eClaims - Payer IDs

What is a Payer ID?

The Payer ID is assigned to the insurance carrier by the clearinghouse and is not necessarily the same number as found on the patients' insurance cards. You should always look up your Payer ID on the clearinghouse's payer list to ensure that you are sending to the correct insurance (Links are provided below for easy access.). The clearinghouse will then route the eClaim to the payer based on the Payer ID sent on the eClaim.

Note: Payer IDs are only used in eClaims.

Where Can I Find a Payer ID?

This can depend on which clearinghouse you’re using.

• For Change Healthcare, you can refer to CHC’s Payer Lists here.Payer Lists

  • You’ll use the “RPA (Revenue Performance Advisor) Claims & Remittance Payer List” option in the resulting list.

• For Inovalon, you can directly find their Payer List inside the Claims Management Pro portal, under “Settings > Payer > List”. See the Inovalon Payer Enrollment Guide for more information.

• For DentalXChange, you can find their Payer List here: https://register.dentalxchange.com/reg/payerList?0

What if it's not listed/I can't find it?

If you can't find a Payer ID, you can contact MacPractice Support for assistance locating the correct Payer ID. Some payers do not accept electronic claims. If this is the case, you have a few options.

Dental:

Option 1: You can enter 06126 as the Payer ID and the clearinghouse will drop the claim to paper and forward it on your behalf for a fee.

Option 2: You can leave the Payer ID field blank and set the default eClaims Template to "None" to print the claim in your office and send it yourself.

Please note: Secondary/supplemental claims will only have EOB information if they are sent electronically. If the clearinghouse has to print the claim, the primary EOB does not go with it.

Medical: 

Option 1: For Medical offices, enter PAPER as the Payer ID. ChangeHealthcare will will attempt to match the Insurance Company & Address listed to a Payer ID. If they find a match, they will send the claim electronically. If they do not, they will print the claim for the office and forward it to the payer for a fee.

Option 2: You can enter PRINT as the Payer ID if you want the clearinghouse to drop the claim to paper and print it for a fee without searching for a Payer ID match.

Option 3: You can leave the Payer ID blank and set the Default eClaims Template to None to print the claim in your office and send it yourself. 

Please note: Secondary/supplemental claims will only have EOB information if they are sent electronically. If the clearinghouse has to print the claim, the primary EOB does not go with it.