Setting Up for Medicare EDI Claims through Availity

Once you have registered for Availity's Medicare claims service, you must configure your PMS, HIS, or other EDI system with the correct payer IDs and billing provider ID before you can send Medicare EDI claims through Availity®. You might need to contact the vendor of your system for assistance with this process. Once your system is configured, you can upload EDI transmission files as you do commercial transmission files.

Note: Availity accepts EDI transactions in ANSI X12 format only.

Payer ID

The payer ID is the identifier associated with the payer and, if applicable, the intermediary. Refer to the Availity Health Plan Partners list or the implementation guide for payer IDs.


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