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Payor IDs

Choose the correct Payor ID numbers based on the patient's type of insurance. Learn more about our HIPAA electronic transaction capabilities.

 

Commercial:

93029

Medicare:

20377

Providers of Medicaid patients

Please contact the patient's dental care organization for guidance.

Choosing a clearinghouse

We contract with two clearinghouses to transmit dental claims electronically.

 

inMediata

20 South Clark Street, Suite 1810
Chicago, IL 60603
800-417-6693
inMediata.com

Emdeon

26 Century Boulevard, Suite 601 
Nashville, TN 37214
615-885-3700 
Emdeon.com

Corrected claims submissions

To help us quickly assess and respond to your correction, please fill out the form completely.

Corrected dental claim form

Questions about dental claims?

For providers of Medicaid patients, please contact the patient's Dental Care Organization for guidance.

Call us

Commercial
866-373-7053

Medicare
888-863-3637

 

Email us

Commercial
Dental@PacificSource.com

Medicare
MedicareCS@PacificSource.com

 

Fax us

541-225-3655