Illinois Medical

Medicare of Illinois

  • Direct- WPS Part B Legacy
  • Needs to be entered in Claimstaker
  • Submitter ID: 17680
  • Payer ID – 00952
  • Fax to WPS Medicare EDI at 618-998-5170
  • Attach Cover Sheet- attention to EDI Department
  • Approval Time- 10 Business days

Medicare Enrollment Form

Change of Submitter Form

ERA Enrollment Form

Medicaid of Illinois

  • Direct Link
  • No enrollment forms
  • Enter valid ID and enrollment in Claimstaker
  • Payer ID – IL621

 

BCBS of Illinois

  • Direct Link
  • No enrollment forms
  • Enter valid ID and enrollment in Claimstaker
  • Payer ID – 00621

 

National Payers Requiring Enrollment

  • Railroad Medicare
  • DMERC (Region B)
  • ASHN  

National Enrollment Forms