Electronic Transactions

IlliniCare Health is committed to providing our participating providers with the best tools possible to support their administrative needs.  Our electronic transactions capabilities will speed up the processing and payment of your claims.

PaySpan
IlliniCare Health and PaySpan are in partnership to provide an innovative web based solution for Electronic Funds Transfers (EFT’s) and Electronic Remittance Advices (ERA’s).

Secure Web Portal
Partial list of secure website functions include verify member eligibility, check/submit claims and submit/confirm authorizations.

EDI
Electronic Transactions (EDI) support for HIPAA transactions is provided for the health plan by Centene Corporation. Centene is currently receiving professional, institutional, and encounter transactions electronically, as well as generating an electronic remittance advice/explanation of payment (ERA/EOP). To conduct other HIPAA transactions not listed, please contact our EDI department at 1-800-225-2573, ext. 25525.

The following list contains contact information for the trading partners currently active with our health plan. All providers are encouraged to contact one of these trading partners to utilize our electronic transaction options.

Our contracted clearinghouses are:

Clearinghouse                   Medical Payer ID       Behavioral Payor ID       
Emdeon 68069 68068
SSI 68066 68068
Trizetto Provider Solutions 68066 68068
Smart Data Solutions 68069 68068
Availity 68066 68068
Capario 68069 68068
Allscripts/Payerpath 68069 68068
IGI 68069 68068
Physicians CC 68069 68068
Claimsource 68069 68068
Claim Remedi 68069 68068
First Health Care 68069 68068
Viatrack 68069 68068
GHNonline 68069 68068
Practice Insight 68069 68068
Relay/Mckesson 68069 68068
MD On-Line 68069 68068
CPSI 68069 68068
DeKalb 68069 68068
Gateway/EDI 68066 68068
Medassets/exactimed 68069 68068
Netwerkes 68069 68068

If you have any questions, please contact: IlliniCare Health c/o Centene EDI Department 1-800-225-2573, ext. 25525 or 1-314-505-6525. 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 https://www.ama-assn.org/practice-management/electronic-transaction-toolkits-administrative-simplification or https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/Versions5010andD0/index.html for more information on data reporting changes in the Version 5010 transactions.