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: 800-282-4548 |
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 | 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: mytools.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 notificationsQuestions?
For assistance, contact us at PHPEDISupport@Providence.org
**Providence does not pay for any cost associated with the submission of paper claims.