Pennsylvania Dental

Medicaid of Pennsylvania  

  • Emdeon Link
  • Payer ID – CKPA1

Medicaid Enrollment Form

BCBS of Pennsylvania (Also known as United Concordia)        

  • Direct Link
  • Payer ID – 89070 and 54771
  • If the office does not have a provider ID:
    • The office needs to call UCCI at (800) 633-5430, option 3, and let UCCI know that they will be submitting claims through Apex EDI.   Be sure to have them acknowledge every provider in the office that submits claims to UCCI.
  • If the office knows their provider ID you can submit the online form for them:
  • To Enroll for ERA’s:

 

Three Rivers Health Plan of Monroe PA

  • Emdeon Link
  • No Enrollment Forms Required
  • Must have valid provider ID number
  • Only applies to Three Rivers Health Plan in Monroe Pennsylvania
  • Payer ID – 25175

 

National Payers Requiring Enrollment

UCCI

  • Direct Link
  • The office needs to call UCCI at (800) 633-5430, option 3, and let UCCI know that they will be submitting claims through Apex EDI.   Be sure to have them acknowledge every provider in the office that submits claims to UCCI.
  • Payer ID – 89070 and 54771

Other National Payers Enrollment Forms