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A note about NPI: Register Your NPI with your health plans.
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Providers must ensure they have correctly registered their Group Level NPI
(National Provider Identifier) with any applicable health plans. TransUnion Healthcare
is not responsible for registering individual NPI numbers or verifying the accuracy
of the NPI registered for a given provider.
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BCBS Plans: Enrollment through any BCBS plan outside of your provider’s state will
not be required as the enrollment will likely reject. All providers should submit
through the local BCBS plan for their state as the Blue Exchange network allows
transactions for out-of-state members to route to the appropriate destination.
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Aetna
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Aetna requires specific NPI registration for all electronic transactions. Please submit the NPI directly via the NPI Submission Form on the Aetna website and view the attached documents which define this requirement and process in detail.
Questions regarding the NPI registration and enrollment process should be directed to Aetna's provider line at 1-888-632-3862.
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2-5 business days
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AgeWell NewYork *
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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Alameda Alliance Health Plan *
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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AmeriHealth
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Please provide the following fields to tupartnersupport@transunion.com
- Provider name
- Group level NPI
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1-3 weeks
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AmeriHealth Administrators
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Please provide the following fields to tupartnersupport@transunion.com
- Provider name
- Group level NPI
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1-3 weeks
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Aspire Health Plan*
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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BCBS of Delaware
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Please provide the following fields to tupartnersupport@transunion.com
- Provider name
- Group level NPI
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1-3 weeks
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BCBS of Michigan (Professional)
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Follow the below BCBS of Michigan (Professional & Institutional) enrollment instructions:
- Visit https://editest.bcbsm.com/tpalogon.html
- Enter your TPA User ID and password.
- Note: If a provider is unable to login, that means the user ID and password are invalid. Provider should call BCBS MI to obtain their correct user ID and password – 800.542.0945, option 3 or email EDISupport@bcbsm.com.
- Note: If a provider doesn’t know their User ID and password, they can contact BCBS MI at 800.542.0945, option 3 or email EDISupport@bcbsm.com to obtain their TPA User ID and PW.
- Once you are logged in, choose Professional Provider Authorization or Institutional Provider Authorization.
- Then enter the following information:
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- Provider ID (PIN) = Leave this field blank
- NPI = Provider or Organization’s NPI
- Source of Payment = Blue Cross Blue Shield
- Submitter ID = c0ina (note the zero) for Professional Providers
- Submitter ID = 204202692 for Institutional Providers
- Unique Receiver ID = Leave this field blank
- Provider email address = Confirmation will go to this email
5. Click Submit
After completing the steps above, BCBS MI will send a confirmation email that the enrollment will become effective in 48 hours. The payer will not send another email. Transactions should work in 48 hours.
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2 business days
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BCBS of Pennsylvania (Highmark) [Professional]
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Please provide the following fields to tupartnersupport@transunion.com
- Provider name
- Group level NPI
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1-3 weeks
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BCBS of West Virginia
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Please provide the following fields to tupartnersupport@transunion.com
- Provider name
- Group level NPI
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1-3 weeks
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Beacon Health Strategies *
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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Blue Cross Independence (Pennsylvania)
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Please provide the following fields to tupartnersupport@transunion.com
- Provider name
- Group level NPI
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1-3 weeks
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Blue Cross Pennsylvania (Capital)
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Email completed enrollment forms to tupartnersupport@transunion.com
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2 weeks
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California Children Services *
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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California Medicaid (Medi-Cal)
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No special enrollment, but the provider's pin (6, 7, or 8 digits) must be sent on ALL transactions.
