All Available Payers with Office Ally Payer List

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Payer Name
Payer ID
Transaction
Available
Non Par
Enrollment
Secondary
attachment
WC / Auto
NOTES
Custom Design Benefits, Inc.
Payer ID
82056
Payer ID
Transaction
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
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
Attachment
Available
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
Attachment
Available
WC / Auto
Work Comp & Auto
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Workers Comp and Auto. At this time, only Professional (HCFA) claims are accepted. Payer returns ERAs automatically once electronic claim submission begins. No enrollment needed.
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
Attachment
Available
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
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
Payer ID
17003
Payer ID
Transaction
Remits
835
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 C Medicare
Payer ID
00885
Payer ID
Transaction
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
Payer ID
00885
Payer ID
Transaction
Remits
835
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 D Medicare
Payer ID
05655
Payer ID
Transaction
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.
DMERC Region D Medicare
Payer ID
05655
Payer ID
Transaction
Remits
835
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.
Dairyland Insurance Company
Payer ID
C1033
Payer ID
Transaction
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.
Dameron Hospital Association
Payer ID
CCHPC
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dameron Hospital Association
Payer ID
CCHPC
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Darigold - CORVEL
Payer ID
J1936
Payer ID
Transaction
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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Workers Comp and Auto. At this time, only Professional (HCFA) claims are accepted.
Dart Management Corporation
Payer ID
43471
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dart Management Corporation
Payer ID
43471
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dawson ISD
Payer ID
J3929
Payer ID
Transaction
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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Workers Comp and Auto. At this time, only Professional (HCFA) claims are accepted. Payer returns ERAs automatically once electronic claim submission begins. No enrollment needed.
Dean Health Plan
Payer ID
39113
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dean Health Plan
Payer ID
39113
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dean Health Plan
Payer ID
39113
Payer ID
Transaction
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dean Health Plan
Payer ID
DEANH
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dean Health Plan (Medica)
Payer ID
41822
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dean Health Plan (Medica)
Payer ID
41822
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Definity Health
Payer ID
DEFINITY
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Del Taco, LLC
Payer ID
J1681
Payer ID
Transaction
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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Workers Comp and Auto. At this time, only Professional (HCFA) claims are accepted.
Delano Regional Medical Group (Managed Care Systems)
Payer ID
MCS03
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delano Regional Medical Group (Managed Care Systems)
Payer ID
MCS03
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delano Regional Medical Group (Managed Care Systems)
Payer ID
MCS03
Payer ID
Transaction
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delaware First Health (Centene)
Payer ID
68069
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delaware First Health (Centene)
Payer ID
68069
Payer ID
Transaction
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delaware First Health (Centene)
Payer ID
68069
Payer ID
Transaction
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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ERA enrollment forms listed under Centene Corporation.
Delaware First Health (Centene)
Payer ID
DEFIRST
Payer ID
Transaction
Claim Status
276 / 277
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delaware First Health (Centene)
Payer ID
DEFIRST
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Dell, Inc. - CORVEL
Payer ID
J1983
Payer ID
Transaction
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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Workers Comp and Auto. At this time, only Professional (HCFA) claims are accepted. Payer returns ERAs automatically once electronic claim submission begins. No enrollment needed.
Delta Dental (Northeast - ME, NH, VT)
Payer ID
02027
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental Classic
Payer ID
WDENC
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental Clear
Payer ID
WDENC
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental Encara
Payer ID
WDENC
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental Ins. Co. - Alabama
Payer ID
DDAL1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental Ins. Co. - Alabama
Payer ID
DDAL1
Payer ID
Transaction
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental Ins. Co. - Florida
Payer ID
DDFL1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental Ins. Co. - Georgia
Payer ID
DDGA1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental Ins. Co. - Louisiana
Payer ID
DDLA1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental Ins. Co. - Mississippi
Payer ID
DDMS1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental Ins. Co. - Texas
Payer ID
DDTX1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental Ins. Co. - Utah
Payer ID
DDUT1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental Of Alaska
Payer ID
DDAK1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental Texas Childrens Medicaid Services
Payer ID
CPPTM
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Arizona
Payer ID
86027
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Arkansas
Payer ID
DDPAR
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of California
Payer ID
77777
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Colorado
Payer ID
DDPCO
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Connecticut
Payer ID
22189
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Delaware
Payer ID
51022
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Georgia
Payer ID
DDGA1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Idaho
Payer ID
82029
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Illinois
Payer ID
47598
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Illinois - Individual
Payer ID
IDIND
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Iowa
Payer ID
CDIA1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Iowa - DWP
Payer ID
CDIAM
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Kentucky
Payer ID
CDKY1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Maryland
Payer ID
23166
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Massachusetts
Payer ID
04614
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Missouri
Payer ID
43090
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Montana
Payer ID
DDMT1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Nevada
Payer ID
DDNV1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of New Jersey
Payer ID
22189
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of New York
Payer ID
11198
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Oklahoma
Payer ID
DDPOK
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Pennsylvania
Payer ID
23166
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Puerto Rico
Payer ID
66043
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Rhode Island
Payer ID
05029
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of South Carolina in Missouri
Payer ID
43091
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of South Dakota
Payer ID
54097
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Tennessee (Dental)
Payer ID
DDPTN
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Texas
Payer ID
DDTX1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Virginia
Payer ID
54084
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of WA
Payer ID
91062
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Washington DC
Payer ID
52147
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Washington State
Payer ID
91062
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of West Virginia
Payer ID
31096
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Wisconsin
Payer ID
39069
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Dental of Wyoming
Payer ID
CDWY1
Payer ID
Transaction
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Delta Health Systems
Payer ID
DHS01
Payer ID
Transaction
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Please Note: P5 Health Plan Solutions of Utah (87068) was taken over by Delta Health Systems and is no longer active. Providers should refer to the patient’s current healthcare ID card for the administrator of benefits and Payer ID.