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
Partial list of secure website 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 Submitter Payer ID
Emdeon/WebMD/Envoy/Change Healthcare
Capario is now part of change Healthcare
Medical - 68069
Medicare Advantage - 68069
Cenpatico - 68068
Availity 68069; Cenpatico - 68068
Emdeon 68069; Cenpatico - 68068
Smart Data Solutions 68069; Cenpatico - 68068
Allscripts/Payerpath 68069; Cenpatico - 68068
IGI 68069; Cenpatico - 68068
Claimsource 68069; Cenpatico - 68068
Claim Remedi 68069; Cenpatico - 68068
Claim MD 68069; Cenpatico - 68068
Medassets/Xactimed 68069; Cenpatico - 68068
Practice Insight 68069; Cenpatico - 68068
SSI 68069; Cenpatico - 68068
Relay/McKesson 68069; Cenpatico - 68068
MDonline 68069; Cenpatico - 68068
Eligibility 68069; Cenpatico - 68068
Encoda 68069; Cenpatico - 68068
Experian 68069; Cenpatico - 68068
Great Expectations 68069; Cenpatico - 68068
Inmediata 68069; Cenpatico - 68068
Ability (formally MDonline) 68069; Cenpatico - 68068
Zirmed 68069; Cenpatico - 68068
Trizetto Provider Solutions 68069; Cenpatico - 68068

Documentation (PDF)