Provider Notification: Availity As Our Primary Gateway Connection

Date: 02/16/17

February 16, 2017

Dear Sunshine Health Provider,

This letter is informational only, and requires no action from you.

Thank you for your continued partnership with Sunshine Health.  In an effort to improve our claims processing our corporate parent, Centene Corporation, has selected Availity as their primary gateway connections for all plans including Sunshine Health. This change will allow Centene to better service our providers with more advanced engagement and communication strategies in the future.

There should be no impact to provider claims and other transactions. We are working with each impacted Clearinghouse through a migration effort including claims, eligibility and claims status. Each of these clearinghouses already submits transactions to Availity today. Clearinghouses are being asked to migrate the volume no later than February 17, 2017.

Clearinghouse list:

      Change Healthcare / Emdeon / Capario / MedAvant / ProxyMed
      TriZetto Provider Solutions / GatewayEDI
      Zirmed
      MedAssets / Xactimed
      SSI
      All Scripts / Payerpath
      SDS – Smart Data Solutions
      MD Online
      Practice Insight
      NEHEN
      Netwerkes/Optum

In summary, no change is required for our provider community.  Providers who currently submit claims through any of the clearinghouses listed below may continue to do so with no interruption to their current business process.  Your connection will remain intact.  Providers who submit directly or through other intermediaries may also continue to do so without interruption.  Your current process will remain intact as well.

If you have questions about this change please do not hesitate to contact Provider Services at 1-866-796-0530.

Very sincerely,
Sunshine Health