Hawaii Medical

Medicare of Hawaii      

  • Direct Link
  • Claims processed through Palmetto GBA
  • Need to do both parts
  • These forms include claim and ERA setups
  • Payer ID – 01001

Medicare Enrollment Packet

Provider Authorization Form

Medicaid of Hawaii

  • Emdeon Link
  • Needs to be entered into Gems
  • Vendor Submitter ID: C2YW Vendor Name: Apex EDI Site ID: 0001 Division ID: 17011
  • Payer ID – SKHI0

Medicaid Enrollment Form

BCBS of Hawaii

  • Emdeon Link
  • Needs to be entered into Gems
  • Vendor Submitter ID: C2YW Vendor Name: Apex EDI Site ID: 0001 Division ID: 17011
  • Payer ID – SB971

BCBS Enrollment Form

National Payers Requiring Enrollment

  • Railroad Medicare
  • DMERC (Region D)
  • ASHN

National Enrollment Forms