Arizona Medical

Medicare of Arizona  

  • Direct Link
  • Claims processed through Noridian (800) 967-7902
  • Must have Submitter ID in Claimstaker
  • Both forms need to be filled out
  • These forms include claim and ERA setups
  • Payer ID 00831

Online Registration (login required)

Online Registration Instructions  

CMS Enrollment Form (Needed if the provider has not sent Medicare claims electronically before)

Medicaid of Arizona

  • Emdeon Link
  • Needs to be entered into Gems
  • No forms required
  • Valid provider ID required
  • Set up in Claimstaker
  • Payer ID SKAZ0

 BCBS of Arizona  

  • Direct Link
  • There are no enrollment forms required for this payer
  • Valid provider ID required
  • Set up in Claimstaker
  • ERA Enrollment forms need to be faxed to E-Solutions at (602)864-3135 with Attention to Debbie Sterling
  • Payer ID 53589

BCBS of AZ ERA Enrollment Form Part 1

BCBS of AZ ERA Enrollment Form Part 2

Arizona Foundation for Medical Care

  • Emdeon Link
  • Needs to be entered into Gems
  • There are no enrollment forms required for this payer
  • Must have valid provider ID number
  • Payer ID – SX147

 Banner Health Arizona

  • Emdeon Link
  • Needs to be entered into Gems
  • There are no enrollment forms required for this payer
  • Must have valid provider ID number
  • Payer ID – SX145

National Payers Requiring Enrollment

  • Railroad Medicare
  • DMERC (Region D)
  • ASHN

National Enrollment Forms