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.
Payer Name
Payer ID
Transaction
Available
Non Par
Enrollment
Secondary
WC / Auto
NOTES
Medicaid Pennsylvania - Oaktree
Payer ID
CX014
Payer ID
Transaction
All
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
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Hide note
Medicaid Pennsylvania - Oaktree CX014 837D
Medicaid Rhode Island
Payer ID
MCDRI
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Rhode Island MCDRI 837P
Medicaid Rhode Island
Payer ID
MCDRI
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Rhode Island MCDRI 835
Medicaid Rhode Island
Payer ID
RIMCD
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
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Hide note
Medicaid Rhode Island RIMCD 270 / 271
Medicaid South Carolina
Payer ID
SCXIX
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
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Hide note
Medicaid South Carolina SCXIX 837P
Medicaid South Carolina
Payer ID
SCXIX
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
Medicaid South Carolina SCXIX 835
Medicaid South Carolina
Payer ID
SCMCD
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
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Hide note
Medicaid South Carolina SCMCD 270 / 271
Medicaid South Dakota
Payer ID
MCDSD
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
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Hide note
Medicaid South Dakota MCDSD 837P
Medicaid South Dakota
Payer ID
MCDSD
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
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Hide note
Medicaid South Dakota MCDSD 835
Medicaid South Dakota
Payer ID
10695
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
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Hide note
Medicaid South Dakota 10695 270 / 271
Medicaid Tennessee
Payer ID
TNMCD
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
A pass through few of $0.04 applies to this transaction
Medicaid Tennessee TNMCD 270 / 271
Medicaid Tennessee - BlueCare
Payer ID
CX014
Payer ID
Transaction
All
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
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Medicaid Tennessee - BlueCare CX014 837D
Medicaid Tennessee / TennCare
Payer ID
00890
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
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Hide note
Medicaid Tennessee / TennCare 00890 837P
Medicaid Tennessee / TennCare
Payer ID
00890
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
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Hide note
Medicaid Tennessee / TennCare 00890 837I
Medicaid Tennessee / TennCare
Payer ID
00890
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
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.
Medicaid Tennessee / TennCare 00890 835
Medicaid Texas
Payer ID
TMHP1
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
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Hide note
Medicaid Texas TMHP1 837P
Medicaid Texas
Payer ID
TMHP1
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Texas TMHP1 837I
Medicaid Texas
Payer ID
TMHP1
Payer ID
Transaction
All
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Texas TMHP1 837D
Medicaid Texas
Payer ID
TMHP1
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Texas TMHP1 835
Medicaid Texas
Payer ID
10730
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
A pass through few of $0.075 applies to this transaction
Medicaid Texas 10730 270 / 271
Medicaid Texas - Delta Dental
Payer ID
CPPTM
Payer ID
Transaction
All
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
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Hide note
Medicaid Texas - Delta Dental CPPTM 837D
Medicaid Texas - MCNA
Payer ID
MCNA1
Payer ID
Transaction
All
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
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Hide note
Medicaid Texas - MCNA MCNA1 837D
Medicaid Texas and Texas Health Steps
Payer ID
TXMCD-THS
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
A pass through few of $0.075 applies to this transaction
Medicaid Texas and Texas Health Steps TXMCD-THS 270 / 271
Medicaid Utah
Payer ID
SKUT0
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
A UHIN pass through few applies to this transaction. Secondary claims: If Medicare is the primary, please use payer ID U4005.
Medicaid Utah SKUT0 837P
Medicaid Utah
Payer ID
SKUT0
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
A UHIN pass through few applies to this transaction. Secondary claims: If Medicare is the primary, please use payer ID U4005.
Medicaid Utah SKUT0 837I
Medicaid Utah
Payer ID
SKUT0
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
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
Payer ID
UTMCD
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Utah UTMCD 270 / 271
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
WC / Auto
View note
Hide note
View note
Hide note
A UHIN pass through few applies to this transaction.
Medicaid Utah Crossovers U4005 837P
Medicaid Vermont
Payer ID
MCDVT
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Vermont MCDVT 837P
Medicaid Vermont
Payer ID
MCDVT
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Vermont MCDVT 835
Medicaid Vermont
Payer ID
10846
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Vermont 10846 270 / 271
Medicaid Virginia
Payer ID
MCDVA
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Virginia MCDVA 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
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Virginia MCDVA 837I
Medicaid Virginia
Payer ID
MCDVA
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Virginia - HealthKeepers Plus CX014 837D
Medicaid Washington
Payer ID
MC006
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Washington MC006 837P
Medicaid Washington
Payer ID
MC006
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Washington MC006 837I
Medicaid Washington
Payer ID
MC006
Payer ID
Transaction
All
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Wisconsin - PrimeCare CX014 837D
Medicaid Wyoming
Payer ID
77046
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
Medicaid Wyoming 77046 835
Medicaid Wyoming
Payer ID
10892
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
WC / Auto
View note
Hide note
View note
Hide note
A pass through few of $0.0325 applies to this transaction
Medicaid Wyoming 10892 270 / 271
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
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
WC / Auto
View note
Hide note
View note
Hide note
Medical Associates Health Plan MAHP 270 / 271
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
WC / Auto
View note
Hide note
View note
Hide note
Newark, OH.
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
WC / Auto
View note
Hide note
View note
Hide note
Newark, OH.
Medical Benefits Administrators, Inc. 74323 837I
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
WC / Auto
View note
Hide note
View note
Hide note
Newark, OH.
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
WC / Auto
View note
Hide note
View note
Hide note
Newark, OH.
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
WC / Auto
View note
Hide note
View note
Hide note
Medical Benefits Mutual 74323 837P
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
WC / Auto
View note
Hide note
View note
Hide note
Medical Benefits Mutual 74323 837I
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
WC / Auto
View note
Hide note
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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
WC / Auto
View note
Hide note
View note
Hide note
Medical Benefits Mutual Life Insurance Co. 74323 837I
