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Availity Portal & EDI Clearinghouse – July 18, 2020
Release Communication
Table of contents
Availity Portal Enhancements.......................................................................................................................3
General...................................................................................................................................................... 4
Arizona, Arkansas, California, Colorado, Idaho, Kansas, Louisiana, Montana, Nebraska, Nevada,New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Utah, Washington,Wyoming.............................................................................................................................................. 20
California, Colorado, Georgia, Indiana, Kentucky, Louisiana, Maine, Missouri, Nevada, New York,Ohio, South Carolina, Virginia, Wisconsin.......................................................................................... 22
Florida......................................................................................................................................................23
Florida, Idaho, Minnesota, Oregon, Pennsylvania, Utah, Washington................................................... 27
Georgia, Kentucky, New York, Texas..................................................................................................... 29
Idaho, Oregon, Utah, Washington.......................................................................................................... 31
Illinois, Montana, New Mexico, Oklahoma, Texas..................................................................................37
Minnesota................................................................................................................................................ 39
EDI Clearinghouse Enhancements............................................................................................................ 41
EDI implementations............................................................................................................................... 41
EDI payer name changes....................................................................................................................... 44
EDI cancellations.....................................................................................................................................45
B2B implementations.............................................................................................................................. 47
B2B cancellations....................................................................................................................................49
Contact Availity........................................................................................................................................... 50
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication© Availity, LLC, all rights reserved | Confidential and proprietary.
Availity Portal EnhancementsThe following Availity Portal enhancements, and any Availity Help topic updates, are available with therelease.
To access Availity Help, click Help & Training at the top of Availity Portal.
If you do not see these enhancements upon login, ask your Availity administrator to grant you access tothe feature. To identify your administrator, click your name in the top navigation bar, and then click MyAdministrators on the My Account page.
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 3 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
General
Availity Portal transactions
Availity is pleased to announce the following payers are now available for the specified transactionsonAvaility Portal .
Payer Regions E&B ClaimStatus
ProfClaims
FacilityClaims
EncClaims
DentalClaims
Remits Refs Auths
Truli Health Florida
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 4 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
Edit Inquiry now available on new Authorization/Referral Inquiry Results page
When you submit an inquiry about an authorization or referral from the new Authorization/Referral Inquiryapplication, the results page now includes an Edit Inquiry button.
Clicking Edit Inquiry opens the Authorization/Referral Inquiry application, populated with the input datafrom the previous inquiry, allowing you to edit any of the fields.
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 5 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
New default for Drug Quantity Unit Code Qualifier field in new professional claimform
The Drug Quantity Unit Code Qualifier field, in the National Drug Code (NDC) Information section ofthe new professional claim form, now defaults to Unit.
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 6 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
Changes to Dental Claim form
We've made the following changes to the Dental Claim form:
• We've added a Claim Filing Indicator field to the Insurance Company/Dental Benefit PlanInformation section.
• We've added a Middle Name field to the Patient Information section.
• We've added fields to the Secondary Insurance Plan Information and Tertiary Insurance PlanInformation sections to specify the address of the subscriber.
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 7 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
• We've added a Remaining Months of Treatment field to the Is Treatment For Orthodontics sub-section of the Ancillary Claim/Treatment Information section.
• We've added fields to the Billing Dentist or Dental Entity section for including contact information forthe specified contact.
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 8 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
Provider NPI replaces PIN for Aetna drug prior authorization
When submitting a drug prior authorization for Aetna through Novologix, the requesting provider's NPInow replaces the Aetna PIN.
Note: The value in the Provider NPI field must be a Type 1 NPI.
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Collect Payment link temporarily removed from E&B results
If you are registered for Availity's patient payments service, the Collect Payment link will not display on apatients eligibility and benefits results.
Availity has temporarily removed the link while it works to improve the service for collecting paymentsfrom a patient's eligibility and benefits. In the meantime, you can still collect payments by doing thefollowing:
1. Note the amount in the patient's eligibility and benefits information that you want to collect.
2. Click Claims & Payments > Collect Payment in the Availity Portal menu.
3. Complete the fields on the Collect Payment page, and then click Collect Payment.
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Changes to coordination of benefits dates on E&B results
Availity has changed the label for the coordination of benefits dates that display on a patient's eligibilityand benefits results. For some payers, the label is different if the payer returns a range of dates versus asingle date for the coordination of benefits.
