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PAYER ID 12B12 SUBMITTER ID P0003785 Emdeon ERA Provider Information Form This form is to ensure accuracy in updating the appropriate account Provider Organization Practice/ Facility Name Provider Name Tax ID Client ID Site ID Address City/State Zip Code Contact Name E-mail Address Telephone Fax Vendor Emdeon certified vendor used to submit files to Emdeon Vendor Submitter ID Vendor Name Division ID Payer 12B12 LOUISIANA BCBS ERA Group ID Individ...
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Emdeon ERA Form Division is a division within Emdeon that handles the processing of ERA (Electronic Remittance Advice) forms.
Healthcare providers and organizations that receive electronic remittance advice are required to file with the Emdeon ERA Form Division.
To fill out the Emdeon ERA Form Division, healthcare providers need to gather the necessary remittance advice information and submit it electronically through the Emdeon platform.
The purpose of the Emdeon ERA Form Division is to streamline the processing of electronic remittance advice, making it easier for healthcare providers to receive and manage payment information.
The Emdeon ERA Form Division requires healthcare providers to report information such as patient identifiers, service codes, payment details, and adjustments.
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