Electronic Claims




Vendor information

Providence contracts with numerous partners to help you file claims electronically.

Electronic claims are free and are paid on an average of 10 business days.

Below is a list of our vendors along with relevant information that can help you decide which vendor is the best fit for your office’s needs.

For assistance, contact us: PHPEDISupport@providence.org

Vendor Name Contact Information Transaction Types Plan ID/Payer ID Numbers Subcontractor
 Availity Contact your Availity representative for electronic claims information:
800-282-4584
Professional claims Health Plans = PHP01
PPO = PHP00
Change Healthcare
 *Capario/Emdeon www.Capario.com Professional claims
Institutional claims
Electronic Remittance Advice (ERA)
Health Plans = PHP01
PPO = PHP00

 CareVu Contact your CareVu representative for electronic claims information: 
www.healthsmart.com
Professional claims Health Plans = PHP01
PPO = PHP00
Change Healthcare
*Change Healthcare Envoy/WebMD/Sage www.changehealthcare.com/support/customer-resources/enrollment-services.com Professional claims
Institutional claims
Electronic Remittance Advice (ERA)
Health Plans = SX133
PPO = SX187

 Claim Logic www.claimlogic.com Professional claims
Institutional claims
Electronic Remittance Advice (ERA)
Health Plans = SX133
PPO = SX187
Change Healthcare
 eClaims Contact your eClaims EDI representative for electronic claims information: 
www.eClaims.com
Professional claims Health Plans = PHP01
PPO = PHP00
Change Healthcare
 EDI Healthcare Contact your EDI Healthcare representative for electronic claims information: 
www.edihealthcare.com
Professional claims Health Plans = PHP01
PPO = not set up
Change Healthcare
 ENS Contact your ENS representative for electronic claims information: 
www.enshealth.com 
 Professional claims Health Plans = PHP01
PPO = PHP00
Change Healthcare
 ET&T www.ettch.com  Professional claims Health Plans = 
SX133
PPO = SX187
Change Healthcare 
 *FCHN   Professional claims
Institutional claims
Washington Providers = 91131 (not Vancouver)  
Gateway EDI/Trizetto Provider Solutions Contact your Gateway EDI representative for electronic claims information: 
www.gatewayedi.com 
Professional claims
Institutional claims
Electronic Remittance Advice (ERA)
Health Plans = PHP01
PPO = PHP00
 
GE Healthcare/Centricity/ IDX Contact your GE Healthcare representative for electronic claims information: 
www.gehealthcare.com 
 Professional claims Health Plans = 
SX133
PPO = SX137
 Change healthcare
 GHN Contact GHN for electronic claim information: 
www.ghnonline.com
 Professional claims Health Plans = 
SX133
PPO = SX187
Change Healthcare
 HeW Contact HeW EDI representative for electronic claims information: 
www.hewedi.com
 Professional claims Health Plans = 
PHP01 
Change Healthcare
 Health Fusion    Professional claims Health Plans = PHP01
PPO = PHP00
Change Healthcare
MCPS- Medical Claims Processing Solutions mcp@mcps-inc.com
800-879-7534
Professional claims
Institutional claims
Electronic Remittance Advice (ERA)
Health Plans = ORD02
PPO = ORD14
Change Healthcare
Misys and PayerPath Contact Misys for electronic claim information Professional claims Health Plans = 000735
PPO = 001478
Change Healthcare
Navicure Contact Navicure for Providence payer IDs 
www.navicure.com
 Professional claims Health Plans = P1238
PPO = 91186
Change Healthcare
*Office Ally 866-575-4120
info@officeally.com
Professional claims
Institutional claims
Electronic Remittance Advice (ERA) 
Health Plans = PHP01
PPO = PHP00
 
*Payer Connection/VisiblEDI sales@payerconnection.com
or 503-820-3803
Professional claims
Institutional claims
Electronic Remittance Advice (ERA)  
Health Plans = PHP01
PPO = PPOOR
 
 Payer Path/Allscripts  See Misys      
 Premera Blue Cross www.premera.com for detailed information  Professional claims  Health Plans = 00430  
 RealMed www.RealMed.com
877-732-5633
 Professional claims Health Plans = SX133
PPO = SX187
Change Healthcare
 RelayHealth/McKesson Contact your RelayHealth representative for electronic claims information: 
www.relayhealth.com 
Professional claims
Institutional claims
Electronic Remittance Advice (ERA) 
Health Plans Professional =
4498
Institutional = 1540
PPO Professional = 2403
Institutional = 1915 
Trizetto Provider Solutions 
 *SSI Group www.TheSSIGroup.com
800-880-3032
Professional claims
Institutional claims
Electronic Remittance Advice (ERA) 
 Contact vendor for Payer ID's  
*Trizetto Provider Solutions Contact your Trizetto Provider Solutions Representative for electronic claims information. Professional claims
Institutional claims
Electronic Remittance Advice (ERA) 
Health Plans = PHP01
PPO = PHP00
 
WebMD/Envoy/Change Healthcare/Sage  You need to fill out an enrollment form here. Professional claims
Institutional claims
Electronic Remittance Advice (ERA) 
Health Plans = SX133
PPO = SX187 
Change Healthcare
 ZirMed Contact ZirMed for electronic claim information: 
877-494-7633 or info@zirmed.com
Professional claims
Institutional claims
Health Plans = PHP01
PPO = PHP00 
 

*Indicates a direct connection with Providence and clearinghouse.


If your clearinghouse is not listed, contact your vendor to check if they have a connection to one of the listed clearinghouses. You also can conduct a search of your clearinghouse online by typing the name of your clearinghouse along with “payer list” into your preferred search engine (e.g., Google, Yahoo, etc.).




835 Electronic Remittance Advice (ERA)

If you are interested in receiving the 835 Electronic Remittance Advice, or ERA, from Providence, please contact your clearinghouse. Your clearinghouse will set up the ERA for you. Once ready, the clearinghouse will contact PHPEDISupport to start sending your data. The ERA will be available each Monday and Wednesday from your clearinghouse. Along with the ERA, you will continue to receive paper EOPs until you notify Providence to stop sending paper.

Sign up for paperless notifications




Electronic Funds Transfer (EFT)

For clinics/facilities wishing to sign up for Electronic Funds Transfer (EFT), please log on to ProvLink through OneHealthPort, find Electronic Transactions on the home page and select EFT – Get your payments deposited directly.




Questions?

For assistance, contact us at PHPEDISupport@Providence.org

**Providence does not pay for any cost associated with the submission of paper claims.

Providers

We've got you covered. If you need information or help, don't hesitate to reach out.

Get in touch
Need help?

Hey!

You are now leaving the Providence Medicare Advantage Plans website. Are you sure thats what youd like to do?

No, I'll stay Yes, I'm leaving