Call-out(imagebelow)
Type of date returned bypayer
New label Old label
A Date range Coordination of Benefits COB Effective Date
B Single date
(all payers except Anthem)
Coordination of Benefits COB Effective Date
C Single date
(Anthem payers only)
COB Verification COB Effective Date
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 12 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
MRM tab relabeled to Letters for Humana overpayments
For Humana overpayments, the MRM Letters tab has been relabeled to Letters.
The Letters tab and the Medical Record Request label will always display for a Humana overpaymenteven if no medical record management letters are associated with the overpayment. The overpaymentcard will always have at least one letter attached to the card that is sent from Humana to the provider.
Access the Letters tabThe Letters tab displays in the detailed view of the overpayment card.
1. On the Overpayments page, on any card, click the More menu and then select View Details.
2. Select the Letters tab to review the information on the card and also any letter attachments that areready for download and review.
Tip: See the Humana payer-specific section in Manage Attachments for an Overpayment for moreinformation in working with Humana attachments and files.
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 13 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
New research procedure code edits tool in Humana payer space
A research procedure code edits tool is now available in Humana's payer space. You can use the tool tosubmit code edit questions about particular claims and procedure codes to Humana.
Access the research procedure code edits tool
1. Click Payer Spaces in the Availity Portal menu, and then click the Humana payer space tile.
2. Click Research Procedure Code Edits on the Applications tab of the payer space page.
Submit a code edit question to Humana
1. In the Organization and Tax ID fields, select the organization and tax ID of the provider for whom youare submitting the code edit question, and then click Submit.
2. Complete the remaining fields on the Research Procedure Code Edits page with information about theclaim and procedure codes for which you are submitting the code edit question. Click Submit to sendthe question to Humana.
To view Humana's response to your question and submit additional information about the question toHumana, use the messaging tool on the Availity Portal home page.
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My Account page enhancements
On the My Account page, the graph in the My Team section has been removed. For administrators, thegraph has been replaced with Add User and Maintain User links. These enhancements make the MyAccount page more user friendly.
Tip: See My Account Page for information about the My Account page.
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Updated Availity Support Community
Availity will be introducing an updated support community page that you can access in Availity Portal. TheAvaility support community gives you access to a variety of resources and information, all in one place.
Note: The updated Availity support community will be made available to a small group of providers inJuly and then expanded to a larger group of providers in August.
Access the Availity support communityClick Help & Training > Availity Support in the Availity Portal menu.
Using the Availity support community
A. Use the menu to access information.
• Help – View articles about a variety of subjects.
• Support Tickets – View your open, closed, and archived support tickets.
• Contact Support – Open a new support ticket or chat with an Availity Client Servicesrepresentative.
• Known Issues – View articles about known issues and view information about outages andscheduled maintenance for Availity Portal.
• COVID-19 – View information and access resources about COVID-19 from Availity and payers.
• Payer List – Access the payer list tool to see the types of transactions available for the payersAvaility does business with.
B. Click the tiles on the Helpful Topics & Links tab to access information.
• Watch Demos – View demos and other training resources in the Availity Learning Center (ALC).
• Troubleshooting – View troubleshooting articles.
• FAQs – View articles about frequently asked questions.
• My Support Requests – View your open, closed, and archived support tickets.
• Network Outages – View information about outages and scheduled maintenance for AvailityPortal.
• Release Notes – Read about updates and enhancements to Availity Portal and EDI Clearinghousein the Availity release blog.
C. Click the links in the Additional Resources section to view articles about a variety of subjects.
D. Click Contact Support to open a new support ticket or chat with an Availity Client Servicesrepresentative.
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Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 18 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
Resolved issues
Availity has resolved the following issues in Availity Portal.
Issue Payer (Region)Affected
The correct patient account number displays on the appeals card. All
Users can now submit a professional claim that includes just a singlevalue of what the patient's condition is related to, in the Ancillary Claim/Treatment Information section.
Aetna (All),Capital BlueCross(Pennsylvania)
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Arizona, Arkansas, California, Colorado, Idaho, Kansas, Louisiana,Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma,Oregon, South Dakota, Texas, Utah, Washington, Wyoming
New pharmacy dispensing information tool in TriWest payer space
A pharmacy dispensing information tool is now available in TriWest Healthcare Alliance's payer space.You can use the tool to view urgent and emergent retail pharmacy claims submitted through theCommunity Care program.
