EDI Clearinghouses

Electronic claims

Electronic Data Interchange (EDI) is the computer-to-computer exchange of business data in standard formats. EDI transmissions must follow the transaction and code set format specifications required by the Health Insurance Portability and Accountability Act (HIPAA).

CareSource has invested in an EDI system to enhance our service to participating providers. Our EDI system complies with HIPAA standards for electronic claims forms. We are committed to offering you the most flexible and efficient means possible of doing business with us.

CareSource accepts electronic claims in the following file format:

• 837 ANSI ASC x 12N (004010A) file format for professional and claims

EDI clearinghouses

To submit claims electronically, providers must work with an electronic claims clearinghouse. CareSource currently accepts electronic claims from Michigan providers through the clearinghouses listed below.  Please contact the clearinghouse of your choice to begin electronic claims submission.  Please provide the clearinghouse with the CareSource payer ID number: 38325

Your CareSource provider billing number must be used in the submission of electronic claims. Please contact your EDI vendor to find out where this number should be used based on the format you are submitting. If you have a question about your CareSource Provider billing number, please contact us at 1-800-390-7102.

For more information, please see the Provider Manual.