You can validate the NPI/PIN combination by entering them as UserID and password, at https://www.medi-cal.ca.gov/
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N/A
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Care1st of California *
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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Central Health Medicare Plan
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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Consolidated Health Plan*
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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Crystal Run Health Plans*
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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Gold Coast Health Plan *
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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Health Partners of MN
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Please provide the following fields to tupartnersupport@transunion.com
- Provider Name (Group)
- Physical Address
- NPI (Group level)
- TIN (Group level)
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1 week
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Highmark Senior Solutions
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Please provide the following fields to tupartnersupport@transunion.com
- Provider name
- Group level NPI
*WV providers only
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1-3 weeks
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Independence Administrators
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Please provide the following fields to tupartnersupport@transunion.com
- Provider name
- Group level NPI
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1-3 weeks
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Iowa Medicaid
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Iowa Medicaid enrollment instructions:
Providers will need to logon to the EDISS Connect Portal to complete the enrollment:
Visit https://connect.edissweb.com/
Follow the instructions in the attached document.
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1 Business day
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Kaiser Foundation Health Plan of Colorado
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Enrollment Requirement for ALL Kaiser Health Plans:
New Providers Only must be enrolled. Providers that are already submitting are exempt.
Please provide the following fields to tupartnersupport@transunion.com
- Name of Provider
- Physical Address
- Contact Name
- Contact Phone
- Contact Email
- Provider ID / NPI
- Tax ID
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2 weeks
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Managed Care Systems*
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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Maryland Medicaid
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Enrollment form must be filled out with original/physical signature.
Mail completed form to:
TransUnion
Attn:Enrollment
6100 Fairview Rd Suite 1200
Charlotte, NC 28210
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2-3 business days
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Medicare (Part A & B)
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Before submitting to Medicare, TransUnion Healthcare must verify your NPI with CMS.
If you have already selected Medicare as a payer, we have been alerted to validate your NPI with Medicare; if you receive a rejection on Medicare transactions, please email tupartnersupport@transunion.com for assistance.
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2-3 business days
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Medicare (Part A & B) – MBI Lookup & Eligibility
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Before submitting to Medicare, TransUnion Healthcare must verify your NPI with CMS.
If you have already selected Medicare as a payer, we have been alerted to validate your NPI with Medicare; if you receive a rejection on Medicare transactions, please email tupartnersupport@transunion.com for assistance.
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2-3 business days
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Medicare Advantage - Pennsylvania
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Please provide the following fields to tupartnersupport@transunion.com
- Provider name
- Group level NPI
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1-3 weeks
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Michigan Medicaid
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Providers will need to logon to Michigan Medicaid’s CHAMPS system and associate both Billing Agent ID's 2243495 and 1630780 with their group level NPI.
How to Questions for the website should be referred to Michigan Medicaid, Provider Enrollment Support, 800-292-2550 option #4
CHAMPS website:
https://milogintp.michigan.gov
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2 business days
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Michigan Medicaid Pending Eligibility
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Providers will need to logon to Michigan Medicaid’s CHAMPS system and associate both Billing Agent ID's 2243495 and 1630780 with their group level NPI.
How to Questions for the website should be referred to Michigan Medicaid, Provider Enrollment Support, 800-292-2550 option #4
CHAMPS website: https://sso.state.mi.us/
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2 business days
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Nebraska Medicaid
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Email completed enrollment forms to tupartnersupport@transunion.com
To ensure there are no additional delays, please confirm that the provider taxonomy and zip+4 included on the enrollment forms are identical to the taxonomy and zip+4 the payer has on file for that particular provider. Incorrect or inaccurate information included on enrollment forms will result in a payer rejection.
Please also note that Nebraska Medicaid enrollment forms should be completed with group level information only.
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2 weeks
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North Carolina Medicaid
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While 270/271 eligibility transactions do not require special enrollment for NC Medicaid, a special enrollment process is required for 276/277 claim status transactions.
To complete the enrollment for 276/277 transactions, credentialed providers will need to log into the NCTracks portal and associate TransUnion's numeric billing agent ID (50300605) to their NPI via the "Manage Change Request" section of the portal. Please see the attached instructions regarding how to associate your NPI to the TransUnion Clearinghouse billing agent ID.
