Electronic transactions include sending and receiving information electronically between trading partners – clients and vendors. Electronic transactions can make your business more efficient and your workflow more precise. Use electronic transactions to:
- Save time and money
- Reduce administrative costs
- Reduce or eliminate data errors
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Receiving claims payments via EFT is a requirement for participation in our networks. We also require all provider claims to be submitted electronically.
EFT deposits will be made two business days after the payment issue date to comply with National Automated Clearing House Association (NACHA) guidelines. Note: We will make only credit entries to your designated bank account. If it becomes necessary to initiate a correcting debit, we will notify you in advance.
To enroll for EFT, use the Transaction Enrollment Tool on Availity Essentials: My Providers>Enrollments Center>Transaction Enrollment. View our step-by-step guide for how to enroll for EFT (PDF).
- Medical pharmacy claims and service: Sign-up for EFT using Availity's Transaction Enrollment Tool
Pharmacy claims and services: Sign-up for EFT by contacting Prime Therapeutics at 1 (844) 765-6827
Note: Only your organization's administrator, administrator assistant and users with the Transaction Enrollment role may enroll for EFT and cancel, change or update EFT setup.
Validation of your EFT information
For security purposes, our EFT enrollment team will contact you to confirm the information you provide as part of the EFT enrollment process. You must confirm your enrollment details with us to complete the EFT enrollment process.
- We will make two attempts to validate your EFT enrollment information by phone.
- If we are unable to reach you, we will leave a message and update the Transaction Enrollment tool with the information we require and who to contact to provide this information.
- If we do not receive a response within 30 calendar days from the date of the second validation attempt, we will reject the EFT enrollment. This will close your credentialing application and cease all onboarding and contracting tasks.
Your credentialing application can only be reopened if Availity registration and EFT enrollment are in progress. Applications are valid for 90 days, after which you will need to re-apply for credentialing and complete required onboarding tasks, including registration for Availity and enrollment for EFT.
You will receive a confirmation email from Availity when your EFT registration is submitted and an email from us when your EFT set-up is complete. Upon completion, the next claim payment cycle will be sent electronically to your designated account.
If you change bank accounts, submit a change request using Availity's Transaction Enrollment Tool.
Call 1 (800) 662-7534 for missing EFT payment, and bank change request issue. At the prompt press 1 and leave a detailed message including your name, phone number, and Tax ID number.
We provide claims processing information in an ANSI 835 Electronic Remittance Advice (835 ERA) format.
You can use the options below to obtain your payment vouchers. Enrollment is quick and easy and there is no cost to you.
- View claims payment information online in human-readable format using Availity's Remittance Viewer.
Receive your remittance advice electronically via an ANSI 835 ERA. Enrollment is quick and easy and there is no cost to you.
Receive claims processing information for your Asuris patients via an 835 ERA. Enroll on Availity Essentials: My Providers>Enrollments Center>Transaction Enrollment.
We use Group Code "PI" (Payer Initiated Reductions) and do not use Group Code "OA" (Other Adjustment) except for the codes indicated on the Claim Adjustment Reason Codes list. View the list on the wpc-edi website. View the Explanation Code (EXCD) ANSI code crosswalk document.
All participating providers and facilities and any non-participating provider or facility located in our service area must submit their medical and dental claims electronically.
Electronic claims may be submitted through many types of practice management software systems or via Internet file transfer protocol (FTP). Contact the billing service or claims clearinghouse of your choice to enroll.
You can key and submit single electronic claims or submit multiple claims via electronic batch transactions. Contact your billing service/clearinghouse to see what options they can provide.
We currently accept the following ANSI v5010 transactions:
Eligibility Request and Response
Claims Status Inquiry and Response
Health Care Claim Status Acknowledgement
No enrollment needed, submitters will receive this transaction automatically
Web portal only: Referral request, referral inquiry and pre-authorization request
Health Care Claim
Implementation Acknowledgement for Health Care Insurance
No enrollment necessary, submitters will receive this transaction automatically
No enrollment needed, submitters will receive this transaction automatically
Note: Availity supports business-to-business (B2B) integration for eligibility and benefit inquiry transactions. Contact your practice management system vendor and ask if they support B2B transactions with Availity for Asuris, or view the Availity technology partners list.
Do not submit attachments with claims unless indicated on our clinical edits by code lists. If medical records are needed to process your claim, we will send you a request.
Our primary method for requesting and receiving claims-related medical records is through Availity's attachment application. Submit the requested records using an easy upload process that will save your office staff hours scanning, printing and mailing—and you’ll receive faster claims processing. You can also view the status and history of submitted records in the attachments dashboard and can message us directly from the application if you have questions.
Getting set up for the Availity attachments application is easy. Your organization’s Availity administrator can assign the Medical Attachments role to users who need access to Attachments – New. Follow the instructions in the Availity Essentials Attachments Tools – Getting Started Guide (PDF).
Use the information below to easily reconcile claims payments.
- Ask your bank or financial institution to provide the Corporate Credit or Debit Entry Plus Addenda Record (CCD+) payment-related information from field 3 of record 7 on the EFT report they send to you. We send the CCD+ information to your financial institution as part of the EFT transaction. View a sample bank letter (PDF).
- To re-associate the EFT with the ERA, you can match the information from the CCD+ Record with the BPR and TRN segments of your ERA. If you do not receive 835 ERAs and use Availity's remittance viewer, enter the CCD+ record number into the Check/EFT Trace Number field.
CCD+ Re-association data elements
Corresponding ERA (835 V5010) data elements
CCD+ Recorded number
Data element segment
Data element name
Availity's remittance viewer
Effective entry date - date the payer intends to provide funds to the payee via EFT
EFT effective date
Payment-related information - payment-related ASC X12 data segments
TRN02 and TRN03
EFT Trace Number and Payer Identifier
Check/EFT trace number
If you submit transactions to Availity, please contact Availity for support related to the following:
- EDI File rejection reports
- Missing Electronic Remittance Advice (ERA) 835s
Missing rejected medical or dental claims
- Contact the clearinghouse that you submit your claims through to resolve all EDI-related transaction issues.
If you have questions about how a claim was processed or paid, access Availity Essentials, then view Claims & Payments>Remittance viewer. If you aren't able to locate this information, contact our Provider Contact Center.
EDI batch transactions support
Contact your clearinghouse or Availity.
Availity payer list
Request for raw data
Complete all fields of the Raw Data Request form to ensure your request for data is processed quickly and accurately.
Third party vendor support
Clearinghouses or other trading partners: To establish direct connections to submit EDI transactions to Asuris on behalf of a facility or a medical or dental office, please contact Availity for further support. If you are a vendor who has contracted with Asuris and need support for direct data connections, please work directly with your assigned Asuris primary account manager.
EFT Hotline Number
Call 1 (800) 662-7534 for missing EFT payments, or issues with bank account changes. At the prompt press 1 and leave a detailed message including your name, phone number, and Tax ID number.