Electronic Transaction Documents for UniCare Claims
Check the data content requirements when exchanging electronically with UniCare, specifically Section B regarding the Transaction Specific Companion Documents. These instructions apply to all transaction types.
The electronic Payor ID number for the UniCare State Indemnity Plan is 80314.
Code Sets
Providers are required to bill with valid code sets. Please reference these sites for the most recent code set information:
These are third-party sites operated by independent entities over which UniCare has no control or right to control. UniCare makes no representations or warranties about the accuracy or validity of the information provided at these sites. You agree to these terms and conditions when you exit this site and link to the other site.
Electronic Remittance Advices (ERA) Registration
Please use Availity to manage account changes and new registrations for electronic remittance advices (835). Please check your organization to ensure you do not have an existing account.
For any questions, please contact Availity Client Services at 800-AVAILITY (282-4548).
Electronic Funds Transfers (EFT) Registration
CAQH for EFT is being replaced with EnrollSafe. If you are already enrolled for EFT in CAQH your information will continue. If you need to make changes to your information, it will need to be in EnrollSafe.
If you are not enrolled, visit https://enrollsafe.payeehub.org to enroll.
Please Note: EnrollSafe does not support registration or enrollment from 3rd party billing agencies currently. The provider must register and submit their enrollment requests directly through the portal.
To register you will need Employer Identification Number or Tax Identification Number, provide practice and contact information.
For step-by-step instructions please visit the EnrollSafe Help Guide or contact the Support team by calling (877) 882-0384, Monday through Friday 9:00 am to 8:00 pm, EST for questions related to registration and enrollment.
How to Submit a Corrected Claim to Avoid Rejection
To prevent your corrected claim from getting rejected as a duplicate claim, ask your software vendor to do the following:
- Populate the claim with the frequency type code of 7 (adjustment) in Loop 2300 (CLM5-3).
- Populate the Original Reference Number (ICN/DCN in Loop 2300 with the UniCare claim number).
If you file your claims using free web-based transactions without a vendor, you should also follow the above steps when submitting corrected claims to avoid the claim getting rejected as a duplicate.
Trading partners can also purchase the full Technical Report Type 3 (TR3) guides from Washington Publishing Company.
UniCare complies with HIPAA 5010 Transaction Standards and Code Sets, and with the electronic data interchange (EDI) standards for healthcare required by the Health Insurance Portability and Accountability Act (HIPAA). EDI is the computer-to-computer transfer of transactions and information. We encourage providers to submit claims electronically to improve productivity and efficiency.
UniCare has a strategic partnership with Availity to serve as our designated EDI gateway for all electronic data and transactions.
Providers, billing services, and clearinghouses that wish to establish a direct connection can register to exchange EDI transactions at www.availity.com.
For more information about UniCare electronic claims, call UniCare e-Solutions at 800-470-9630, Monday through Friday from 8 a.m. to 6 p.m. ET.