The pharmacy dispensing information tool is currently available to providers in the following regions:
• Arizona
• Arkansas
• California
• Colorado
• Idaho
• Kansas
• Louisiana
• Montana
• Nebraska
• Nevada
• New Mexico
• North Dakota
• Oklahoma
• Oregon
• South Dakota
• Texas
• Utah
• Washington
• Wyoming
Access the pharmacy dispensing information tool
1. Click Payer Spaces in the Availity Portal menu, and then click the TRIWEST payer space tile.
2. Click Urgent/Emergent Pharmacy Dispensing Information on the Applications tab of the payerspace page.
View pharmacy claims
1. Enter search criteria in the fields on the Urgent/Emergent Pharmacy Dispensing Information page, andthen click Submit.
2. View the pharmacy claims matching the search criteria you entered. Each pharmacy claim is displayedas a separate card.
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Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 21 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
California, Colorado, Georgia, Indiana, Kentucky, Louisiana,Maine, Missouri, Nevada, New York, Ohio, South Carolina, Virginia,Wisconsin
Specialty/Taxonomy relabeled to Taxonomy on provider list for out-of-areaauthorizations
The Specialty/Taxonomy column, on the provider list for out-of-region authorizations for Anthem (andother affiliated health plans), has been relabeled to Taxonomy since the specialty code is no longerrequired.
This change applies to the following health plans:
• Anthem (California, Colorado, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, Ohio, Virginia,and Wisconsin)
• Anthem MaineHealth
• Empire BlueCross
• Empire BlueCross BlueShield
• Healthy Blue Dual Advantage
• Healthy Blue Louisiana
• Healthy Blue South Carolina
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 22 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
Florida
Care reminders now available for Truli for Health members
When viewing eligibility and benefits information for Truli for Health members, click the Care Reminderstab to view clinical information and reminders specific to the patient.
The number badge on the Care Reminders tab indicates the number of care reminders.
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 23 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
Patient cost estimator now available for Truli for Health
You can now use the patient cost estimator to obtain a patient cost estimate for services rendered byprofessional providers to Truli for Health members.
Access the patient cost estimator
1. Submit a an eligibility and benefits request for the patient. Make sure you select Truli Health in thePayer field on the Eligibility and Benefits request page.
2. Click Patient Cost Estimator near the top of the eligibility and benefits results.
Submit a patient cost estimate request
1. Complete the fields on the Patient Cost Estimator Professional request page.
2. Click Estimate Cost to submit the patient cost estimate request to the payer.
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View a patient cost estimateUsing the information you submitted in the estimate request, the payer calculates the patient’s estimatedresponsibility.
A. The Patient Cost Estimator Professional results page displays the total patient estimate. It alsodisplays information such as deductible and co-payment amounts.
B. To save the patient cost estimate to a PDF file that you can print or keep in the patient's records, clickAction > Print. Follow your browser's prompts to save the PDF file.
C. Codes identify messages related to the procedure codes displayed on the estimate results.
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D. Click Request Authorization to access the authorizations tool to submit an authorization for thepatient.
Tip: See Using the Patient Cost Estimator for information about using the patient cost estimator torequest and view patient cost estimates.
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Florida, Idaho, Minnesota, Oregon, Pennsylvania, Utah, Washington
Search and status updates in messaging app
In the messaging app, the search feature has been enhanced and there is a new status and status barcolor for conversations that have been reopened.
Enhanced searching for conversationsUsers can use the Search By field to filter conversations using the following criteria:
• Member ID
• Member Name
• Provider IDs
• Claim Number
New status for reopened conversationsFor any conversations that are reopened, the status is indicated on the conversation card with the statusbar color of olive green.
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Tip: See Accessing and Reviewing Messages and Using the Messaging Application to Search, Sort, andFilter Conversations for more information about the different statuses of a conversation and how to usethe messaging app to search and filter on conversations.
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Georgia, Kentucky, New York, Texas
Comprehensive health assessment now available for WellCare Medicare plans
The comprehensive health assessment application is now available for WellCare Medicare plan providersin Georgia, Kentucky, New York, and Texas. Providers can submit health assessment data on theirpatients to WellCare Medicare plans via a convenient online form in Availity Portal.
