Medicaid Providers

Electronic data interchange

Availity serves as our electronic data interchange (EDI) partner for all electronic data and transactions.

Methods to exchange EDI transmissions with the Availity EDI gateway:

  1. If you are already exchanging EDI files, you can use your existing clearinghouse or billing company for your Healthy Blue transmissions. Please work with them to ensure connectivity to the Availity EDI gateway.
  2. Become a direct trading partner with the Availity EDI gateway.
  3. Use a direct, single claim entry through the Availity Portal.

Providers, billing services and clearinghouses who are not currently exchanging EDI transactions can register with Availity.

The Availity Welcome Application is your map to setting up your business for exchanging EDI transactions with Availity.

Already registered with Availity?

Use your existing login and choose My Providers > Enrollments Center.

Additionally, the following will guide you through the transition and provide detailed instructions:

Your organization can exchange the following transactions through the Availity EDI gateway:

  • 837 — Institutional claims
  • 837 — Professional claims
  • 837 — Dental claims
  • 835 — Electronic remittance advice
  • 276/277 — Claim status (batch)
  • 270/271 — Eligibility request (batch)

Payer name and ID
Your payer name is Healthy Blue North Carolina, and the payer ID is 00602.

Electronic funds transfer registration

To register or manage account changes for electronic funds transfer (EFT) only, use the Council for Affordable Quality Healthcare (CAQH®) Solutions EnrollHubâ„¢ tool, a secure, electronic EFT registration platform. This tool eliminates the need for paper registration, reduces administrative time and costs, and allows you to register with multiple payers at one time.

If you were previously registered to receive EFT only, you must register with EnrollHub to manage account changes.

Electronic remittance advice registration

You can also use the Availity link to register and manage electronic remittance advice (ERA) accounts.

  • If you were previously registered to receive ERA, you must register using Availity to manage ERA account changes.

Navigate to My Providers > Enrollments Center > ERA Enrollment.

Contacting Availity

For questions, please contact Availity Client Services at 1-800-Availity (1-800-282-4548) Monday through Friday 8 a.m. to 7:30 p.m. Eastern time.

Provider tools & resources

Interested in becoming a provider in the Healthy Blue network?

We look forward to working with you to provide quality services to our members.