Electronic Transactions

IlliniCare is committed to providing our participating providers with the best tools possible to support their administrative needs. These tools will help you receive get claims processed faster and easier. PaySpan Health – Free EFT/ERA Service for Providers IlliniCare and PaySpan Health are partnering to provide an innovative web based solution for Electronic Funds Transfers (EFTs) and Electronic Remittance Advices (ERAs).

EDI

Our contracted clearinghouses are:

Clearinghouse                   Medical Payer ID       Behavioral Payor ID       
Emdeon 68069 68068
SSI 68066 68065
Trizetto Provider Solutions (Formally:Gateway EDI) 68066 68068
Smart Data Solutions 68069 68068
Availity 68066 68068

 

If you have any questions, please contact: IlliniCare Health Plan c/o Centene EDI Department (800) 225-2573, ext. 25525 or 314-505-6525. Or by email at EDIBA@centene.com

Tips for 5010 EDI Claims EDI Claims

  • Correct Use of the Date of Service/Onset Date Fields
    • If the onset date is the same as the date of service, leave the onset date field blank.  Entering the same date on both the onset field and service field will cause an error.
    • If the onset date is prior to the date of service, enter the two dates in their applicable fields.
  • National Provider Identifier (NPI) vs Social Security Number (SSN)
    • Be sure to sue the NPI and not an employer identification or social security number as the primary identifier on your claim.

Please visit www.ama-assn.org/go/5010 or www.cms.gov/Versions5010andD0 for more information on data reporting changes in the Version 5010 transactions.