Payer Enrollment Forms
Some payers require pre-enrollment before permitting the provider to/ submit electronic claims to them. Typically payers such as Medicare, Medicaid, Blue Cross, and Blue Shield require pre-enrollment. Payers that require pre-enrollment are indicated on our Payer Lists (PreEnr column). As a service to our customers, Office Ally provides these agreements and forms below, pre-filled with Office Ally’s information where ever required. Below is a list of all Pre-Enrollment forms available (sorted by state and payer).
Be sure to complete the form(s) as indicated on the Instructions Cover Page to ensure applications are not denied for incorrect/missing information.
ALL or Multiple States Payer Enrollment Forms
Payer Enrollment Forms for State Specific Payers:
AL | AK | AZ | AR | CA | CO | CT | DE | FL | GA | HI | ID | IL | IN | IA | KS | KY | LA | ME | MD
MA | MI | MN | MS | MO | MT | NE | NV | NH | NJ | NM | NY | NC | ND | OH | OK | OR | PA | RI | SC
SD | TN | TX | UT | VT | VA | WA | DC | WV | WI | WY
Electronic Remittance / ERA / 835 Enrollment Forms
All or Multiple States Payer Enrollment Forms
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Adaptis
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Cahaba GBA Part A – 10301
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DMERC Region A (CT, DE, DISTRICT OF COLUMBIA, ME, MD, MA, NH, NJ, NY, PA, RI, VT)
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DMERC Region B (IL, IN, KY, MI, MN, OH, WI)
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DMERC Region C (AL, AR, CO, GA, FL, LA, MS, NC, NM, OK, SC, TN, TX, VA, WV)
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DMERC Region D (AK, AZ, CA, HI, ID, IA, KS, MO, MT, NE, NV, ND, OR, SD, UT, WA,WY)
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Global Health
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Indian Health Services/Veteran Affairs Part A
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Indian Health Services/Veteran Affairs Part B
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Intercommunity Health Net
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Managed Healthcare Administration
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Medicare HHH J11 (Palmetto)
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Medicare HHH J15 (CGS)
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Medicare J04901
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Railroad Medicare
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TriCare for Life
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TriCare Overseas
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US Department of Labor
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Value Options
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VAPCCC Region 3 (AL, AR, FL, IL, IN, KS, KY, LA, MS, MO, OK, TN, TX, WV)
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VAPCCC Region 5A (AZ, CA, CO, ID, NV, NM, OR, West TX, WA)
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VAPCCC Region 5B (HI, American Samoa, Guam, Northern Mariana Islands)
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VAPCCC Recion 6 (AK)
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Back to top Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
Back to top New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Virgin Islands
Washington
Washington DC
West Virginia
Wisconsin
Wyoming
Back to top Electronic Remittance / ERA / 835 Enrollment Forms
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1199 National Benefit 835 ERA
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3P Administrators 835 ERA
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AARP 835 ERA
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Access Medicare (Cuatro LLC) 835 ERA
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Administrative Concepts, Inc. 835 ERA
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Advantek Benefit Administrators 835 ERA
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Aetna 835 ERA & EFT
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Aetna Better Health of Illinois (Medicaid) 835 ERA
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Aetna Better Health of Michigan 835 ERA
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Aetna Better Health of Nebraska 835 ERA
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Aetna Better Health of New Jersey 835 ERA
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Aetna Better Health of New York 835 ERA
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Aetna Better Health of Pennsylvania (Medicaid) 835 ERA
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Aetna Better Health of Ohio 835 ERA
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Aetna Dental 835 ERA
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Aetna TX Medicaid and CHIP 835 ERA
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Affinity Health Plan 835 ERA
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Affinity Health Plan (Medicare Advantage) 835 ERA
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AgeWell New York 835 ERA
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Allegiance Benefit Plan Managment 835 ERA
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Alliant Health Plans of Georgia 835 ERA
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Allied Benefit Systems 835 ERA
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Amalgamated Insurance Company 835 ERA
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AmeriBen Solutions 835 ERA
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American National Insurance Company 835 ERA
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Amerigroup Corporation (FL, GA, IL, MD, NM, NV, OH, TX, WA) 835 ERA
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Amerigroup - Virginia (INTotal Health) 835 ERA
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AmeriHealth Administrators 835 ERA
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AmeriHealth Connect 835 ERA
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AmeriHealth Delaware (HMO) 835 ERA
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AmeriHealth Delaware (Non HMO) 835 ERA
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AmeriHealth District of Columbia 835 ERA
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AmeriHealth New Jersey (HMO) 835 ERA
