Claim and Attachment Submission
Electronic Data Interchange (EDI) is the preferred method for submitting claims. EMI Health works with all major clearinghouses. Our payer ID number is SX110. If your claim requires attachments or otherwise cannot be submitted via EDI, you may submit a secure online claim for processing by EMI Health using the form below.
You may also use this form to submit supporting documentation (attachments) for claims, medical preauthorization, or dental predetermination.
(Do not initiate a preauthorization request using this form. See Preauthorization treatments for details on preauthorization requirements.)
To ensure prompt and accurate processing, complete all fields and include all necessary documentation and narrative.
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