When you have a request available in your work queue, you will see a notification on the Availity Portalhome page. You can also open the work queue by clicking Access comprehensive health assessment.
Access comprehensive health assessment
1. At the top of Availity Portal, click Payer Spaces > Wellcare Health.
2. On the WellCare payer space page on the Applications tab, click Comprehensive HealthAssessment.
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Clinical quality validation now available for WellCare Medicare plans
The clinical quality validation application is now available for WellCare Medicare plan providers inGeorgia, Kentucky, New York, and Texas. Providers can monitor, work, and submit an electronic versionof the clinical quality validation form and supporting medical records for their patients.
When you have a request available in your work queue, you will see a notification on the Availity Portalhome page. You can also open the work queue by clicking Access clinical quality validation.
Access clinical quality validation
1. At the top of Availity Portal, click Payer Spaces > Wellcare Health.
2. On the WellCare payer space page on the Applications tab, click Clinical Quality Validation.
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Idaho, Oregon, Utah, Washington
Void an authorization request for Asuris Northwest Health, BridgeSpan HealthCompany or Regence
Providers will now be able to void (cancel) certain pending authorization requests that they've submittedto any of the following health plans:
• Asuris Northwest Health
• BridgeSpan Health Company
• Regence BlueShield of Idaho
• Regence BlueCross BlueShield of Oregon
• Regence BlueCross BlueShield of Utah
• Regence BlueShield (Washington)
You can void an authorization request, from one of the above health plans, from the auth/referraldashboard or from the authorization/referral inquiry application.
To void an authorization request from the auth/referral dashboard, follow these steps:
1. In the Availity Portal menu, click Patient Registration > Authorizations & Referrals.
2. On the Authorizations & Referrals page, click Auth/Referral Dashboard under Multi-PayerAuthorizations and Referrals.
3. In the auth/referral dashboard, locate the request that you want to void, click the View/Action menu,and then select View Details.
4. In the Authorization Information window, click Void if available. If the Void button is not available, theauthorization cannot be voided from within Availity Portal.
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To void an authorization request from the authorization/referral inquiry application, follow these steps:
1. In the Availity Portal menu, click Patient Registration > Authorizations & Referrals.
2. On the Authorizations & Referrals page, click Auth/Referral Inquiry under Multi-PayerAuthorizations and Referrals.
3. On the Authorization/Referral Inquiry page, specify the information for the authorization that you wantto void, and then click Submit.
4. On the results page for the authorization that you want, click Void if available. If the Void button is notavailable, the authorization cannot be voided from within Availity Portal.
Note: Asuris Northwest Health, BridgeSpan Health Company and the Regence health plans dictatewhich authorization requests can be voided based on their business rules.
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Attachments now available for Regence providers
The following Regence providers can now access the new attachments tool to receive and respond torequests for additional documentation electronically:
• Asuris Northwest Health
• BridgeSpan Health Company
• Regence BlueCross BlueShield (BCBS) of Oregon
• Regence BlueCross BlueShield (BCBS) of Utah
• Regence BlueShield of Idaho
• Regence BlueShield (Washington)
When a payer requires documentation to support a claim or additional activities in which medicaldocumentation is needed, an attachment request is added to the organization's Inbox on the AttachmentsDashboard. The user manages the Inbox queue and submits supporting documentation.
The Attachments Dashboard tool provides you with the capability to:
• Respond to payer requests for supporting documentation.
• Respond to a request by submitting documentation to the payer from the Inbox tab as needed.
• Manage requests in the Sent and History tabs.
Access this toolAt the top of Availity Portal, click Claims & Payments > Attachments - New under Claims.
If the payer has requested that you send follow-up documentation, you can also open the attachmentstool by clicking Notifications in the top tier menu (when it displays a green circle with a number indicatingyou may have pending requests). Select Review your open Attachment’s request in your work queuein the Notification Center. If you are associated to more than one organization, select the appropriateorganization in the Organization field.
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Tip: See Submitting Attachments for information about submitting attachments.
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Messaging feature now available for Regence providers from attachments app
The following Regence providers can now send messages to the payer from the new attachments app:
• Asuris Northwest Health
• BridgeSpan Health Company
• Regence BlueCross BlueShield (BCBS) of Oregon
• Regence BlueCross BlueShield (BCBS) of Utah
• Regence BlueShield of Idaho
• Regence BlueShield (Washington)
From the Attachments Detail page, you can send a message to the payer should you have questionsabout an attachment request.
