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Electronic Claim Attachments Payer List

Updated: 04/11/2025|Views: 1648

The commercial payers listed below support electronic claim attachments and certain payers require enrollment for the service.

Note: The electronic data interchange (EDI) payer IDs listed are the specific payer IDs used to connect with the Trizetto clearinghouse when adding a new insurance or configuring the Insurance Company Electronic Claims Settings. If the exact payer name and payer ID combination is not available when setting up the payer in Tebra, use a payer with the same payer ID as the payer ID is used to establish the electronic payer connection.

Payer List

To find a specific payer, click the appropriate button to jump to a specific group of payers in alphabetical order, or press Ctrl+F on your keyboard and search for a keyword of the payer's name or search for the EDI payer ID number.

Payer Names Aa-Al

  • Absolute Total Care (68055)
  • Advantage by Bridgeway Health Solutions (68069)
  • Advantage by Buckeye Community Health Plans (68069)
  • Advantage by Managed Health Services (68069)
  • Advantage by Peach State (68069)
  • Advantage by Sunshine State (68069)
  • Advantage by Superior Health Services (68069)
  • Aetna (60054)
  • Aetna Better Health of California (128CA)
  • Aetna Better Health of Florida (128FL)
  • Aetna Better Health of Illinois (68024)
  • Aetna Better Health of Kansas (128KS)
  • Aetna Better Health of Kentucky (128KY)
  • Aetna Better Health of Lousiana (128LA)
  • Aetna Better Health of Maryland (128MD)
  • Aetna Better Health of Michigan (128MI)
  • Aetna Better Health of New Jersey (46320)
  • Aetna Better Heatlh of New York (34734)
  • Aetna Better Health of Ohio (50023)
  • Aetna Better Health of Oklahoma (128OK)
  • Aetna Better Health of Pennsylvania (23228)
  • Aetna Better Health of Texas (38692)
  • Aetna Better Health of Virginia (128VA)
  • Aetna Better Health of West Virginia (128WV)
  • Aetna Better Health Premier Plan MMAI (26337)
  • Aetna US Healthcare (J1JVH)
  • Allina Health & Aetna (54398)
  • Allwell from Absolute Total Care (68069)
  • Allwell from Arizona Complete Care (68069)
  • Allwell from Arkansas Health & Wellness (68069)
  • Allwell from Buckeye Health Plan (68069)
  • Allwell from Home State Health (68069)
  • Allwell from Illinicare Health (68069)
  • Allwell from Louisiana Healthcare Solutions (68069)
  • Allwell from Magnolia Health (68069)
  • Allwell from Managed Health Services (68069)
  • Allwell from MHS Health Wisconsin (68069)
  • Allwell from Pennsylvania Health & Wellness (68069)
  • Allwell from Peach State Health Plan (68069)
  • Allwell from Silver Summit Health Plan (68069)
  • Allwell from Sunflower Health Plan (68069)
  • Allwell from Sunshine Health (68069)
  • Allwell from Superior Health Plan (68069)
  • Allwell from Western Sky Community Care (68069)

