Claims Payer List

EDI Direct connects with select payers for electronic claim transactions processing. Please refer to the payer of interest to learn more about plan and transaction type availability, enrollment instructions, and other unique payer-related information.

Common Ground Healthcare Cooperative 

Common Ground Healthcare Cooperative – Payer ID 77170

http://www.commongroundhealthcare.org ›

Beginning January 1, 2014, EDI Direct will begin accepting electronic claim transactions for Common Ground Healthcare Cooperative. Providers may submit X12 837 Professional and Institutional transactions using the following options:

  • EDI Direct File Exchange web portal (batch submission)
  • SFTP connection (secure file transfer protocol)
  • Any software vendor, billing agent, or clearinghouse (through your current vendor)

If you will be submitting electronic claims directly to EDI Direct, please complete the following form. If you are using a third party vendor to submit electronic claims on your behalf, please contact them and request that they complete the enrollment form.

EDI Direct Trading Partner Enrollment Form ›

If you have questions about enrolling to submit claims to Common Ground Healthcare Cooperative through EDI Direct, please email the EDI Commercial Support Team or call 1-800-952-0495. 

Gold Coast Health Plan

Gold Coast Health Plan – Payer ID 77160

http://www.goldcoasthealthplan.org ›

Gold Coast Health Plan is currently accepting 5010 production claims.  GCHP 4010 transaction submissions will be discontinued on June 30, 2012.

EDI Direct accepts electronic claim transactions for Gold Coast Health Plan. Providers may submit X12 837 Professional and Institutional transactions using the following options:

  • EDI Direct File Exchange web portal (batch submission)
  • SFTP connection (secure file transfer protocol)
  • Any software vendor, billing agent, or clearinghouse (through your current vendor)
  • EDI Direct’s WINASAP5010, a free downloadable software program that allows you to create and submit X12 837 transactions

NOTE: Please download the WINASAP5010 Quick Reference Guide for Gold Coast Health Plan (PDF, 1.2 MB) for guidance on downloading, installing, and using WINASAP5010.

Providers may also retrieve electronic EOBs (X12 835 transactions) from Gold Coast Health Plan for X12 837 Professional and Institutional transactions only. 

Enrollment for Electronic Claims Submission

If you will be submitting electronic claims directly to EDI Direct, please complete the following form. If you are using a third party vendor to submit electronic claims on your behalf, please contact them and request that they complete the enrollment form.

EDI Direct Trading Partner Enrollment Form ›

Provider Authorization for X12 835

Vendors requesting to retrieve the 835 transaction (electronic EOB) must have authorization from their provider customer. The following form must be completed by each provider in order to retrieve an 835.

Provider 835 Authorization Form ›

 In addition, you must read and electronically sign our Trading Partner Agreement.

Trading Partner Agreement Form ›

If you have questions about submitting claims to Gold Coast Health Plan through EDI Direct, please email the EDI Commercial Support Team or call 1-800-952-0495.

HealthyCT

HealthyCT – Payer ID 77180

http://www.healthyct.org ›

Beginning January 1, 2014, EDI Direct will begin accepting electronic claim transactions for HealthyCT. Providers may submit X12 837 Professional and Institutional transactions using the following options:

  • EDI Direct File Exchange web portal (batch submission)
  • SFTP connection (secure file transfer protocol)
  • Any software vendor, billing agent, or clearinghouse (through your current vendor)

If you will be submitting electronic claims directly to EDI Direct, please complete the following form. If you are using a third party vendor to submit electronic claims on your behalf, please contact them and request that they complete the enrollment form.

EDI Direct Trading Partner Enrollment Form ›

If you have questions about enrolling to submit claims to HealthyCT through EDI Direct, please email the EDI Commercial Support Team or
call 1-800-952-0495. 

Liberty Mutual Insurance Company

Liberty Mutual Insurance Company – Payer ID 77138

http://www.libertymutual.com ›

EDI Direct is your entry-point for submitting electronic medical bills to the following Liberty Mutual Group companies for Personal Lines insurance including No Fault and Medical Payments Coverage:

  • The First Liberty Insurance Corp 
  • Liberty County Mutual Ins Co
  • Liberty Insurance Corp
  • Liberty Mutual Mid Atlantic Ins Co
  • Liberty Mutual Fire Insurance
  • Liberty Mutual Insurance Co
  • Lm Insurance Corp

EDI accepts the X12N 837 Professional and Institutional Healthcare claim transactions and enables the retrieval of electronic EOBs using the following options:

  • Submit Claims to Liberty Mutual for free using a Direct Data Entry web portal (data-key claims through MD On-line)
  • EDI Direct File Exchange web portal (batch submission)
  • SFTP connection (secure file transfer protocol)
  • A software vendor, billing agent, or clearinghouse (through your current vendor)

PLEASE NOTE: Bills for the treatment of worker’s compensation claims will not be processed if submitted to EDI Direct. Please contact Liberty Mutual directly regarding worker’s compensation claims.

Enrollment for Batch Electronic Claims Submission

If you will be submitting electronic claims directly to EDI Direct, please complete the following form. If you are using a third party vendor to submit electronic claims on your behalf, please contact them and request that they complete the enrollment form.

EDI Direct Trading Partner Enrollment Form ›

Provider Authorization for X12 835

Vendors requesting to retrieve the 835 transaction (electronic EOB) must have authorization from their provider customer. The following form must be completed by each provider in order to retrieve an 835.

Provider 835 Authorization Form ›

MD On-line Free Web Portal

You may submit claims to Liberty Mutual for free through MD On-line. MD On-line offers a Direct Data Entry (DDE) application that allows Providers to submit medical bills (CMS-1500s) through a web interface to Liberty Mutual Group companies. For further details on MD On-line’s exclusive offer for Liberty Mutual providers and to register to begin submitting claims electronically, visit MD On-Line.

Notice Regarding MD On-line: If you intend to use or are currently using the MD On-line free web portal to submit your Liberty Mutual medical bills, you do not need to enroll with EDI Direct using the Trading Partner Enrollment Form referenced above. You only need to register with MD On-line.

Attachments

Attachments required to be submitted with a Liberty Mutual medical bill (X12N 837 transaction) can be mailed. Please be sure to include the Claim Number in the upper right-hand corner and send to:

Liberty Mutual
P.O. Box 1052
Montgomeryville, PA 18936

PLEASE NOTE: Do NOT send the corresponding paper claim if submitted electronically. 

XL Health

XL Health/Care Improvement Plus – Payer ID 77082

https://www.careimprovementplus.com ›

EDI Direct accepts X12 837 Professional and Institutional transactions for the following XL Health plan:

  • Care Improvement Plus

All direct submitters (trading partners) must first enroll with EDI Direct.

Enrollment for Electronic Claims Submission

If you will be submitting electronic claims directly to EDI Gateway, please complete the following form. If you are using a third party vendor to submit electronic claims on your behalf, please contact them and request that they complete the enrollment form.

EDI Gateway Trading Partner Enrollment Form ›

In addition, you must read and electronically sign our Trading Partner Agreement.

Trading Partner Agreement Form ›