You must follow these steps to ensure your enrollments are processed as quickly as possible.
Forms
must be completed in blue ink, and signed by the Provider.Please complete only the Provider related sections.EClaims
must be notified once you have received approval to submit claims electronically.
Failure to do so will cause your claims to be processed as paper claims.You must complete the Provider Setup Form for EClaims, even if the Payer requires
no enrollment forms.Complete
two copies and return them via US Mail to:EClaims, Inc.Attn: Enrollment
DeptP.O. Box 9Kearney, NE 68848For
Overnight or other expedited delivery please send to:EClaims, Inc.Attn: Enrollment
Dept2201 Central Avenue
Suite DKearney,
NE 68847 Name |
Payer ID |
Transactions Available |
Enrollment Forms Required |
ASH Plans (American Specialty Health Plans) |
00001 |
Claims |
|
Commercial |
Claims |
||
Commercial |
ERA |
||
Blue Cross Blue Shield - Highmark |
54771 |
Claims & ERA |
 |
AmeriHealth - NJ (Non-HMO Claims) |
SX075 |
Claims |
Not Available Online Please call Client Services 626.549.4517 |
Capital Blue Cross/CAIC |
23045 |
Claims |
Not Available Online Please call Client Services 626.549.4517 |
First Priority |
23241 |
Claims |
Not Available Online Please call Client Services 626.549.4517 |
Gateway |
SX078 |
Claims |
Not Available Online Please call Client Services 626.549.4517 |
IBC Personal Choice |
SX083 |
Claims |
Not Available Online Please call Client Services 626.549.4517 |
Inter-County Health Plan |
SX079 |
Claims |
Not Available Online Please call Client Services 626.549.4517 |
Keystone Health Plan Central |
SX049 |
Claims |
Not Available Online Please call Client Services 626.549.4517 |
Keystone Health Plan Senior Blue |
SX051 |
Claims |
Not Available Online Please call Client Services 626.549.4517 |
Keystone Health Plan East |
SX055 |
Claims |
Not Available Online Please call Client Services 626.549.4517 |
Keystone Health Plan West |
SX056 |
Claims |
Not Available Online Please call Client Services 626.549.4517 |
Medicare |
00865 |
Claims |
|
ERA |
|
||
Medicaid |
SKPA0 |
Claims |
|
DME |
SDMEA |
Claims |
|
RailRoad Medicare |
SRRGA |
Claims |
|
TriCare |
Claims |
Not Available Online Please call Client Services 626.549.4517 |
|
Please contact Client
Services if you have
any questions. 626.549.4517 |
|||