Electronic Data Interchange (EDI)
Amerigroup Community Care uses Availity as its exclusive partner for managing all electronic data interchange (EDI) transactions. EDI, including electronic remittance advices (ERAs) and electronic funds transfers (EFTs), allow for a faster, more efficient and cost-effective way for providers and employers to do business.
EDI lets you:
- Process claims faster by submitting coordination of benefits electronically and fixing errors early with in-system notification and correction.
- Reduce overhead and administrative costs by eliminating paper claim submissions.
- Speed up enrollment and payment for employer groups benefits.
- Upload files through file transfer protocol or directly in Availity as a batch or single claim submission.
For Amerigroup in Availity, you can complete the following HIPAA transactions:
- Healthcare Claim: Professional (837P)
- Healthcare Claim: Institutional (837I)
- Healthcare Claim: Dental (837D)
- Healthcare Eligibility Benefit Inquiry and Response (270/271)
- Healthcare Services Review and Response (278)
- Healthcare Services Inquiry and Response (278)
- Healthcare Claim Payment/Advice (835)
- Healthcare Claim Status Request and Response (276/277)
- Medical Attachments (275)
Ways you can use EDI with Availity
Availity’s EDI clearinghouse options:
- EDI clearinghouse for direct submitters
- For organizations with fewer than 10,000 monthly transactions
- Submit batch files through the portal or Secure File Transfer Protocol using third‑party software, such as billing software
- EDI clearinghouse for high-volume trading partners
Or use your existing clearinghouse vendor:
- Work with your vendor to ensure connection with the Availity EDI Gateway.
Payer IDs route EDI transactions to the appropriate payer.
Amerigroup Payer ID: 26375
Note: If you use a clearinghouse, billing service or vendor, please work with them directly to determine payer ID. These may be different when submitting Amerigroup EDIs in Availity.
Use Availity to register and manage ERA account changes with these three easy steps:
- Log in to Availity.
- Select My Providers.
- Select Enrollment Center and choose ERA Enrollment.
Note: If you use a clearinghouse, billing service or vendor, please work with them on ERA registration.
Use the EnrollHub™, a CAQH Solutions™ enrollment tool to register and manage EFT account changes.
EnrollHub™ makes it easy for you to handle multiple payers at once, reducing administrative time and costs.
EDI trading partner
The trading partner, such as clearinghouse, billing company and vendor, connects with Availity’s EDI Gateway to send and receive EDI transmissions easily.
New to Availity and want to submit EDI transactions?
- Visit www.availity.com and select Register.
- Select your organization type and complete the registration process.
- Check your email to verify your account.
- Once your account is verified, agree to the disclaimer, set up your security questions and change your password.
- Set up any authorized users.
Already have an Availity login but want to submit EDI transactions?
- Log into Availity.
- Choose My Providers, then select Enrollments Center, then select Transaction Enrollment.
- Follow the steps to enroll as a trading partner.
Please contact Availity Client Services with any questions at
1-800-AVAILITY (282-4548), Monday to Friday, 8 a.m. to 7:30 p.m. Eastern time.