Payer Names Am-Az

  • Ambetter (68069)
  • Ambetter from Absolute Total Care (68069)
  • Ambetter from Arizona Complete Care (68069)
  • Ambetter from Arkansas Health & Wellness (68069)
  • Ambetter from Buckeye Health Plan (68069)
  • Ambetter from Coordinated Care (68069)
  • Ambetter from Home State Health (68069)
  • Ambetter from Magnolia Health (68069)
  • Ambetter from Managed Health Services (68069)
  • Ambetter from Meridian (68069)
  • Ambetter From Nebraska Total Care (68069)
  • Ambetter from New Hampshire Healthy Families (68069)
  • Ambetter from Pennsylvania Health & Wellness (68069)
  • Ambetter from Peach State Health Plan (68069)
  • Ambetter from Silver Summit Health Plan (68069)
  • Ambetter from Sunflower Health Plan (68069)
  • Ambetter from Sunshine Health (68069)
  • Ambetter from Superior Health Plan (68069)
  • Ambetter from Wellcare of Kentucky (68069)
  • Ambetter from Wellcare of New Jersey (68069)
  • Ambetter from Western Sky Community Care (68069)
  • Ambetter of Illinois (68069)
  • Ambetter of North Carolina Inc. (68069)
  • Ambetter of Oklahoma (68069)
  • Ambetter of Tennessee (68069)
  • Amerigroup (26375)
  • Amerihealth Caritas Delaware (77799)
  • Amerihealth Caritas District of Columbia (77002)
  • Amerihealth Caritas Louisiana (27357)
  • Amerihealth Caritas New Hampshire (87716)
  • Amerihealth Caritas Next - A Product of Amerihealth Caritas Florida (45408)
  • Amerihealth Caritas Next Delaware (47073)
  • Amerihealth Caritas Next North Carolina (83148)
  • Amerihealth Caritas North Carolina (81671)
  • Amerihealth Caritas Pennsylvania (22248)
  • Amerihealth Caritas Pennsylvania Community Health Choices (77062)
  • Amerihealth Caritas VIP Care - Delaware DSNP (87406)
  • Amerihealth Caritas VIP Care - Florida DSNP (88232)
  • Amerihealth Caritas VIP Care Plus MI MMP (7701P)
  • Anthem Blue Cross Blue Shield Colorado (00072)
  • Anthem Blue Cross Blue Shield Connecticut (00103)
  • Anthem Blue Cross Blue Shield Georgia (GA512)
  • Anthem Blue Cross Blue Shield Indiana (00715)
  • Anthem Blue Cross Blue Shield Kentucky (00660)
  • Anthem Blue Cross Blue Shield Maine (20180)
  • Anthem Blue Cross Blue Shield Missouri (00012)
  • Anthem Blue Cross Blue Shield Nevada (00265)
  • Anthem Blue Cross Blue Shield Nevada Medicaid (00265)
  • Anthem Blue Cross Blue Shield New Hampshire (10770)
  • Anthem Blue Cross Blue Shield Ohio (00834)
  • Anthem Blue Cross Blue Shield Ohio Medicaid (SKOH5)
  • Anthem Blue Cross Blue Shield Virginia (00923)
  • Anthem Blue Cross Blue Shield Wisconsin (09500)
  • Anthem Blue Cross of California (47198)
  • Anthem Maine Health (00958)
  • Arizona Complete Care (68069)
  • Arizona Complete Health (68069)
  • Arkansas Total Care (68069)
  • Ascension Complete (68069)

Payer Names B-K

  • Banner Health and Aetna (67895)
  • Blue Cross Blue Shield of Arkansas (00181)
  • Blue Cross Blue Shield of Minnesota Blue Plus Medicaid (00726)
  • Blue Cross Blue Shield of Texas Medicaid STAR, CHIP, STAR Kids (66002)
  • Blue Cross Blue Shield of Western New York Medicaid (99246)
  • Blue Choice of South Carolina (00403)
  • Blue Cross Blue Shield of Kansas (00031)
  • Blue Cross Blue Shield of Michigan Complete (7771M)
  • Blue Cross Medicare Advantage (66006)
  • Bridgeway Arizona (68069)
  • Buckeye Community Health (68069)
  • Buckeye Health Plan (68069)
  • California Health & Wellness (68069)
  • Carolina Complete Health (68069)
  • Celtic (68069)
  • Centene (68069)
  • Centene Advantage Plans (68069)
  • Centene Corporation (68069)
  • Clear Health Alliance (CLEAR)
  • Colorado Community Health Alliance (COCHA)
  • Coordinated Care (68069)
  • Dell Childrens Health Plan (38261)
  • Empire New York (00804)
  • First Choice by Select Health of South Carolina (23285)
  • First Choice Next of South Carolina by Select Health (57103)
  • First Choice VIP Care (SC DSNP) by Select Health of South Carolina (32456)
  • First Choice VIP Care Plus (SC MMP) by Select Health of South Carolina (77009)
  • Granite State Health Plan (68069)
  • Health Net Mental Health Network (68069)
  • Health Net National (68069)
  • HealthChoice (71064)
  • HealthChoice DOC/DRC (71065)
  • Healthscope Benefits (40026)
  • Healthy Blue Dual Advantage (00552)
  • Healthy Blue Louisiana (HBLUE)
  • Healthy Blue Missouri (00541)
  • Healthy Blue Nebraska (00544)
  • Healthy Blue North Carolina (00602)
  • Healthy Blue South Carolina (57028)
  • Healthy Texas (68069)
  • Home State Health (68069)
  • Humana (61101)
  • Humana Ohio Medicaid (61103)
  • Illinicare Health (68069)
  • Innovation Health (40025)
  • Iowa Total Care (68069)
  • Keystone First (23284)
  • Keystone First VIP Choice (77741)

