Electronic data interchange (EDI)
Wellpoint uses Availity as its exclusive partner for managing all electronic data interchange (EDI) transactions.
EDI lets you:
- Process claims faster by submitting coordination of benefits electronically and fix 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 the Secure File Transfer Protocol (SFTP) or through the Availity Essentials website
HIPAA transaction codes
Providers can use the following HIPAA transaction codes and submit through Availity:
- Healthcare Claim: Professional (837P)
- Healthcare Claim: Institutional (837I)
- Healthcare Claim: Dental (837D)
- Healthcare Eligibility Benefit Inquiry and Response (270/271)
- Healthcare Services Prior Authorization (278)
- Healthcare Services Inpatient Admission and Discharge Notification (278N)
- Healthcare Claim Payment/Advice (835)
- Healthcare Claim Status Request and Response (276/277)
- Medical Attachments (275)
* Availity, LLC is an independent company providing administrative support services on behalf of Wellpoint.
EDI submissions and transactions
Availity makes submissions and transactions easy.
Availity's EDI submission options:
1. Use existing clearinghouse or billing vendor. Work with your vendor to ensure connection to the Availity EDI Gateway.
2. Become a direct submitter with the Availity EDI clearinghouse. A third-party practice or revenue cycle management system capable of generating EDI batch files is required.
Already have an Availity login but want to submit EDI transactions?
1. Log in to Availity.
2. Select My Providers > choose Enrollments Center > select Transaction Enrollment.
3. Follow the steps to enroll as a trading partner.
New to Availity and want to submit EDI transactions?
1. Choose an administrator to register your organization.
2. When the admin is ready to register, choose the register button on the top of the page.
3. Select your organization type and complete the registration process.
4. Admin should check email to verify account.
5. Once account is verified, admin will agree to the disclaimer, set up security questions, change password, and set up authorized users.
Payer name and ID
Payer IDs route EDI transactions to the appropriate payer.
Payer Name: Wellpoint
Payer ID: WLPNT
Note: If you use a clearinghouse, billing service or vendor, please work with them directly to determine payer ID.
Electronic remittance advice (ERA)
The 835 eliminates the need for paper remittance reconciliation. Use Availity to register and manage ERA account changes with these easy steps:
1. Log in to Availity.
2. Select My Providers > Enrollment Center > Transaction Enrollment.
Note: If you use a clearinghouse or vendor, please work with them on ERA registration and receiving your ERAs.
Electronic funds transfer (EFT)
Electronic claims payment through electronic funds transfer (EFT) is a secure and fast way to receive payment, reducing administrative processes. EFT deposits are assigned a trace number that is matched to the 835 electronic remittance advice (ERA) for simple payment reconciliation. Use EnrollSafe to register and manage EFT account changes.
Contact information
For more information on EDI, please refer to your provider manual or contact your Provider Relationship Management Representative.
Provider Services
Available Monday to Friday 9:00 a.m. to 5:00 p.m.
Availity Client Services
Interested in becoming a provider in the Wellpoint network?
We look forward to working with you to provide quality service for our members.