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Electronic Transactions

CeltiCare Health is committed to providing our participating providers with the best tools possible to support their administrative needs.  Our electronic transactions capabilities will speed up the processing and payment of your claims.

CeltiCare Health and PaySpan are in partnership to provide an innovative web based solution for Electronic Funds Transfers (EFT’s) and Electronic Remittance Advices (ERA’s).

Secure Web Portal
Partial list of secure website functions include verify member eligibility, check/submit claims and submit/confirm authorizations.

Electronic Data Interchange (EDI) support for HIPAA transactions is provided for the health plan by Centene Corporation. Centene is currently receiving professional, institutional, and encounter transactions electronically, as well as generating an electronic remittance advice/explanation of payment (ERA/EOP). To conduct other HIPAA transactions not listed, please contact our EDI department at 1-800-225-2573, ext. 25525.

The following list contains contact information for the trading partners currently active with our health plan. All providers are encouraged to contact one of these trading partners to utilize our electronic transaction options.

CeltiCare Health’s Payer ID number is 68069 unless otherwise indicated below, our behavioral health partner, Cenpatico’s Payer ID number is 68068.

  • Allscripts/ PayerPath
  • Availity
  • Capario/MedAvant
  • ClaimMD
  • ClaimRemedi
  • Emdeon
  • Encoda
  • First Healthcare
  • GHNonline
  • Great Expectations
  • IGI
  • MDonline
  • Medassets/Xactimed
  • Netwerkes/Optum
  • Practice Insight
  • Relay Health/Mckesson
  • Smart Data Solutions
  • SSI
  • Trizetto/GatewayEdi
  • Zirmed

Envolve Vision is CeltiCare’s designated vendor for routine vision services.

EDI Companion Guides: