Electronic Claims
Electronic Data Interchange (EDI) is the computer-to-computer exchange of business data in standard formats. EDI transmissions must follow the transaction and code set format specifications required by the Health Insurance Portability and Accountability Act (HIPAA).
CareSource has invested in an EDI system to enhance our service to participating providers. Our EDI system complies with HIPAA standards for electronic claims submission. We are committed to offering you the most flexible and efficient means possible of doing business with us.
EDI Clearinghouses
To submit claims electronically, providers must work with an electronic claims clearinghouse. CareSource currently accepts electronic claims from Ohio providers through the clearinghouses listed below. Please contact the clearinghouse of your choice to begin electronic claims submission. Please provide the clearinghouse with the CareSource payer ID number: 31114.
|
Clearinghouse |
Contact Number |
|
Consult |
1-800-327-1213 |
|
CPS (Computer Processing Services) |
1-888-255-7293 |
|
Dyserv |
(614) 294-6078 |
|
Emdeon (formerly known as WebMD) |
1-800-845-6592 |
|
Manacon |
(937) 746-6685 |
|
Practice Insight |
(832) 476-9030 or
(713) 333-6000 |
|
RelayHealth |
1-866-735-2963 |
|
Quadax |
(440) 777-6305 |
|
ZirMed |
1-877-494-7633 |
File Format
CareSource accepts electronic claims in the 837 ANSI ASC X12N (004010A1) file format for professional, hospital and dental claims.
If you have questions, call our service center toll free at 1-800-488-0134. Representatives are available to speak with you 8 a.m. to 6 p.m., Monday through Friday, except holidays.