Where's Experian Payer ID List?

The Experian Health portal shows the payer IDs you need for claim submission.

1. Log in at the Experian Health portal login page with your username and password.
2. Click the Payer Management menu, then select Payer IDs.
3. Type the payer's name into the search box; suggestions appear instantly.
4. The matching row lists the exact payer ID in the designated column - copy it exactly as shown.
5. Use the Export button to download a CSV of all visible IDs if you need a bulk list.
6. Compare the exported IDs with the list you'll use in your clearinghouse (see section 'use major clearinghouse lookup tools you already have').
7. If a payer does not appear, move on to the alternative sources covered in the next section.

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• Access your clearinghouse's web portal (e.g., Change Healthcare, Emdeon) and type the payer name; the displayed payer ID matches the Experian Health list.
• Call the clearinghouse's batch‑lookup API - often labeled 'Payer ID Service' or 'Provider Directory' - to retrieve many payer IDs in a single request.
• Open the clearinghouse's EDI configuration screen, locate the X12 837 partner record, and read the payer ID shown beside the submitter/receiver entry.
• Use the clearinghouse's built‑in 'Payer Search' tool that cross‑references the HIPAA Provider Identifier database; copy the Experian‑compatible payer ID it returns.
• Draft a test claim through the clearinghouse's 'Claim Draft' feature; the preview page displays the exact payer ID that will be used for the real claim.

When Experian Health portal or support can't supply the payer ID, turn to these proven backups.

• Experian Health support team - phone or email for direct assistance
• Your clearinghouse's provider lookup (for example, Availity provider directory) - most clearinghouses maintain up‑to‑date payer IDs
• Individual payer enrollment portals such as CMS enrollment system, UnitedHealthcare provider portal, or Cigna provider portal - log in and view the payer ID section
• State Medicaid agency websites (e.g., Medicaid.gov state pages) - each state publishes its own payer identifiers
• Professional association directories like the AMA Provider Directory - includes many commercial payer IDs

These sources complement the earlier 'look in Experian Health portal' step and feed into the later 'bulk retrieve payer IDs from enrollment portals and APIs' process.

Bulk retrieve payer IDs by exporting the provider‑enrollment list from each portal you already use and by invoking the available enrollment APIs.

In the Experian Health portal, open the 'Provider Enrollment' tab, select 'All Payers', and click the CSV export button - the file contains every active payer ID together with the contract start date.

Do the same in your clearinghouse dashboard (e.g., Change Healthcare or Emdeon) where the 'Payer Directory' offers a bulk download option.

For programmatic access, call the enrollment APIs such as the CMS PECOS endpoint that returns JSON rows of payer information; supply your NPI and use the 'includeAll=true' query parameter to get the full set in one request.

Combine the CSV files and API response into a single spreadsheet, remove duplicates, and you have a ready‑to‑load master list.

Load the master list into your practice management system, then proceed to verify each payer ID before claim submission (see the next section on verification).

If the API paginates results, loop through the 'nextPageToken' until the response is empty; respect the documented rate limits to avoid throttling.

Store the file in a secure location and schedule a weekly pull so newly added payer IDs appear automatically.

For detailed API parameters, consult the CMS PECOS enrollment API guide.

Confirm the payer ID with the payer directly before you submit any claim. A mismatched ID triggers rejections, delays reimbursement, and wastes staff time, so a quick validation saves effort later.

1. Call the payer's provider relations line; ask the representative to read back the ID linked to your enrollment number and note the exact alphanumeric string.
2. Log into the payer's online provider portal (for example, the payer provider portal) and locate the enrollment section; the portal typically displays the current payer ID.
3. Email the payer's enrollment or credentialing department with your NPI and request written confirmation of the payer ID; keep the reply for audit purposes.
4. If the payer offers an API or enrollment web service, query it using your contract number; the response returns the active payer ID in real time.

Once the ID is verified, you can move on to sending a real test claim to confirm EDI formatting.

Submit a real test claim to confirm that the payer ID works in production.

• Build a minimal‑value claim (e.g., one CPT 99213 office visit) using a test patient and the exact payer ID you retrieved from the Experian Health portal or the payer's enrollment system.
• Route the claim through the same clearinghouse and EDI transmission method you use for live billing.
• Review the 277/999 response: a successful acknowledgment (277) or acceptance code (999) proves the payer ID is valid; any rejection code points to a typo, wrong ID format, or mis‑matched submitter number.
• Record the response details in your verification log before moving the ID into the production claim queue.

A passed test claim lets you proceed confidently to the next step of matching the payer ID to your EDI submitter and billing address.

The Experian Payer ID List resides in the Experian Health portal, typically under Settings → Payers or Payer Management, where a 'Payer ID List' or 'Payer Directory' can be viewed or downloaded; once you have the list, match each payer ID to the corresponding EDI submitter code and the payer's billing address by cross‑referencing the three columns in the export.

Example: The directory shows payer ID 12345 with EDI submitter XYZ01 and billing address 123 Main St, Suite 100, Anytown, NY 10001.

Enter 12345 in your claim‑submission system, set the submitter field to XYZ01, and configure the billing address block with the exact address line. When you send a test claim, the clearinghouse will route the transaction using the matched submitter and address, confirming the alignment.

Update your system by replacing the old payer ID with the newly verified value in every reference table, clearing‑house profile, and EDI submitter record. Pull the current ID from the Experian Health portal or your clearinghouse lookup tool, then edit the master payer list in your practice‑management software.

Synchronize the change across all dependent modules: adjust the payer‑ID‑to‑billing‑address mapping, update the submitter ID used for EDI transmission, and run a real test claim to confirm acceptance. Most systems let you bulk‑import a CSV; if not, use the API endpoint documented in the Experian Health portal documentation to push the update programmatically.

After the edit, enable change‑tracking alerts so future ID revisions trigger the same workflow, and keep an eye on the '5 reasons Experian list might be missing a payer' section for clues when a new discrepancy appears.

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• The payer hasn't finished Experian's enrollment, so the portal shows no payer ID.
• The payer uses paper‑only billing, so it lacks an electronic ID in Experian's system.
• The payer recently updated its ID and Experian's database hasn't synchronized yet.
• The payer belongs to a niche or state‑specific network that Experian doesn't cover.
• A sync error or stale cache in the Experian Health portal hides the latest IDs.

If a payer has no electronic ID and only sends paper bills, obtain the ID by calling the payer's enrollment desk or faxing a request to the number listed on the bill (payer enrollment contact page); record the number in your EDI submitter file, then treat it as you would any ID found via the Experian Health portal or a clearinghouse lookup.

If you cannot reach the enrollment desk before the claim deadline, use a generic submitter tied to the payer's billing address, submit a real‑test claim to confirm acceptance, and replace the generic ID with the official one as soon as it arrives; this workaround follows the verification steps described in section 5 and prepares you for the bulk retrieval methods in section 4.