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AmeriHealth New Jersey (Non HMO) 835 ERA
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AmeriHealth NorthEast 835 ERA
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Amfirst Insurance Company 835 ERA
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Arbor Health Plan 835 ERA
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Arkansas Best Corp - Choice Benefits 835 ERA
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ASRM Corporation 835 ERA
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Assurant Health 835 ERA
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Asuris Northwest Health 835 ERA
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Automated Benefit Services 835 ERA
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Avera Health Plans 835 ERA
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Beacon Health Strategies 835 ERA
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Benefit Administrative Systems 835 ERA
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Benefit Coordinators Corporation 835 ERA
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Benefit Management Systems, Inc. 835 ERA
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BeneSys, Inc. 835 ERA
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Blue Benefit Administrators of MA 835 ERA
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Blue Choice of South Carolina 835 ERA
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Blue Cross Blue Shield Alabama 835 ERA
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Blue Cross Blue Shield Arizona 835 ERA
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Blue Cross Blue Shield Arkansas 835 ERA
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Blue Cross Blue Shield CareFirst DC/NCA 835 ERA
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Blue Cross Blue Shield CareFirst MD 835 ERA
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Blue Cross Blue Shield Colorado 835 ERA
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Blue Cross Blue Shield Connecticut 835 ERA
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Blue Cross Blue Shield Delaware 835 ERA
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Blue Cross Blue Shield Florida 835 ERA
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Blue Cross Blue Shield Georgia 835 ERA
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Blue Cross Blue Shield Hawaii 835 ERA
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Blue Cross Blue Shield Horizon New Jersey/New York 835 ERA
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Blue Cross Blue Shield Illinois 835 ERA
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Blue Cross Blue Shield Indiana 835 ERA
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Blue Cross Blue Shield Iowa 835 ERA and EFT
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Blue Cross Blue Shield Kansas 835 ERA
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Blue Cross Blue Shield Kansas City 835 ERA
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Blue Cross Blue Shield Kentucky 835 ERA
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Blue Cross Blue Shield Louisiana 835 ERA
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Blue Cross Blue Shield Maine 835 ERA
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Blue Cross Blue Shield Massachusetts 835 ERA
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Blue Cross Blue Shield Michigan Part A 835 ERA
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Blue Cross Blue Shield Michigan Part B 835 ERA
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Blue Cross Blue Shield Minnesota 835 ERA
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Blue Cross Blue Shield Mississippi 835 ERA
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Blue Cross Blue Shield Missouri 835 ERA
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Blue Cross Blue Shield Montana 835 ERA
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Blue Cross Blue Shield Nebraska 835 ERA
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Blue Cross Blue Shield Nevada 835 ERA
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Blue Cross Blue Shield New York - Central Region 835 ERA
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Blue Cross Blue Shield New York - Empire 835 ERA
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Blue Cross Blue Shield New York - Rochester Region 835 ERA
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Blue Cross Blue Shield New York - Utica Region 835 ERA
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Blue Cross Blue Shield New Hampshire 835 ERA
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Blue Cross Blue Shield New Mexico 835 ERA
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Blue Cross Blue Shield North Carolina 835 ERA
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Blue Cross Blue Shield Western New York 835 ERA
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Blue Cross Blue Shield Ohio 835 ERA
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Blue Cross Blue Shield Oklahoma 835 ERA
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Blue Cross Blue Shield Pennsylvania 835 ERA
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Blue Cross Blue Shield Rhode Island 835 ERA
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Blue Cross Blue Shield South Carolina 835 ERA
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Blue Cross Blue Shield South Dakota 835 ERA and EFT
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Blue Cross Blue Shield Tennessee 835 ERA
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Blue Cross Blue Shield Texas 835 ERA
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Blue Cross Blue Shield Vermont 835 ERA
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Blue Cross Blue Shield Virginia 835 ERA
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Blue Cross Blue Shield Wisconsin 835 ERA
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Blue Cross Blue Shield West Vigrinia/ Mountain States 835 ERA
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Blue Cross California 835 ERA
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Blue Shield of California EFT & ERA
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Blue Shield of North Dakota 835 ERA
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Blue Shield Northeastern New York 835 ERA
