Electronic Claims and Payments
Vendor information
Providence Health Plan designates Zelis to carry out all claim payment-related functions, including check issue, EFT payments, and online EOPs. We no longer offer direct EFT payment arrangements. If you are interested in arranging electronic payments, please contact your bank or Zelis (855 496-1571) directly for assistance.
Below is a list of clearinghouses that Providence Health Plan has a direct connection with for submitting electronic claims and providing electronic remittance advice.
Providence Health Plan offers free electronic claim transaction fees for our members, so there will be little cost to you to send claims electronically.
Electronic claims are paid on an average of 10 business days.
| Vendor Name | Contact Information | Transaction Types | Plan ID / Payer ID Numbers |
|---|---|---|---|
| Optum (formerly Change Healthcare) | https://www.unitedhealthgroup.com/ns/changehealthcare/iedi.html |
|
SX133 |
| Office Ally | https://cms.officeally.com/ 360-975-7000 |
|
PHP01 |
| SSI Group | https://thessigroup.com/ 800-820-4774 |
|
SX133 |
| Trizetto Provider Solutions | https://www.trizettoprovider.com/ 800-556-2231 |
|
PHP01 |
| VisibilEDI | https://www.visibiledi.com/ 503-345-6440 |
|
PHP01 |
Download this information here (PDF)
If your clearinghouse is not listed, contact your vendor to check if they have a connection to one of the listed clearinghouses. Also check the internet for payer IDs by looking for your clearinghouse and finding the payer identification list.
835 Electronic Remittance Advice (ERA). If you are interested in receiving the 835 Electronic Remittance Advice (ERA) from Providence, please contact your clearinghouse as they will set it up for you. Once ready, the clearinghouse will contact Providence Health Plan to start sending your ERA data. The ERA will be available on Mondays and Wednesdays of each week from your clearinghouse.
Regarding electronic claims or electronic remittance advice questions:
Please send questions on electronic claims or ERAs to PHPEDISupport@Providence.org.
Please include your tax id and clearinghouse information.