Emdeon ERA Provider Information Form 2025

Get Form
Emdeon ERA Provider Information Form Preview on Page 1

Here's how it works

01. Edit your form online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send it via email, link, or fax. You can also download it, export it or print it out.

The easiest way to modify Emdeon ERA Provider Information Form in PDF format online

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2

Handling paperwork with our feature-rich and user-friendly PDF editor is simple. Follow the instructions below to fill out Emdeon ERA Provider Information Form online easily and quickly:

  1. Sign in to your account. Sign up with your email and password or register a free account to test the service prior to choosing the subscription.
  2. Upload a form. Drag and drop the file from your device or import it from other services, like Google Drive, OneDrive, Dropbox, or an external link.
  3. Edit Emdeon ERA Provider Information Form. Easily add and highlight text, insert images, checkmarks, and symbols, drop new fillable fields, and rearrange or remove pages from your paperwork.
  4. Get the Emdeon ERA Provider Information Form completed. Download your modified document, export it to the cloud, print it from the editor, or share it with other participants using a Shareable link or as an email attachment.

Make the most of DocHub, the most straightforward editor to rapidly manage your documentation online!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
Office Ally is a full-service, cloud-based clearinghouse employed by health and wellness professionals who accept insurance for their services. Office Ally software allows providers to create, submit, and track insurance claims, as well as run reports, check eligibility, and verify codes.
The submitter ID is an internal ID used by Optum. If you would like to pursue individual submitter IDs, please docHub out to our team at assuranceediimplementations@changehealthcare.com to schedule a call for additional information.
Who uses Change Healthcare? CompanyWebsiteCountry Florence Healthcare florencehc.com United States EverCommerce evercommerce.com United States OneMedical Group onemedicalgroup.co.uk United Kingdom Cognizant Technology Solutions Corp cognizant.com United States1 more row
Change Healthcare FormerlyEmdeon Number of employees c. 14,000 (2022) Parent UnitedHealth Group Website changehealthcare.com Footnotes / references Financials as of March 31, 202210 more rows
CPIDPayer NamePayer ID 1077 IDEALCARE UV440 1083 TRANSAMERICA LIFE INSURANCE COMPANY - PLANO AND HU TRTLC 1087 SOLIDARITY HEALTHSHARE SH777 1088 EMPLOYEE BENEFIT SERVICES, INC. (EBSI) 60221161 more rows

People also ask

Once Office Ally receives your Change Healthcare ERA Enrollment Form, we will process the request within 24-48 hours. o Note: Incomplete forms will delay the enrollment process. Every field is required. The time it takes ERAs to start coming through is dependent upon that individual payer.

Related links