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Blue Shield of Wyoming 835 ERA
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BMC HealthNet Plan 835 ERA
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Boon Chapman Administrators 835 ERA
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BridgeSpan 835 ERA
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Brokerage Concepts 835 ERA
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Brown & Toland Medical Group
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Capital Blue Cross 835 ERA
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Capital Dental 835 ERA
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Capital District Physicians Health Plan (CDPHP) 835 ERA
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Capital Health Plan 835 ERA
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CapRock HealthPlans 835 ERA
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Caremore 835 ERA
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Carepoint Health Plan 835 ERA
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CareSource of Kentucky 835 ERA
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CareSource of Ohio 835 ERA
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Care Improvement Plus (CIP) 835 ERA
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Care Wisconsin Health Plan 835 ERA
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Cariten 835 ERA
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Cariten Senior Health 835 ERA
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CenCal Health 835 ERA
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Centene Corporation (68069) 835 ERA
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Central California Alliance for Health 835 ERA
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Chiropractic Health Plans 835 ERA
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Cigna 835 ERA
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Cigna EFT
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C.L. Frates and Company 835 ERA
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Colorado Access 835 ERA
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Common Ground Healthcare 835 ERA
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Community Health Choice 835 ERA
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Community Health Plan of Washington 835 ERA
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Complementary Healthcare Plan 835 ERA
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Connecticare Medicare 835 ERA
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Consolidated Health Plans 835 ERA
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Consumer Mutual of Michigan 835 ERA
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Continental General Insurance Company 835 ERA
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Convent Administrators Inc 835 ERA
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Co-ordinated Benefit Plans LLC 835 ERA
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CoreSource (AZ, IL, IN, MN, MD, NC,PA) 835 ERA
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Cornerstone Benefits Administrator Inc 835 ERA
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Coventry Healthcare (25133) 835 ERA
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Cox Health Plan 835 ERA
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CWIBenefits, Inc 835 ERA
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Dean Health Plan 835 ERA
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Delta Health Systems 835 ERA
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Deseret Mutual Benefit Administrators 835 ERA
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DMERC Region A 835 ERA
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DMERC Region B 835 ERA
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DMERC Region C 835 ERA
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DMERC Region D 835 ERA
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East Carolina Behavioral Health 835 ERA
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EDS Healthchoice (OK State Employees & Educators) 835 ERA
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ElderPlan, Inc. 835 ERA
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EMI Health 835 ERA
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Employee Benefit Management Services 835 ERA
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E.S. Beveridge & Associates, Inc. 835 ERA
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Equitable Plan Services 835 ERA
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Everence 835 ERA
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Fallon Community Health 835 ERA
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Family Care Medicare 835 ERA
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Federated Mutual Health Insurance Company 835 ERA
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Fidelis Care of New York 835 ERA
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First Choice Health Administrators (FCHA) 835 ERA
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Firstcare and Firstcare Medicaid 835 ERA
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Florida Healthcare Plan 835 ERA
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FMH Benefit Services 835 ERA
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Fox-Everett, Inc 835 ERA
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Freedom Blue 835 ERA
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Gateway Health Plan - Medicaid PA 835 ERA
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Gateway Health Plan - Medicare Assured 835 ERA
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GEHA / Texas Dental Plan 835 ERA
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Geisinger Health Plans 835 ERA
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GHI - New York (Group Health Inc.) 835 ERA
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Gilsbar, LLC 835 ERA
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Great Oregon Behavioral Health Inc 835 ERA
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Great-West Healthcare 835 ERA
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Group Benefit Services 835 ERA
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Group Health Cooperative 835 ERA