Payer Names L-P

* National Government Services (NGS) requires enrollment for the electronic claim attachments service.

  • Louisiana Healthcare Connections (68069)
  • Louisiana Healthcare Solutions (68069)
  • Magnolia Health (68069)
  • Managed Health Services (68069)
  • Managed Health Services Indiana Medicaid HMO (68069)
  • Managed Health Services Wisconsin (68069)
  • Maryland Physicians Care (68069)
  • Meridian Health Plan Illinois (MHPIL)
  • Meridian Health Plan Michigan (MHPMI)
  • Meritain Health (41124)
  • Michigan Complete Health (68069)
  • Michigan Fidelis Secure Care (68069)
  • Missouri Home State Health (68069)
  • National Government Services (NGS) - J6 CA Part A HHH (06014)*
  • National Government Services (NGS) - J6 IL Part A (06101)*
  • National Government Services (NGS) - J6 IL Part B (06102)*
  • National Government Services (NGS) - J6 MN Part A (06201)*
  • National Government Services (NGS) - J6 MN Part B (06202)*
  • National Government Services (NGS) - J6 WI Part A HHH (06001)*
  • National Government Services (NGS) - J6 WI Part B (06302)*
  • National Government Services (NGS) - JK CT Part A (13101)*
  • National Government Services (NGS) - JK CT Part B (13102)*
  • National Government Services (NGS) - JK MA Part A (14211)*
  • National Government Services (NGS) - JK MA Part B (14212)*
  • National Government Services (NGS) - JK ME Part A HHH (14011)*
  • National Government Services (NGS) - JK ME Part B (14112)*
  • National Government Services (NGS) - JK NH Part A (14013)*
  • National Government Services (NGS) - JK NH Part B (14312)*
  • National Government Services (NGS) - JK NY Part A (13201)*
  • National Government Services (NGS) - JK NY Part B Downstate (13202)*
  • National Government Services (NGS) - JK NY Part B Queens (13292)*
  • National Government Services (NGS) - JK NY Part B Upstate (13282)*
  • National Government Services (NGS) - JK RI Part A (14411)*
  • National Government Services (NGS) - JK RI Part B (14412)*
  • National Government Services (NGS) - JK VT Part A (14013)*
  • National Government Services (NGS) - JK VT Part B (14512)*
  • Nebraska Total Care (68069)
  • New Hampshire Healthy Families (68069)
  • Novasys Health Network (68069)
  • Oklahoma Complete Care (68069)
  • Oxford (06111)
  • Peach State Health Plan (68069)
  • Pennsylvania Health & Wellness (68069)
  • Perform Care (65391)
  • Prestige Health Choice (77003)

