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Provider Name Tax ID Client ID Site ID Address City/State Zip Code Contact Name E-mail Address 2 Telephone Fax Vendor (Emdeon certified vendor used to submit files to Emdeon) Vendor Submitter ID Vendor Name Division ID Contact Name E-mail Address 3 Payer Payer ID 12M15 MISSOURI MEDICARE HOSPITAL Group ID Individual Provider ID 4 NPI ID Confirmations Send Emdeon Claim Confirmations To: Special Instructions: All Payer Registration forms must contain signatures when appli.
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2008 rating
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PTAN FAQ
Emdeon is a leading provider of revenue and payment cycle solutions that connect payers, providers and patients to improve healthcare business processes.
You have several options for enrollment. You can enroll online, or simply complete the Emdeon ePayment Enrollment and Authorization Form and return it to Emdeon by email, mail or fax to complete your enrollment. Please note, you only need to return pages 2-8 of the Emdeon ePayment Enrollment and Authorization Form.
You can use the Claims Correct and Refile application to review all the fields of a claim, correct errors that may have caused the claim to be rejected, then send the updated claim directly to the payer.
A submitter ID is assigned to any entity submitting healthcare transactions to a payer. Basically, a submitter ID is your account number with Optum.
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