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Group Health Cooperative (Pacific Northwest) 835 ERA
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Gundersen Lutheran Health Plan 835 ERA
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Harvard Pilgrim 835 ERA
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Hawaii Medical Alliance Association (HMAA) 835 ERA
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HealthCare Partners - CA & AZ 835 ERA
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HealthCare Solutions Group 835 ERA
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HealthFirst 835 ERA
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HealthNow New York 835 ERA
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HealthSCOPE Benefits, Inc. 835 ERA
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HealthSmart Benefit Solutions (formerly JSL) 835 ERA
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Health Alliance 835 ERA
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Health Choice Arizona 835 ERA
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Health Net Arizona 835 ERA
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Health Net of CA, OR 835 ERA
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Health Net of the Northeast 835 ERA
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Health New England 835 ERA
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Health Partners MN 835 ERA
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HealthPartners of MN (Dental) 835 ERA
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Health Partners of Philadelphia 835 ERA
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Health Plan Services 835 ERA
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Health Plans, Inc. 835 ERA
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Health Services Management (HSM) 835 ERA
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Healthy CT 835 ERA
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HealthSpring (formerly Bravo) 835 ERA
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Highmark Health Options 835 ERA
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Highmark Senior Health Company PA 835 ERA
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Highmark Senior Health Company WV 835 ERA
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HIP Health Plan of NY 835 ERA
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Hometown Health Plan Nevada 835 ERA
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Horizon New Jersey Health Plan 835 ERA
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Humana 835 ERA
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IBC Personal Choice 835 ERA
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IE Shaffer & Company 835 ERA
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Independence Administrators 835 ERA
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Independence Blue Cross 835 ERA
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Independent Health 835 ERA
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InnovAge 835 ERA
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Insurance Administrator of America, Inc. 835 ERA
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Insurance Design Administrators 835 ERA
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Johns Hopkins Healthcare 835 ERA
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Johns Hopkins Healthcare (USFHP) 835 ERA
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John Muir Physician Network 835 ERA
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Kaiser Foundation Health Plan of Colorado 835 ERA
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Kaiser Foundation Health Plan of Georgia 835 ERA
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Kaiser Health Plan of the Mid-Atlantic States (MD, VA, DC) 835 ERA
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Kaiser Northern California 835 ERA
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Kaiser Southern California 835 ERA
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Kaiser NW Region 835 ERA
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Kaweah Delta Medicare Advantage 835 ERA
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Kempton Group 835 ERA
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Key Medical Group 835 ERA
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Key Medical Group - Medicare Advantage 835 ERA
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Keystone Health Plan (East) 835 ERA
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Keystone VIP Choice 835 ERA
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KPS HealthPlans 835 ERA
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LA Care 835 ERA
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Landmark Healthcare 835 ERA
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Land of Lincoln Health 835 ERA
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Lifetime Benefit Solutions 835 ERA
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Lifewise Health Plan of OR Part A 835 ERA
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Lifewise Health Plan of OR Part B 835 ERA
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Lifewise Health Plan of WA Part A 835 ERA
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Lifewise Health Plan of WA Part B 835 ERA
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Lockard & Williams 835 ERA
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Magellan Behavioral Health 835 ERA
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Maine Community Health Options 835 ERA
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Managed Health Network (MHN) 835 ERA
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Maryland Physicians Care 835 ERA
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Mdwise Hoosier Alliance 835 ERA
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MED3000 CMS Early Steps 835 ERA
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MED3000 CMS Title 21 835 ERA
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MED3000 PED Title 21 835 ERA
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Medica2 835 ERA
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Medical Mutual of Ohio 835 ERA
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Medical Associates Health Plan 835 ERA
