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.

Remittances and PaySpan

If you are currently receiving paper checks and would like to switch to Electronic Funds Transfer (EFT), please register with PaySpan.

Contact PaySpan via the following channels:

• Online: Payspan
• Call: 1-877-331-7154
• Email: providersupport@payspanhealth.com
  

Note: If Payspan does not have your correct address, contact Payspan to have it updated, If Sunshine Health does not have your correct address, update it using the Provider Demographic Updates Tool or by calling Provider Services at 1-844-877-8313.

Secure Provider Portals

Sunshine Health

Use Sunshine Health’s secure portal to check a member’s eligibility, verify benefits, submit a referral to Case Management, submit claims, submit claim reconsiderations, etc.

Availity Essentials

Many of the same functions described above can be completed using the Availity portal. We will inform providers when new functionalities are released.

Availity Client Services: If you need assistance, call 1-800-AVAILITY (1-800-282-4548). Assistance Monday through Friday from 8 a.m. to 8 p.m. Eastern.

Electronic Data Interchange (EDI)

Electronic Data Interchange (EDI) support for HIPAA transactions are 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, call 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.