Electronic data interchange (EDI)
Wellpoint uses Availity as its exclusive partner for managing all electronic data interchange (EDI) transactions. EDI, including electronic remittance advice (ERA), allows providers to do business faster, more efficiently, and cost-effectively.
EDI and Availity
Wellpoint uses Availity as its exclusive partner for managing all electronic data interchange transactions. Electronic data transactions, including electronic remittance advice (ERA), offer providers a fast, efficient, and cost-effective way to do business.
EDI lets you:
- Process claims faster by submitting electronically and fixing errors early with in-system notification and correction.
- Reduce overhead and administrative costs by eliminating paper claim submissions.
- Upload files through file transfer protocol (FTP) or directly in Availity Essentials as a batch or single claim submission.
You can use your existing clearinghouse vendor or billing company with Availity or become a trading partner to exchange direct transactions with Availity.
Your organization can submit and receive the following transactions through Availity’s EDI gateway:
- 837P – Healthcare claim: Professional
- 837I – Healthcare claim: Institutional
- 270/271 – Healthcare eligibility benefit inquiry and response
- 278 – Healthcare services review and response
- 278 – Healthcare services inquiry and response
- 835 – Healthcare claim payment/advice
- 276/277 – Healthcare claim status request and response
- 275 – Medical attachments
Note: All trading partners must use Availity to submit Wellpoint EDI transactions.
Payer name and ID
Payer IDs route EDI transactions to the appropriate payer.
Your Payer name is WELLPOINT, and the Payer ID is WLPNT.
Note: If you use a billing company or clearinghouse for your EDI transactions, please work with them directly to determine the payer ID. These may be different when submitting Wellpoint EDIs in Availity Essentials.
EDI resources
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.
Electronic Data Interchange trading partner
The trading partner, such as a clearinghouse, billing company, and vendor, connects with Availity’s EDI gateway to send and receive EDI transmissions easily.
Electronic remittance advice (ERA)
The ERA (835) eliminates the need for paper remittance reconciliation.
Use Availity Essentials to register and manage ERA account changes with these easy steps:
- Log in to Availity Essentials.
- Select My Providers > Enrollment Center > ERA Enrollment.
For assistance with missing or late ERA, please contact Availity Client Services at 800-282-4548.
Note: If you use a clearinghouse or vendor, please work with them on ERA registration and receive your ERAs.
Already have an Availity Essentials login and want to submit EDI transactions?
- Select My Providers > Enrollment Center > ERA Enrollment.
- Follow the steps to enroll as a trading partner.
Don’t have an Availity Essentials account?
New to Availity Essentials and want to submit EDI transactions?
- Visit Availity.com and select Get Started.
- 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.
Contact Availity
If you have any questions, please contact Availity Client Services at 800-Availity (800-282-4548), Monday through Friday, 8 a.m. to 8 p.m. Eastern time.
Interested in becoming a provider in the Wellpoint network?
We look forward to working with you to provide quality service for our members.