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Medica and Medica UnitedHealthcare 835 ERA
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Medica HealthCare Plans 835 ERA
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Medicaid Alabama 835 ERA
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Medicaid Alaska 835 ERA
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Medicaid Arkansas 835 ERA
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Medicaid Arizona 835 ERA
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Medicaid Colorado 835 ERA
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Medicaid Connecticut 835 ERA
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Medicaid Delaware 835 ERA
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Medicaid Florida 835 ERA
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Medicaid Georgia Dental 835 ERA
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Medicaid Georgia 835 ERA
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Medicaid Hawaii 835 ERA
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Medicaid Idaho 835 ERA
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Medicaid Illinois 835 ERA
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Medicaid Indiana 835 ERA
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Medicaid Iowa 835 ERA
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Medicaid Kansas 835 ERA
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Medicaid Kentucky 835 ERA
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Medicaid Louisiana 835 ERA
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Medicaid Maine 835 ERA
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Medicaid Massachusetts 835 ERA
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Medicaid Michigan 835 ERA
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Medicaid Minnesota 835 ERA
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Medicaid Mississippi 835 ERA
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Medicaid Missouri 835 ERA
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Medicaid Montana 835 ERA
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Medicaid Nebraska 835 ERA
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Medicaid Nevada 835 ERA
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Medicaid New Jersey 835 ERA
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Medicaid New Hampshire 835 ERA
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Medicaid New Mexico 835 ERA
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Medicaid New York 835 ERA
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Medicaid North Carolina 835 ERA
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Medicaid North Dakota 835 ERA
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Medicaid Ohio 835 ERA
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Medicaid Oklahoma 835 ERA
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Medicaid Oregon 835 ERA
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Medicaid Pennsylvania 835 ERA
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Medicaid Rhode Island 835 ERA
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Medicaid South Carolina 835 ERA
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Medicaid Texas 835 ERA
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Medicaid Vermont 835 ERA
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Medicaid Virginia 835 ERA
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Medicaid Washington (ProviderOne) 835 ERA
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Medicaid Washington DC 835 ERA
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Medicaid West Virginia 835 ERA
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Medicaid Wisconsin 835 ERA
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Medi-Cal 835 ERA
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Medicare Alaska 835 ERA
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Medicare Arizona 835 ERA
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Medicare Arkansas 835 ERA
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Medicare CA North Part B 835 ERA
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Medicare CA Part A 835 ERA
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Medicare CA South Part B 835 ERA
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Medicare Colorado (Part A) 835 ERA
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Medicare Colorado (Part B) 835 ERA
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Medicare Connecticut 835 ERA
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Medicare Delaware 835 ERA
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Medicare Florida (Part A) 835 ERA
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Medicare Florida (Part B) 835 ERA
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Medicare Hawaii 835 ERA
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Medicare HHH J11 (Palmetto)
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Medicare HHH J15 (CGS) 835 ERA
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Medicare Idaho 835 ERA
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Medicare Illinois 835 ERA
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Medicare Indiana 835 ERA
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Medicare Iowa 835 ERA
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Medicare Kansas 835 ERA
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Medicare Kentucky 835 ERA
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Medicare Louisiana (Part A) 835 ERA
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Medicare Louisiana (Part B) 835 ERA
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Medicare Maine 835 ERA
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Medicare Maryland 835 ERA
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Medicare Massachusetts 835 ERA
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Medicare Michigan 835 ERA
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Medicare Minnesota 835 ERA
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Medicare Mississippi 835 ERA
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Medicare Missouri East and West 835 ERA
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Medicare Montana 835 ERA
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Medicare Nebraska 835 ERA