Access the messaging feature from attachments
1. In the Availity Portal menu, click Claims & Payments > Attachments - New under Claims.
2. On the Attachments - New | Attachments Dashboard page, click a request.
3. On the Attachments Detail page, click the Send a message to the payer link.
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Tip: See the What are some payer-specific features? in Submitting Attachments for more informationabout sending messages to the payer. See also, Accessing and Reviewing messages on how to access amessage sent to you by the payer.
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 36 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
Illinois, Montana, New Mexico, Oklahoma, Texas
View member ID cards from the E&B results for BCBSIL, BCBSMT, BCBSNM,BCBSOK, and BCBSTX members
You can now view member ID cards from the eligibility and benefits results for members of the followinghealth plans:
• Blue Cross and Blue Shield of Illinois (BCBSIL)
• Blue Cross and Blue Shield of Montana (BCBSMT)
• Blue Cross and Blue Shield of New Mexico (BCBSNM)
• Blue Cross and Blue Shield of Oklahoma (BCBSOK)
• Blue Cross and Blue Shield of Texas (BCBSTX)
View a member ID card
1. Click View Member ID card near the top of the eligibility and benefits results.
2. The patient's member ID card displays in a separate window.
• Click Save to PDF to save the member ID card to a PDF file that you can print or keep in thepatient's records.
• Click Close in the member ID card window when you are finished viewing the member ID card.
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Minnesota
New fields for injectable drug authorizations for Blue Cross and Blue Shield ofMinnesota
When submitting an outpatient authorization request to Blue Cross and Blue Shield of Minnesota andselecting Injectable Drug for the Service Type, additional fields will now display on the Add ServiceInformation step and the Rendering Provider/Facility step as follows:
A. The following fields will now display in the PROCEDURE CODE(S) section on the Add ServiceInformation step:
• Prescribed Dose and Frequency
• Patient Weight
• Weight Units
B. The following fields will now display in the SERVICE INFORMATION (CONTINUED) section on theAdd Service Information step:
• Site of Care
• Site of Care Rationale – Displays only when the value in the Site of Care field is Off Campus -Outpatient Hospital (19) or On Campus - Outpatient Hospital (22).
• Will this member be trained to self-administer this drug?
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EDI Clearinghouse Enhancements
EDI implementationsThese payers are now available for the transmission of certain EDI transactions via EDI Clearinghouse.
Base plan (available for all providers)
Payer Name Payer ID 270 276 278 837P 837I 837E 837D 835
TRIWESTHEALTHCAREALLIANCE
VAPCCC3
TRULI HEALTH TRULI
Comprehensive plan (fee-based subscription required)
Payer Name Payer ID 270 276 278 837P 837I 837E 837D 835
ALLCARE IPA AC101
ARMADACARE 90886
AVAILITY ALLPAYER PRINT
CAMP LEJUNEFAMILY MEMBERPROGRAM
CLFM1
COMMUNITYFAMILY CARE
NMM05
ENTERPRISEGROUP PLANNING
EGPIN
GONZABAMEDICAL GROUP
GMGSA
HEALTH ANDHUMAN SERVICENATIONALDISASTERMEDICAL SYSTEM
NDMSA
HEALTHCARESTRATEGICINITIATIVES
HSICS
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Payer Name Payer ID 270 276 278 837P 837I 837E 837D 835
HEALTH EQUITY 43700
INTEGRATEDHOMECARESERVICES
IHCS1
ISLAND HOMEINSURANCECOMPANY
ISLAH
KEY BENEFITADMINISTRATORS(INDIANAPOLISINDIANA)
37217
LONE STAR TPA 45289
MEDICAREPENNSYLVANIAPART A
12501
ONE HOMECARESOLUTIONS
ONEHC
OPTIMED HEALTH 96277
PIEDMONTCOMMUNITYHEALTH PLAN
A1441
SOLIS HEALTHPLANS
SOLIS
SUTTER PACIFICMEDICALFOUNDATION
77304
THE ZERO CARD 75296
TUALITY HEALTHALLIANCE
THA01
TUALITY HEALTHSELECT
THASC
UNIVERSITY TEXASMEDICAL BOARD
UTMBC
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Payer Name Payer ID 270 276 278 837P 837I 837E 837D 835
ZENITH AMERICANSOLUTIONS INC
89677
Note: To submit EDI transactions to any of these new Comprehensive plan payers, you'll need tosubscribe to the Availity Comprehensive plan, using the EDI Clearinghouse Plan Selection application. Ifyou already have a subscription to the Availity Comprehensive plan, no further action is required.