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Presbyterian Health Plan *
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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Rhode Island Medicaid *
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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Riverlink Health*
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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Texas Medicaid - Long Term Care
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Texas Medicaid – Long Term Care
Texas Medicaid - Long Term Care requires a three-step enrollment process for EDI transactions. If the provider has completed any of the earlier steps, they may simply skip to the next relevant step.
Step 1 (Contracting with Texas Medicaid - Long Term Care):
Providers must be contracted with this payer before submitting an enrollment. To contract with Texas Medicaid - Long Term Care, providers can visit the DADS website at: http://www.dads.state.tx.us/providers/. Providers can also contact DADS Provider Enrollment at Texas.Medicaid.Enrollment@dads.state.tx.us. Once DADS processes the contract application, the provider will be given a “Contract Number”.
Step 2 (Completing the EDI Agreement):
The provider is required to submit an EDI Agreement form to Texas Medicaid. Providers with a valid Contract Number that have not completed the EDI agreement form must do so by completing the following Electronic Data Interchange Agreement for Long Term Care Providers: Texas Medicaid EDI Trading Partner Agreement. Once completed, the form must be mail it to TMHP at the following address:
Texas Medicaid & Healthcare Partnership
Attention: EDI Help Desk, MC–B14
PO Box 204270
Austin, TX 78720-4270
Step 3 (Completing the Submitter ID Linking Form):
Providers with a valid Contract Number will then need to fill out a Submitter ID linking form: TX Medicaid Submitter ID Linking Form. The provider will need to fill out all sections on this form.
Section I. Provider Number field must contain the providers “Contract Number” not the provider’s NPI.
Section II, Submitter ID: is 146215201 and “I want to link this Submitter ID and Provider Number” box should be checked
*Please note, the Submitter ID Linking form is annexed to the EDI Agreement and can, therefore, be submitted to the payer concurrently with the EDI Agreement if the provider has not completed step 2.
If the provider has any questions/issues about any of the steps during this enrollment process, they can get help directly from Texas Medicaid EDI by calling The TMHP EDI Helpdesk at 1-888-863-3638 option 4.
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Up to 2 months for new providers & 30 days providers completing step 3 only.
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Unified Group Services*
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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University Health Alliance*
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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Utah Medicaid
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Utah Medicaid requires providers to enroll directly via their PRISM system. For providers that are already enrolled with Utah Medicaid but submitting to a different Trading Partner/Clearinghouse, the enrollment process will need to be completed again and the new Trading Partner/Clearinghouse information entered during step 10 of the application process.
To enroll with the Utah Medicaid PRISM system please visit: https://medicaid.utah.gov/accessing-prism
If you have questions, please call Provider Enrollment at (801) 538-6155, or toll-free 1-800-662-9651 (option 3 then 4) or by email: providerenroll@utah.gov.
For a step by step walk through of submitting the enrollment application through PRISM please visit: https://medicaid.utah.gov/pe-training
Enrollment Process Notes:
During the application process, when completing step 9 of the application, please select EDI Submission Details – UHIN as well as check the UHIN mode of submission option. You will be able to select your desired Trading Partner during step 10.
· When adding the TransUnion Trading Partner ID, please use the following:
Utah Medicaid Trading Partner ID (TPID): HT006748-001
Contact Information: TransUnion Healthcare, Inc. 555 West Adams Street Chicago, IL 60661
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2 - 4 weeks
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Value Options *
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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WINhealth Partners *
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Web Credentials Required.
Submit a request for enrollment using your web portal "Web Credentials" page.
Refer to the Web Credential Enrollment guide for more details.
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3-5 business days
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Enrollment Information:
TransUnion Healthcare
Attn: Enrollment
6100 Fairview Rd Suite 1200
Charlotte, NC 28210
Email: TUPartnerSupport@transunion.com
Phone: 877-732-6853
Fax: 704-970-1436
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