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Medicare Nevada 835 ERA
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Medicare New Hampshire 835 ERA
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Medicare New Jersey 835 ERA
-
Medicare New Mexico 835 ERA
-
Medicare New York (Downstate) 835 ERA
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Medicare New York (Queens) 835 ERA
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Medicare New York (Upstate) 835 ERA
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Medicare North Carolina 835 ERA
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Medicare North Dakota 835 ERA
-
Medicare Northern Virginia 835 ERA
-
Medicare Ohio 835 ERA
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Medicare Oklahoma 835 ERA
-
Medicare Oregon 835 ERA
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Medicare Pennsylvania 835 ERA
-
Medicare Railroad 835 ERA
-
Medicare Rhode Island 835 ERA
-
Medicare South Carolina 835 ERA
-
Medicare South Dakota 835 ERA
-
Medicare Texas (Part A) 835 ERA
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Medicare Texas (Part B) 835 ERA
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Medicare Utah 835 ERA
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Medicare Vermont 835 ERA
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Medicare Virginia (Palmetto) 835 ERA
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Medicare Virgin Islands 835 ERA
-
Medicare Washington 835 ERA
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Medicare Washington DC 835 ERA
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Medicare West Virginia (Palmetto) 835 ERA
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Medicare Wisconsin (Part A) 835 ERA
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Medicare Wisconsin (Part B) 835 ERA
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Medicare Wyoming 835 ERA
-
MedSolutions, Inc 835 ERA
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Medstar Select 835 ERA
-
Mercy Maricopa Integrated Care 835 ERA
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Mercy Physicians Medical Group (NAMM) 835 ERA
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Meridian Health Plan 835 ERA
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Meritage Medical Network 835 ERA
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Metropolitan Health Plan (MHP) 835 ERA
-
Metro Plus HealthPlan 835 ERA
-
MHNet 835 ERA
-
Mid-America Associates, Inc. 835 ERA
-
Midwest Group Benefits 835 ERA
-
MMSI 835 ERA
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Moda Health (Formerly ODS Health Plan) 835 ERA
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Mohawk Valley (MVP) Health Plan 835 ERA
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Molina Healthcare of Illinois 835 ERA
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Molina Healthcare of New Mexico 835 ERA
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Molina Healthcare of Ohio 835 ERA
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Molina Healthcare of South Carolina 835 ERA
-
Molina Healthcare of Wisconsin 835 ERA
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Mutual Health Services (Antares) 835 ERA
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Mutual of Omaha Ins. Company 835 ERA
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NAMM Partners, Inc 835 ERA
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Nationwide Health Plan 835 ERA
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Neighborhood Health Partnership 835 ERA
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Network Health 835 ERA
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Network Health Plan of Wisconsin 835 ERA
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NGS America, Inc 835 ERA
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NHIC (Network Health Insurance Corporation)- Medicare 835 ERA
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Nippon Life Insurance Company of America 835 ERA
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North America Administrators (NAA) 835 ERA
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North American Medical Management (NAMM) 835 ERA
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North Shore - LIJ CareConnect Insurance Company 835 ERA
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Nova Healthcare Administrators 835 ERA
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Ogden Benefits Administration (EBC) 835 ERA
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OptiCare Managed Vision 835 ERA
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Optima Insurance Company 835 ERA
-
OptumHealth Physical (Includes Oxford) 835 ERA
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Optum Medical Network / Lifeprint Network 835 ERA
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Optum Salt Lake County (SLC) 835 ERA
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Oregon's Health CO-OP 835 ERA
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PacificSource Health Plans 835 ERA
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Partnership HealthPlan of California 835 ERA
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Passport Health Plan 835 ERA
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PatientPay 835 ERA
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Pekin Life Insurance 835 ERA
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Peoples Health Network 835 ERA
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PHCS Savility Payers 835 ERA
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Physician Associates of Greater San Gabriel Valley 835 ERA
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Physicians Health Plan (PHP) - Northern Indiana 835 ERA
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Piedmont WellStar Health Plan 835 ERA
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PIH Health 835 ERA
-
Planned Administrators, Inc. 835 ERA
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POMCO 835 ERA
-
Prairie States Enterprises 835 ERA
-
PreferredOne 835 ERA
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Preferred Health Plan (PHP) 835 ERA
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Premera Blue Cross of WA Institutional 835 ERA
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Premera Blue Cross of WA Professional 835 ERA
