Care1st Health Plan Arizona

Filing a claim

Electronic Data Interchange (EDI)

We strongly encourage you to submit your claims electronically!

Advantages include:

  • Decreased submission costs (printing, handling, mailing, etc.)
  • Faster processing and reimbursement
  • Allows for documentation of timely filing
  • Data submission accuracy (eliminates keystroke errors)

EDI is for primary claims only with the exception of claims when a member’s primary insurance is WellCare Liberty (FKA ONECare) and their secondary insurance is Care1st. For all services other than Home Health Care, Durable Medical Equipment, MSIC/IC, or FQHC/RHC services our system automatically coordinates processing for these services submitted and no secondary submission is required. Any other claims that require secondary payments submit on paper with a copy of the primary remittance advice attached.

Medical (CMS1500) Claims
We work with Emdeon for acceptance of EDI CMS 1500 claims. Our Emdeon Payer I.D. is 57116. Questions may be directed to Emdeon at 800.215.4730.

Claims may be submitted electronically directly to Emdeon or from your clearinghouse to Emdeon. If you experience problems with your EDI submission, first contact your software vendor to validate the claim submissions and upon verification of successful submission, contact Emdeon directly at 800.215.4730. If you need additional assistance contact our EDI team at

Medical (UB-04) Claims
We work with SSI for acceptance of EDI UB-04 claims. Questions may be directed to SSI Help Desk at 800.880.3032. If you need additional assistance contact our EDI team at

Electronic Funds Transfer (EFT)

EFT allows payments to be electronically deposited directly into a designated bank account without the need to wait for the mail and then make a trip to the bank to deposit your check!

Medical Claims
The EFT form is available on our website under the Forms section of the Provider menu. If you do not have internet access, contact Network Management and we will provide you with the form.

Paper Claims

Medical Claims Address:
Attention Claims Department
P.O. Box 31224
Tampa, FL 33631-3224

Note: The address above is for claims only (including claims with attachments). All other non-claim correspondence should be sent to the following address:
Attention Correspondence Department
432 N 44th Street, Suite 100
Phoenix, AZ 85008

Dental Claims Address:
Claims for Date of Service on or after October 1, 2019
DentaQuest of Arizona, LLC - Claims
PO Box 2906
Milwaukee, WI 53201-2906

Claims for dates of Service on or before September 30, 2019
PO Box 8510
St. Louis, MO 63126