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Electronic Transactions

Sunshine Health is committed to providing our participating providers with the best tools possible to support their administrative needs.  Our electronic transactions capabilities will speed up the processing and payment of your claims.

PaySpan

Sunshine Health and PaySpan are in partnership to provide an innovative web based solution for Electronic Funds Transfers (EFT’s) and Electronic Remittance Advices (ERA’s).

Secure Web Portal

Secure Web Portal functions include verify member eligibility, check/submit claims and submit/confirm authorizations.

EDI

Electronic Transactions (EDI) support for HIPAA transactions is provided for the health plan by Centene Corporation. Centene is currently receiving professional, institutional, and encounter transactions electronically, as well as generating an electronic remittance advice/explanation of payment (ERA/EOP). To conduct other HIPAA transactions not listed, please contact our EDI department at 1-800-225-2573, ext. 6075525.

The following list contains contact information for the trading partners currently active with our health plan. All providers are encouraged to contact one of these trading partners to utilize our electronic transaction options.

Clearinghouse/Direct SubmitterPayer ID
Emdeon/WebMD/Envoy/Change Healthcare
Capario is now part of change Healthcare
Medical - 68069
Medicare Advantage - 68069
Cenpatico - 68068
Availity68069; Cenpatico - 68068
Emdeon68069; Cenpatico - 68068
Smart Data Solutions68069; Cenpatico - 68068
Allscripts/Payerpath68069; Cenpatico - 68068
IGI68069; Cenpatico - 68068
Claimsource68069; Cenpatico - 68068
Claim Remedi68069; Cenpatico - 68068
Claim MD68069; Cenpatico - 68068
Medassets/Xactimed68069; Cenpatico - 68068
Practice Insight68069; Cenpatico - 68068
SSI68069; Cenpatico - 68068
Relay/McKesson68069; Cenpatico - 68068
MDonline68069; Cenpatico - 68068
Eligibility68069; Cenpatico - 68068
Encoda68069; Cenpatico - 68068
Experian68069; Cenpatico - 68068
Great Expectations68069; Cenpatico - 68068
Inmediata68069; Cenpatico - 68068
Ability (formally MDonline)68069; Cenpatico - 68068
Zirmed68069; Cenpatico - 68068
Trizetto Provider Solutions68069; Cenpatico - 68068

Documentation