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Premera Blue Cross Blue Shield of AK Institutional 835 ERA
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Premera Blue Cross Blue Shield of AK Professional 835 ERA
-
Presbyterian Health Plan 835 ERA
-
Prestige Health Choice Medicaid 835 ERA
-
PrimeWest Health Systems 835 ERA
-
Professional Benefit Administrators 835 ERA
-
Providence Health Plan 835 ERA
-
Providence Risk & Insurance 835 ERA
-
Regence Blue Cross Blue Shield OR 835 ERA
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Regence Blue Cross Blue Shield UT 835 ERA
-
Regence Blue Shield ID 835 ERA
-
Regence Blue Shield WA 835 ERA
-
Right Care from Scott and White 835 ERA
-
Rocky Mountain Health Plan 835 ERA
-
Sandhills Center 835 ERA
-
Sanford Health Plan 835 ERA
-
Santa Barbara Select IPA (Mckesson) 835 ERA
-
SCAN AZ, CA 835 ERA
-
Select Health of SC 835 ERA
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Select Health of UT 835 ERA
-
Self Insured Plans LLC 835 ERA
-
Self Insured Services Company 835 ERA
-
Sendora Health 835 ERA
-
Sentara Family Health Plan / Sentara Health Management 835 ERA
-
Shasta Administrative Services 835 ERA
-
Sierra Health Services 835 ERA
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SoundPath Health 835 ERA
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Southeastern Indiana Health Organization (SIHO) 835 ERA
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South Florida Community Care Network / Memorial Integrated Healthcare 835 ERA
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State Farm Payer 31053 835 ERA
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State Farm Property & Casualty Payer 31059 835 ERA
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Summit Administration Services, Inc. 835 ERA
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Texas Agricultural Cooperative Trust 835 ERA
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Texas Municipal League 835 ERA
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TLC Benefit Solutions 835 ERA
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Total Plan Services 835 ERA
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Tricare for Life 835 ERA
-
Tricare North 835 ERA
-
Tricare South 835 ERA
-
Tricare West 835 ERA
-
Tricare Overseas 835 ERA
-
TriState Benefit Solutions 835 ERA
-
Trillium Community Health Plans (LIPA) 835 ERA
-
Trusted Health Plan 835 ERA
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Trustmark Insurance Company 835 ERA
-
Tufts Health Plan 835 ERA
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Ucare of Minnesota 835 ERA
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Ultra Benefits 835 ERA
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UMR (Formerly UMR Onalaska) 835 ERA
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UMR Wausau UHIS 835 ERA
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Unified Group Services, Inc. 835 ERA
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United Concordia - Blue Shield of PA (UCCI) 835 ERA
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United Concordia – Blue Shield of PA – Dental Plus- (UCCI) 835 ERA
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United Concordia – Fee for Service (UCCI) 835 ERA
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United Concordia – FMDP (Champus)- (UCCI) 835 ERA
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UnitedHealthcare Commercial / UnitedHealthcare West 835 ERA
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UnitedHealthcare Community Plan - AZ (APIPA) 835 ERA
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UnitedHealthcare Community Plan - DE, LA, MD, OH, PA, WA 835 ERA
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UnitedHealthcare Community Plan - IA and TN 835 ERA
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UnitedHealthcare Community Plan - KS (KanCare) 835 ERA
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UnitedHealthcare Community Plan - MI (Great Lakes) 835 ERA
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UnitedHealthcare Community Plan - MS CAN & CHIP 835 ERA
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UnitedHealthcare Community Plan - NE 835 ERA
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UnitedHealthcare Community Plan - NJ 835 ERA
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UnitedHealthcare Community Plan - NYU 835 ERA
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UnitedHealthcare Community Plan - TX 835 ERA
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UnitedHealthcare Community Plan - WI 835 ERA
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UnitedHealthcare / Golden Rule 835 ERA
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UnitedHealthcare / MAHP - MD IPA - Optimum - MLH (MAMSI) 835 ERA
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UnitedHealthcare Military & Veterans 835 ERA
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UnitedHeathcare of the River Valley 835 ERA
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UnitedHealthcare / Oxford 835 ERA
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UnitedHealthcare / Spectera Eyecare Networks 835 ERA
-
UnitedHealthcare StudentResources 835 ERA
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United HealthOne / UnitedHealthcare Life / UnitedHealthcare Pacificare Life 835 ERA
-
United of Omaha 835 ERA
-
Unity Health Insurance 835 ERA
-
Univera Healthcare 835 ERA
-
University Health Alliance (UHA) 835 ERA
-
University of Utah 835 ERA & EFT
-
University Physicians Healthcare 835 ERA
-
UPMC Health Plan 835 ERA
-
Upper Peninsula Health Plan 835 ERA
-
US Benefits 835 ERA
-
US Family Health Plan 835 ERA
-
US Imaging Network 835 ERA
-
Valley Care IPA (Mckesson) 835 ERA
-
Value Options 835 ERA
-
Vantage Health Plan Inc 835 ERA
-
VAPCCC Region 3 835 ERA
-
VAPCCC Region 5A 835 ERA
-
VAPCCC Region 5B 835 ERA
-
VAPCCC Region 6 835 ERA
-
Virginia Premier Health 835 ERA
-
Volusia Health Network 835 ERA
-
WEA Insurance Group 835 ERA
-
WellCare (14163) 835 ERA
-
Western Oregon Advanced Helath CCO (Behavioral Health Claims Only) 835 ERA
-
WINhealth Partners/Wyoming Health Solutions 835 ERA
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Wisconsin Physicians Services (WPS) 835 ERA
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WPS Arise 835 ERA
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Yamhill CCO 835 ERA
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