Electronic claims

Vendor information

Providence Health Plan contracts with numerous vendors to assist in filing claims electronically. Below is a list of our vendors along with pertinent information that can help you decide which vendor is the best fit for your office’s needs. Providence Health Plan offers electronic claims payment at no charge to our providers. Claims sent electronically are paid on average of 10 business days.

For assistance, contact us:

PHPEDISupport@Providence.org
503-574-7450

Vendor Name Contact Information Transaction Types Plan ID/
Payer ID Numbers
Subcontractor
Availity Contact your Availity representative for electronic claims information: 800-282-4548 Professional claims Health Plans = PHP01
PPO = PHP00
Emdeon
*Capario/Emdeon www.Capario.com Professional claims
Institutional claims
Electronic Remittance Advice (ERA)
Health Plans = PHP01
PPO = PHP00
CareVu Contact your CareVu representative for electronic claims information:
www.healthsmart.com
Professional claims Health Plans = PHP01
PPO = PHP00
Emdeon
Claim Logic www.claimlogic.com Professional claims
Institutional claims
Electronic Remittance Advice (ERA)

Health Plans = SX133
PPO = SX187

Emdeon
eClaims Contact your eClaims EDI representative for electronic claims information: www.eClaims.com Professional claims Health Plans = PHP01
PPO = PHP00
Emdeon
EDI Healthcare Contact EDI Healthcare for electronic claim information: www.edihealthcare.com Professional claims Health Plans = PHP01
PPO = not set up
Emdeon
*Emdeon
Envoy/WebMD/Sage
www.emdeon.com/enrollment
Professional claims
Institutional claims
Electronic Remittance Advice (ERA)
Health Plans = SX133
PPO = SX187
ENS Contact your ENS representative for electronic claims information: www.enshealth.com Professional claims Health Plans = PHP01
PPO = PHP00
Emdeon
ET&T www.ettch.com
Professional claims Health Plans = SX133
PPO = SX187
Emdeon
*FCHN Professional claims
Institutional claims
Washington providers =
91131 (not Vancouver)
Gateway EDI/ Trizetto Provider Solutions Contact your Gateway EDI representative for electronic claims information: www.gatewayedi.com Professional claims
Institutional claims
Electronic Remittance Advice (ERA)
Health Plans = PHP01
PPO = PHP00

GE Healthcare/Centricity/IDX Contact your GE Healthcare representative for electronic claims information:
www.gehealthcare.com
Professional claims Health Plans = SX133
PPO = SX137
Emdeon
GHN
Contact GHN for electronic claim information: www.ghnonline.com
Professional claims
Health Plans = SX133
PPO = SX187 
Emdeon
Health-e-Web
Contact Health-e-Web EDI representative for electronic claims information: www.Health-e-Web.net
Professional claims  
Health Plans = PHP01
Emdeon
Health Fusion Professional claims Health Plans = PHP01
PPO = PHP00
Emdeon
MCPS - Medical Claims Processing Solutions mcp@mcps-inc.com
800-879-7534 
Professional claims
Institutional claims
Electronic Remittance Advice (ERA)
Health Plans = ORD02
PPO = ORD14
Emdeon
Misys and PayerPath Contact Misys for electronic claim information: www.misyshealthcare.com Professional claims Health Plans = 000735
PPO = 001478
Emdeon
Navicure Contact Navicure for Providence payer IDs www.navicure.com Professional claims Health Plans = P1238
PPO = 91186
Emdeon
*Office Ally 866-575-4120
info@officeally.com
Professional claims 
Institutional claims 
Electronic Remittance Advice (ERA)
Health Plans = PHP01
PPO = PHP00
*Payer Connection sales@payerconnection.com
or 503-820-3803
Professional claims 
Institutional claims 
Electronic Remittance Advice (ERA)
Health Plans = PHP01
PPO = PPOOR
Payer Path/Allscripts See Misys
Premera Blue Cross www.premera.com for detailed information Professional claims Health Plans = 00430
RealMed www.RealMed.com
877-732-5633
Professional claims Health Plans = SX133
PPO = SX187
Emdeon
*RelayHealth/McKesson Contact your RelayHealth representative for electronic claims information: www.RelayHealth.com Professional claims 
Institutional claims 
Electronic Remittance Advice (ERA)
Health Plans
Professional = 4498
Institutional = 1540
PPO
Professional = 2403
Institutional = 1915
Trizetto Provider Solutions
*SSI Group www.TheSSIGroup.com
800-880-3032
Professional claims 
Institutional claims 
Electronic Remittance Advice (ERA)
Contact vendor for Payer ID's.
*Trizetto Provider Solutions Contact your Trizetto Provider Solutions representative for electronic claims information. Professional claims 
Institutional claims 
Electronic Remittance Advice (ERA)
Health Plans = PHP01
PPO =  PHP00
 
WebMD/Envoy/Emdeon Sage You need to fill out an enrollment form: www.emdeon.com/enrollment
Professional claims 
Electronic Remittance Advice (ERA)
Health Plans = SX133
PPO = SX187
Emdeon
ZirMed Contact ZirMed for electronic claim information: 877-494-7633 or info@zirmed.com Professional claims
Institutional claims
Health Plans = PHP01
PPO = PHP00

*Indicates a direct connection with Providence Health Plan and clearinghouse.

If your clearinghouse is not listed, contact your vendor to check if they have a connection to one of the listed clearinghouses. You also can conduct a search of your clearinghouse online by typing the name of your clearinghouse along with “payer list” into your preferred search engine (e.g., Google, Yahoo, etc.)

835 Electronic Remittance Advice (ERA)

If you are interested in receiving the 835 Electronic Remittance Advice, or ERA, from Providence, please contact your clearinghouse. Your clearinghouse will set up the ERA for you. Once ready, the clearinghouse will contact PHPEDISupport to start sending your data. The ERA will be available each Monday and Wednesday from your clearinghouse. Along with the ERA, you will continue to receive paper EOPs until you notify Providence to stop sending paper.

Electronic Funds Transfer (EFT)

For clinics/facilities wishing to sign up for Electronic Funds Transfer (EFT), please log on to ProvLink through www.onehealthport.com, find "Electronic Transactions" on the home page and select EFT – Get your payments deposited directly

Questions?

For assistance, contact us:

PHPEDISupport@Providence.org
503-574-7450

**Providence Health Plan does not pay for any costs associated with submission of paper claims.