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EDI payer name changesThis payer's name has changed for the transmission of certain EDI transactions via EDI Clearinghouse.
Comprehensive plan (fee-based subscription required)
Old Payer Name New Payer Name Payer ID
Trusted Health Plans, Inc. COMMUNITY HEALTH PLAN DISTRICTOF COLUMBIA
L0230
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EDI cancellationsThese payers are no longer available for the transmission of certain EDI transactions via EDIClearinghouse.
Base plan (available for all providers) and comprehensive plan (fee-based subscriptionrequired)
Payer Name Payer ID ExpirationDate
270 276 278 837P 837I 837E 837D 835
ADVANTAGEPREFERREDPLUS
35199 7/1/20
CAMP LEJUNEFAMILYMEMBERPROGRAM
CLFM1 6/30/2020
CMCSMEDICAREADVANTAGE
35219 12/19/19
COOPERATIVEMANAGEDCARESERVICES(CMCS)
77070 4/10/20
CSI OFMICHIGAN
27136 6/25/2020
DELAWAREPHYSICIANSCAREINCORPORATED
27009 6/20/2020
INTER VALLEYHEALTH PLANCALIFORNIA
SPIVH 6/24/2020
MEDICAIDILLINOIS
SKIL0 6/10/2020
PEOPLESHEALTH
PPLSH 6/22/2020
PRIMARYCARE OFJOLIET
PCJOL 7/1/2020
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Payer Name Payer ID ExpirationDate
270 276 278 837P 837I 837E 837D 835
UMASSMEDICALSCHOOLHEALTH ANDCRIMINALJUSTICEPROGRAM
UMHCJ 6/17/2020
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B2B implementationsThese payers are now available for the transmission of certain B2B transactions via EDI Clearinghouse.
Base plan (available for all providers)
Payer Name Payer ID 270 276 278 837P 837I 837E 837D 835
TRULI HEALTH TRULI
Comprehensive plan (fee-based subscription required)
Payer Name Payer ID 270 276 278 837P 837I 837E 837D 835
ADVANTRAFREEDOM
25152
AETNA BETTERHEALTHKENTUCKY
ABHKY
AETNA BETTERHEALTHMARYLAND
128MD
ARIZONAPHYSICIANS IPA
03432
BC IDAHO 100061 andBCIDC
BLUESHIELD CA 100935
CALOPTIMA 101160
HEALTH AMERICAINCORPORATEDHEALTHASSURANCEADVANTRA
25126
MEDICAID WESTVIRGINIA
100305
MERITAIN HEALTH MTAIN
NETWORK HEALTH 04332
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Payer Name Payer ID 270 276 278 837P 837I 837E 837D 835
PARTNERSHIPHEALTH PLANCALIFORNIA
10164
PROFESSIONALBENEFITADMINISTRATORSINCORPORATED(OAK BROOKILLINOIS)
36331
SHARP HEALTHPLAN
10967
TUFTS HEALTHPLAN
04298 andTUFTS (276only)
UNITEDHEALTHCARECOMMUNITY PLANARIZONA
03432
UPMC HEALTHPLAN
23281
VIVIDA HEALTH 45488
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 48 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
B2B cancellationsThis payer is no longer available for the transmission of certain B2B transactions via EDI Clearinghouse.
Base plan (available for all providers) and comprehensive plan (fee-based subscriptionrequired)
Payer Name Payer ID ExpirationDate
270 276 278 837P 837I 837E 837D 835
INTER VALLEYHEALTH PLANCALIFORNIA
SPIVH 6/24/2020
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 49 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.
Contact AvailityAvaility is committed to providing you with comprehensive customer service and enhancements that makeyour Availity experience a more enjoyable one.
For assistance or additional information on any of these enhancements, please contact Availity ClientServices.
Availity Portal & EDI Clearinghouse – July 18, 2020: Release Communication | Page 50 of 50© Availity, LLC, all rights reserved | Confidential and proprietary.