Ohio Medical

Medicare of Ohio    

  • Direct- Palmetto GBA
  • Needs to be entered in Claimstaker
  • Submitter ID:   N10155
  • Payer ID – PMGBA
  • ALL pages need to be mailed to Palmetto
  • Approval Time- Up to 10 Business Days

Medicare Enrollment Form

Medicare Change Form (To be used if provider is changing clearinghouses)

Medicaid of Ohio    

  • Emdeon Link
  • No Enrollment Forms  
  • Needs to be entered into GEMS
  • Needs to entered in Claimstaker
  • Payer ID – SKOH0

 

BCBS of Ohio

  • Direct Link
  • No enrollment forms
  • Payer ID – ANTOH

 

Ohio Medical Mutual    

  • Emdeon Link
  • No Enrollment Forms  
  • Needs to be entered into GEMS
  • Payer ID – 29076

 

National Payers Requiring Enrollment

  • Railroad Medicare
  • DMERC (Region B)
  • ASHN

National Enrollment Forms