If you are a healthcare provider and have the capability to submit healthcare claims electronically and use one of the clearinghouses listed below, please use the associated payor ID to submit claims destined for HealthComp.
Clearinghouse | Medical Payor ID | Dental Payor ID |
Availity | 85729 | |
Capario | HCOMP | |
CareVu | 85729 | |
Dental XChange | DX029 | |
Emdeon/WebMD | 85729 | 85729 |
Claimant.com | 85729 | |
I-Plexus Solutions | 85729 | |
McKesson (RelayHealth) | 85729 CPID: HCFA - 3206 UB - 2934 |
|
NDC | 85729 | |
Office Ally | 85729 | |
OptumInsight (Formerly Ingenix) | 85729 | |
Tesia | 85729 |
We strongly advise that you confirm our payor ID with your clearinghouse before you submit claims electronically to us.
For questions regarding our EDI capabilities, please contact our EDI Coordinator
Online Forms
Claims — Request for Other Insurance Information
Claims — Request for Medical Information
Claims — Request for Vision Information
Downloadable Forms
COVID-19 Questionnaire
Claim Forms
Group Enrollment/Change Form
Group Enrollment/Change Form (Spanish)
Group Medical Claim Form
Group Dental Claim Form
Group Vision Claim Form
FSA / Flex Benefits Forms
Flexible Benefits Enrollment/Change Form
Flexible Benefits Plan Claim Form
HRA Claim Form
HRA Enrollment/Change Form
Direct Deposit Instructions
Direct Deposit Authorization
Direct Deposit Cancellation
Eligible Medical Expenses
Health Savings Account
Welcome Guide
Transfer Form
Other Forms
Authorization to Release PHI
Authorization to Obtain Medical Records (Spanish)
Claims - Pre Cert Form
Claims - Request for Accident Details
Claims - Request for Accident Information (Spanish)
Claims - Request for Other Insurance Information
Claims - Request for Other Insurance Information (Spanish)
Claims - Request for Primary EOB/Secondary EOB
Request for HIPAA Certificate
Request for HIPAA Certificate (Spanish)
PCP Selection