Essence
EDI Connectivity for
Institutional Claims
Revised October 2, 2014
Essence EDI Connectivity for Institutional Claims
Table of Contents
Chapter 1: Introduction to The SSI Group, Inc.
Setting up EDI Connectivity
Costs
Contact Information
Chapter 2: Introduction to Emdeon
Setting up EDI Connectivity
Costs
Contact Information
Chapter 1: Introduction to The SSI Group, Inc.
Essence and The SSI Group, Inc® are offering facilities in the Essence network an easy and effective way to submit institutional claims electronically.
The SSI Group, Inc. At-A-Glance.
SSI leads the healthcare industry in claims management technology, EDI platforms and networking. ClickON technology has more than 200,000 built-in edits, delivering Claredi-certified transactions. SSI's EHNAC-certified clearinghouse has 800 direct payer connections including Medicare and Medicaid payers nationally. As a testament to leadership, the company annually processes over 600 million transactions totaling in excess of $800 billion in billed electronic claims revenue for its providers.
The company offers a wide range of provider / payer / physician services and technologies for managing the revenue cycle - claims processing (ASP / Direct / Clearinghouse), document management and business office outsourcing of paper claims. The company maintains corporate headquarters in Mobile, Alabama and branch facilities in Clearwater, Florida and Chesapeake, Virginia. SSI has over 400 employees and 2,400-plus customers nationwide
Please visit or contact Customer Service for more information:
The SSI Group Inc. Customer Service: 1-800-820-4774
Setting up EDI Connectivity
Payer ID
Essence Payer ID and Sub ID for The SSI Group, Inc. Institutional Claims: Payer ID and Sub ID 99999-0648.
Current SSI Clients
If you are currently partnered with The SSI Group, Inc. as your clearinghouse, please contact your SSI Group account representative or The SSI Group’s Customer Service to inquire about sending your Essence claims electronically. New clients can contact The SSI Group, Inc. sales department at 800-881-2739
Current Connection via Existing Clearinghouse
Many clearinghouses already have a connection to The SSI Group, Inc. (e.g. Availity, MedAvant, PayerPath, PostNTrack); therefore, you may be able to utilize your current clearinghouse in order to send Essence claims electronically.
To find out if your current clearinghouse has a connection to The SSI Group, Inc., please contact The SSI Group’s Customer Service at 800-820-4774.
New Clients
If a provider is not using a clearinghouse that is currently submitting to The SSI Group, Inc. and they want to send Essence claims to The SSI Group, Inc., please visit contact Customer Service:
The SSI Group Inc. Customer Service: 1-800-820-4774
Costs
The cost of sending Essence claims to The SSI Group, Inc. will be dependent on the software package utilized by the provider. Please contact The SSI Group’s Customer Service to speak to a sales representative to determine associated costs.
Contact Information
For more information regarding setup with The SSI Group, Inc. and/or further assistance, please contact:
The SSI Group, Inc.
Physician Sales Representative
Phone: 800-881-2739
Essence
Customer Service
Phone: 314-209-2700
Phone Toll Free: 866-597-9560
Email:
For ongoing support and/or further assistance from The SSI Group, Inc, please contact:
The SSI Group, Inc. Help Desk:1-800-820-4774
Chapter 2: Introduction to Emdeon
POBOX 12488
St. Louis, MO63132
Essence – Payer ID 20818
Dear Essence Providers:
In an effort to expand our acceptance of electronic claims, streamline claims processing and reduce claims payment turn-around times, we have partnered with an additional vendor/clearinghouse. Payer ID 20818 is now activated for sending claims electronically to Essence.
If you already submit claims electronically via one of our other Payer ID’s then no change is necessary. However, if the claim ID’s on your Essence Remittance Notice do not indicate an “E” in the sixth position, we are not receiving your claims electronically. If you have been unable to send claims via one of our other Payer ID’s please use Payer ID 20818 when submitting to your system vendor, clearinghouse, or billing service.
Please note that the Rendering Provider’s NPI and Tax ID need to be registered with Essence Healthcare priorto initiation of electronic claims. If you need assistance with this matter, please call Essence Healthcare Customer Service Monday-Friday 8:00AM-5:00PM at 314-209-2700 or toll free at 1-866-597-9560. You can also reach us via email at .
Technical questions regarding that submission should be directed to your system vendor, clearinghouse or billing service. However, if you have specific billing, eligibility or benefit questions regarding an Essence member or the Plan, please contact Essence Customer Service Monday-Friday 8:00AM-5:00PM at 314-209-2700 or toll free at 1-866-597-9560 or via email to . You can also visit our website at
Our goal is the same, to process your claims timely and accurately so let’s help ourselves by eliminating the paper and margin for errors by using electronic claims submission.
Thank you,
Essence
Setting up EDI Connectivity
Payer ID
Essence Payer ID for Emdeon Institutional Claims: Payer ID 20818.
Current Emdeon Clients
If you are currently partnered with Emdeon as your clearinghouse, the transition for sending EDI to Essence will be seamless. Just populate our Payer ID on the claim. For questions regarding sending claims via Emdeon, please contact your account representative or Customer Service to inquire about sending your Essence claims electronically:
EmdeonCustomer Service: 1-877-EMDEON-6 (877-363-3666)
Current Connection via Existing Clearinghouse
Many clearinghouses already have a connection to Emdeon(e.g. Availity, Misys, Zirmed); therefore, you may be able to utilize your current clearinghouse in order to send Essence claims electronically.
To find out if your current clearinghouse has a connection to Emdeon, please contact Customer Service to speak to a sales representative:
Emdeon
Customer Service
Phone: 1-877-EMDEON-6 (877-363-3666)
New Clients
If a provider is not using a clearinghouse that is currently submitting to Emdeon and they want to send Essence claims to Emdeon, they will need to contact Customer Service to speak to a sales representative:
Emdeon
Customer Service
Phone: 1-877-EMDEON-6(877-363-3666)
Costs
The cost of sending Essence claims to Emdeon will be dependent on the software package utilized by the provider. Please contact Emdeon Customer Service to speak to a sales representative to determine associated costs.
Contact Information
For more information regarding setup with Emdeon and/or further assistance, please contact:
Emdeon
Customer Service
Phone: 1-877-EMDEON-6(877-363-3666)
Essence
Customer Service
Phone: 314-209-2700
Phone Toll Free: 866-597-9560
Email:
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