What are alternative payer names and IDs on the payer list?

What are alternative payer names and IDs on the payer list?

In a medical EDI clearinghouse, an alternative payer name or ID refers to additional identifiers associated with a primary payer. These are displayed directly on the payer list under the main payer record as “Also known as” values.

These alternative names and IDs represent legacy identifiers, extended payer IDs, or commonly used variations that still map to the same payer for claim routing purposes.

How “Also known as” values work

When viewing a payer on the list, you may see an “Also known as” section beneath the primary payer name. This section includes:

• Alternate payer IDs (such as extended or updated IDs)

• Legacy payer IDs that may still be used in workflows

• Common or alternate payer names

These values are all linked to the same payer record. When any of them are used in the system, Claim.MD automatically maps them to the correct primary payer and ensures the claim is routed properly.

Additionally, the Payer Search field supports searching by these alternative names and IDs, allowing users to find the correct payer even if they enter a variation instead of the primary listing.

Example

Main Payer Listing:

• Name: Buckeye Ohio Medicaid

• Payer ID: 00042

Also known as:

• 0004202

• Buckeye Access2Care

For example, if you go to Provider Enrollment in Claim.MD, select a provider, and enter payer ID 00042, the system will recognize it as an alternative ID and return the Buckeye Ohio Medicaid payer.

In this example, even if you entered an alternative ID, Claim.MD maps it to the primary payer and uses the correct extended payer ID (0004202) when transmitting the claim. To view these alternative names and IDs, click the black triangle next to the payer to expand the “Also Known As” section.

This structure helps prevent errors by allowing multiple valid identifiers to point to the same payer while ensuring the correct ID is used for outbound claim submission.