Payer Names Q-Z

** Wisconsin Physician Services (WPS) requires enrollment for the electronic claim attachments service.

  • Silversummit Healthplan (68069)
  • Simply Healthcare (SMPLY)
  • Summit Community Care (PASSE)
  • Sunflower Health Plan (68069)
  • Sunflower State Health (68069)
  • Sunshine Health (68069)
  • Superior Health Plan (68069)
  • Superior Health Plan Texas (68069)
  • Texas Health (88221)
  • Trillium Advantage (68069)
  • Trillium Community Health Plan (68069)
  • United Medical Resources UMR (39026)
  • United Healthcare (87726)
  • United Healthcare Community Plan Arizona (03432)
  • United Healthcare Community Plan Kansas (96385)
  • United Healthcare Community Plan Michigan (95467)
  • United Healthcare Community Plan Missouri (86050)
  • United Healthcare Community Plan New Jersey (86047)
  • United Healthcare Community Plan Tennessee (95378)
  • Washington Coordinated Care (68069)
  • Wellcare (14163 or 59354)
  • Wellcare by Allwell from Nebraska Total Care (68069)
  • Wellcare by Allwell of Oklahoma (68069)
  • Wellcare of Georgia (68069)
  • Western Sky Community Care (68069)
  • Westpoint formerly Unicare (WLPNT)
  • Wisconsin Physician Services (WPS) - J5 IA Part A (05101)**
  • Wisconsin Physician Services (WPS) - J5 IA Part B (05102)**
  • Wisconsin Physician Services (WPS) - J5 KS Part A (05201)**
  • Wisconsin Physician Services (WPS) - J5 KS Part B (05202)**
  • Wisconsin Physician Services (WPS) - J5 MO Part A (05301)**
  • Wisconsin Physician Services (WPS) - J5 MO Part B (05302)**
  • Wisconsin Physician Services (WPS) - J5 National (05901)**
  • Wisconsin Physician Services (WPS) - J5 NE Part A (05401)**
  • Wisconsin Physician Services (WPS) - J5 NE Part B (05402)**
  • Wisconsin Physician Services (WPS) - J8 IN Part A (08101)**
  • Wisconsin Physician Services (WPS) - J8 IN Part B (08102)**
  • Wisconsin Physician Services (WPS) - J8 MI Part A (08201)**
  • Wisconsin Physician Services (WPS) - J8 MI Part B (08202)**
  • Youthcare Healthchoice Illinois (68069)

Payers That Require Enrollment

National Government Services (NGS) and Wisconsin Physician Services (WPS) requires enrollment for the electronic claim attachment service.

National Government Services (NGS) Enrollment

  1. To enroll, go to the NGS EDI Enrollment Form page.
  2. Complete an EDI Registration Form as a Provider with the following information.
    Note: Although the payers are set up in Tebra with Trizetto as the clearinghouse, electronic claims with attachments are submitted through Tebra's clearinghouse connection with Jopari. Enrollment is completed with Jopari's information and is only for 275 transactions (electronic claim attachments) through Jopari.
    • Transactions: 275 Inbound Electronic Attachments
    • Trading Partner Information:
      • Action: Update TPID
      • Trading Partner ID:
        • For Medicare Part A: CHA075397
        • For Medicare Part B: CHB075311
    • Software Vendor: Jopari Solution (275 Attachments only)
      Note: Once selected, additional vendor information auto-populates and should not be edited.
    • Operating Information:
      • Network Service Vendor: Waystar
  3. When finished, submit the form. Then, print and save the Enrollment Packet for record keeping before exiting.

The payer will send notification once the enrollment is complete. For inquiries directly related to the submitted enrollment, contact NGS directly. For all other general enrollment questions, create a Tebra Customer Care case.

Wisconsin Physician Services (WPS) Enrollment

  1. To enroll, go to the WPS EDI Express Enrollment page.
  2. Complete enrollment for providers with the following information.
    Note: Although the payers are set up in Tebra with Trizetto as the clearinghouse, electronic claims with attachments are submitted through Tebra's clearinghouse connection with Jopari. Enrollment is completed with Jopari's information and is only for 275 transactions (electronic claim attachments) through Jopari.
    • Electronic Transaction Type: 6020 275 Transaction
    • Clearinghouse/Billing Agency Trading Partner ID: 200787505
    • Clearinghouse Information:
      • Clearinghouse Company Name: Jopari Solutions Inc
      • Clearinghouse Contact First Name: Jopari
      • Clearinghouse Contact Last Name: Operations
      • Clearinghouse Contact Job Title: ATTACH Operations
      • Clearinghouse Contact Phone Number: (925) 459-5200
      • Clearinghouse Extension: Leave blank
      • Clearinghouse Contact E-Mail Address and Confirm Contact E-Mail Address: attach@jopari.com
  3. When finished, submit the enrollment.

The payer will send notification once the enrollment is complete. For inquiries directly related to the submitted enrollment, contact WPS directly. For all other general enrollment questions, create a Tebra Customer Care case.

 

 

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