Colorado Medical

  Medicare of Colorado

  • Direct- Trailblazers
  • Needs to be entered in Claimstaker
  • Payer ID- 00824
  • Only need pages 1-8
  • Mail to Trailblazers
  • Approval Time – 20 Business days upon receipt of the paperwork

Medicare Enrollment Form

Medicare ERA Enrollment Form

 Medicaid of Colorado

  • Direct Link
  • Claims processed through ACS EDI Gateway
  • Call (800) 237-0757 to follow-up on enrollment
  • The form listed below is for providers who have a valid provider ID and a submitter ID with Medicaid (most providers). If the provider is not set up at all with Medicaid go to and download the applicable form to become a Medicaid provider.
  • Payer ID – 77016

Medicaid Enrollment Form

Medicaid Update Form

Medicaid ERA Enrollment Form

 BCBS of Colorado

  • Direct Link
  • No forms required
  • Must Call Paula @ (303) 831-2427 To Verify Correct Provider Id.
  • Set up in Claimstaker
  • Payer ID – COBCS

 National Payers Requiring Enrollment

  • Railroad Medicare
  • DMERC (Region C)
  • ASHN

National Enrollment Forms