Electronic claims
About electronic claim filing
Electronic transaction documents for Wellpoint claims
Check the data content requirements when exchanging electronically with Wellpoint, specifically Section B regarding the Transaction Specific Companion Documents. These instructions apply to all transaction types.
The electronic Payor ID number for Wellpoint is WLPNT.
Code sets
Providers must bill with valid code sets. Refer to the following websites for the most recent code set information:
Centers for Medicare & Medicaid Services
These are third-party sites operated by independent entities over which Wellpoint has no control or right to control. Wellpoint makes no representations or warranties about the accuracy or validity of the information provided at these sites. You agree to these terms and conditions when you exit this site and link to the other sites.
Registering for Electronic Remittance Advices (ERA)
Use Availity to manage account changes and new registrations for electronic remittance advices (835). Before you create a new Availity account, check whether your office already has one set up.
For any questions, contact Availity Client Services at 800-AVAILITY (800-282-4548).
Registering for Electronic Funds Transfers (EFT)
To log in or register for EnrollSafe, visit https://enrollsafe.payeehub.org . When you register, you will need to provide an Employer Identification Number or Tax Identification Number, as well as practice and contact information.
Please note: EnrollSafe does not currently support registration or enrollment from third party billing agencies. Providers must register and submit their enrollment requests directly through the portal.
For step-by-step instructions, refer to the EnrollSafe Help Guide or contact EnrollSafe Support at 877-882-0384, Monday through Friday 9:00 am to 8:00 pm ET.
How to prevent rejection when submitting corrected claims
To prevent your corrected claim from getting rejected as a duplicate, ask your software vendor to do the following:
- Populate the claim with the frequency type code of 7 (adjustment) in Loop 2300 (CLM5-3).
- Populate the Original Reference Number (ICN/DCN in Loop 2300 with the Wellpoint claim number).
Even if you are submitting corrected claims through web-based transactions instead of a software vendor, you should still follow these steps to avoid rejected claims.
Trading partners can also purchase the full Technical Report Type 3 (TR3) guides from Washington Publishing Company.
Providers, billing services, and clearinghouses that wish to establish a direct connection can register to exchange EDI transactions at www.availity.com.
For more information about Wellpoint electronic claims, call Wellpoint e-Solutions at 800-470-9630, Monday through Friday from 8 a.m. to 6 p.m. ET.