EDI | Providers – Amerigroup

Providers

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Electronic data interchange

Electronic Data Interchange Claims Process

Get paid faster and submit more accurate claims using Electronic Data Interchange (EDI)! Please contact one of the clearinghouses listed below, and they will assist with submitting claims to Amerigroup.*

Here are the clearinghouses we work with and how to contact them:

  • Clearinghouse: Emdeon
    Payer ID: 27514
    For more information, call: 1-866-858-8938
  • Clearinghouse: Capario
    Payer ID: 28804
    For more information, call: 1-800-586-6938
  • Clearinghouse: Availity
    Payer ID: 26375
    For more information, call: 1- 800-282-4548
  • Clearinghouse: Smart Data Solutions
    Payer ID: 81237
    For more information, call: 1-855-297-4436

Need help with EDI? You can call our EDI Hotline at 1-800-590-5745 and speak to an EDI Helpdesk Technician.

*In Louisiana, Amerigroup Louisiana, Inc. In Texas, Amerigroup members in the Medicaid Rural Service Area are served by Amerigroup Insurance Company; all other Amerigroup members are served by Amerigroup Texas, Inc. In Washington , Amerigroup Washington, Inc.

Electronic Data Interchange (EDI) registration

Providers, billing services and clearinghouses can now register to exchange 270/271 (eligibility), 276/277 (claim status), and 835 (electronic remittance advice*) X12 transactions for Amerigroup members and claim payments. To become a trading partner, submit a Trading Partner Agreement form and an Electronic Data Interchange (EDI) Registration Form. An E-Solutions representative will provide outreach to complete the trading partner ID assignment and establish connectivity with our Enterprise Clearinghouse.

*A trading partner ID is required to register for electronic remittance advices (ERA).

Combined ERA/EFT or EFT-only registration

To register or manage account changes for electronic funds transfers (EFT) only or EFT and ERA combined, use the EnrollHub™, a CAQH Solution™ enrollment tool, a secure electronic ERA/EFT registration platform. This tool eliminates the need for paper registration, reduces administrative time and costs, and allows you to register with multiple payers at one time.

If you were previously registered to receive combined ERA/EFT or EFT only, you must register using EnrollHub to manage account changes. No other action is needed.

ERA-only online registration

Providers or their third-party billing agents (e.g., billing vendor or clearinghouses) will use the ERA Registration e-form to register and manage account changes for ERA only. Providers enrolling for EFT or ERA/EFT combined must use EnrollHub™. Providers who previously registered for EFT using EnrollHub™ should add ERA to their profile by using EnrollHub™. Please do not submit duplicate requests using multiple form submission methods.

Clearinghouses may opt to submit registration requests on behalf of their clients at Clearinghouse ERA registration. If a clearinghouse wishes to provide this service to their clients, a user ID and password will be required. Clearinghouse should contact E-Solutions for additional information on requirements and information needed.

Note: Only registrations submitted by clearinghouses with login credentials can be checked using the status tool at Clearinghouse ERA registration status.

Complete Trading Partner Agreement

Other Resources

Providers can manage suppression of paper remittance vouchers using the link below.
Manage paper remittance vouchers

Transaction specific companion documents

The companion documents below are applicable for trading partners who have registered to exchange EDI transactions using the EDI Registration form.