Electronic Connectivity (EDI)

Electronic claims transactions

To learn how to get set up to submit claims to us electronically, please select the option that most closely describes your office.

For providers who submit their own claims

Software vendor

You must meet our testing requirements (PDF) and complete these steps:

  1. Complete self-testing.
  2. Once you have completed self-testing and received three passed files for each line of business tested, call the number on the test instruction letter to begin subsystem testing. If you have not received testing instructions, please contact the EDI helpdesk at 1-800-542-0945.

Clearinghouse or service bureau

You must meet our testing requirements (PDF) and complete these steps:

  1. Complete self-testing.
  2. Once you have completed self-testing and received three passed files for each line of business tested, call the number on the test instruction letter to begin subsystem testing. If you have not received testing instructions, please contact the EDI helpdesk at 1-800-542-0945.

Pharmacy

To submit pharmacy claims, you should be set up to bill Medco. For technical requirements and instructions, please contact:

  • Medco: 1-800-922-1557

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Electronic eligibility and claims status access

Learn how to get eligibility and claims status information electronically.

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Sign up for Provider Secured Services to access to patient eligibility, benefits and more.

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