
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Coventry Health Care Carelink Medicaid
Payer ID
00182
Payer ID
Transaction
Claim Status
276 / 277
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Coventry Health Care Carelink Medicaid
Payer ID
00182
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Coventry Health Care USA (HCUSA)
Payer ID
00186
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Coventry Health Care of MO, MS, AK, TN(00184)
Payer ID
10205
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Coventry Health Care of Georgia
Payer ID
00154
Payer ID
Transaction
Claim Status
276 / 277
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Coventry Health Care of Georgia
Payer ID
10190
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Coventry Health Care of Louisiana
Payer ID
10150
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Coventry National/University of MO(00250)
Payer ID
10196
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Coventry National/University of MO(COVON)
Payer ID
COVON
Payer ID
Transaction
Claim Status
276 / 277
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Coventry National/University of MO(COVON)
Payer ID
13129
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Coventry Wellpath Select
Payer ID
10153
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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CoventryCares of West Virginia
Payer ID
SCNCC
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Coworx Staffing, LLC
Payer ID
J1046
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp
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Workers Comp Only. 835’s are automatic. At this time, only Professional (HCFA) claims are accepted.
Cox Health Plan
Payer ID
00019
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Cox Health Plan
Payer ID
00019
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Cox Health Plan
Payer ID
00019
Payer ID
Transaction
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Cox Health Plan
Payer ID
COX-HP
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Craftworks Holdings - CORVEL
Payer ID
J3862
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp
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Workers Comp only.
Create Healthcare
Payer ID
CREA8
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Create Healthcare
Payer ID
CREA8
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Create Healthcare
Payer ID
CREATE
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Crescent Health Solutions
Payer ID
56213
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Crescent Health Solutions
Payer ID
56213
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Crestbrook Insurance Company
Payer ID
J1550
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp
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Workers Comp Only. At this time, only Professional (HCFA) claims are accepted.
Crossway HealthShare
Payer ID
33213
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Crossway HealthShare
Payer ID
33213
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Crown Life - Great West
Payer ID
62308
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Crown Life - Great West
Payer ID
62308
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Crown Life - Great West
Payer ID
62308
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Croy - Hall Management, Inc.
Payer ID
37266
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Croy - Hall Management, Inc.
Payer ID
37266
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Crum & Forster Indemnity Co
Payer ID
31348
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp & Auto
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Workers Comp and Auto.
Crystal Run Health Plans
Payer ID
46120
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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For claims with DOS prior to January 1, 2018.
Crystal Run Health Plans
Payer ID
46430
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
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For claims with DOS on/after January 1, 2018.
Crystal Run Health Plans
Payer ID
46120
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
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For claims with DOS prior to January 1, 2018.
Crystal Run Health Plans
Payer ID
46430
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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For claims with DOS on/after January 1, 2018.
Culinary Health Fund
Payer ID
CULINARY
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Cumberland Insurance Group
Payer ID
C1091
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Auto
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Auto only.
CuraeChoice
Payer ID
CC304
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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CuraeChoice
Payer ID
CC304
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Curative Health
Payer ID
CURTV
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Curative Health
Payer ID
CURTV
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Curative Health
Payer ID
CURATIVE
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Custody Medical Services Program (CMSP)
Payer ID
AMM03
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Custody Medical Services Program (CMSP)
Payer ID
AMM03
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Custom Benefit Administrators
Payer ID
39081
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Custom Benefit Administrators
Payer ID
39081
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Custom Benefit Administrators
Payer ID
39081
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Custom Benefit Administrators
Payer ID
39081
Payer ID
Transaction
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Custom Design Benefits, Inc.
Payer ID
82056
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Custom Design Benefits, Inc.
Payer ID
82056
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Custom Design Benefits, Inc.
Payer ID
82056
Payer ID
Transaction
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Cypress Security (Member of BHHC)
Payer ID
20044
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp
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Workers Comp Only. At this time, only Professional (HCFA) claims are accepted. Covers CA, IL, LA, MN, NC, NJ, OR, TN, TX, VA.
DBi Services LLC - CORVEL
Payer ID
J3761
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
Work Comp & Auto
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Workers Comp and Auto.
DC Health Ryan White Program
Payer ID
DCRWP
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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DC Health Ryan White Program
Payer ID
DCRWP
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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DC Risk Solutions
Payer ID
DCRSS
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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DC Risk Solutions
Payer ID
DCRSS
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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DCHP Texas Medicaid
Payer ID
38261
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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For claim DOS on or after 9/1/22. Claims with DOS prior to 9/1/21 should be sent using payer code 74272.
DCHP Texas Medicaid
Payer ID
38261
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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For claim DOS on or after 9/1/22. Claims with DOS prior to 9/1/21 should be sent using payer code 74272.
DDIC
Payer ID
94276
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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DH Cook Associates
Payer ID
DHCOOK
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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DHMN - Preferred IPA Hospital Risk
Payer ID
DHM02
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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DHMN - Preferred IPA Hospital Risk
Payer ID
DHM02
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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DHMN - Preferred IPA Hospital Risk
Payer ID
DHM02
Payer ID
Transaction
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Automatic ERA enrollment upon electronic claim submission
DHMN Santa Cruz
Payer ID
DHM01
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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DHMN Santa Cruz
Payer ID
DHM01
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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DHMN Santa Cruz
Payer ID
DHM01
Payer ID
Transaction
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Automatic ERA enrollment upon electronic claim submission
DHR Provider Management
Payer ID
DHRPM
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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Please contact Debra (949-635-0434) to become approved for electronic submissions.
DMERC Region A Medicare
Payer ID
16003
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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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
Payer ID
16003
Payer ID
Transaction
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
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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 B Medicare
Payer ID
17003
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
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
Payer ID
17003
Payer ID
Transaction
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
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 C Medicare
Payer ID
00885
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
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
Payer ID
00885
Payer ID
Transaction
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
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.