| CareFirst BlueCross BlueShieldCommercial | Check current payer-list availabilityReviewed 2026-10-03 | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan | Use the payer’s authorization routeNot handled here | Verify current availabilityPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Verify current availability | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| CareFirst BlueCross BlueShieldCommercial | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| CareFirst BlueCross BlueShieldCommercial | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| CareFirst BlueCross BlueShieldCommercial | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| CareFirst BlueCross BlueShieldCommercial | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| UnitedHealthcare / OptumCommercial / Behavioral | Listed on the current payer listReviewed 2026-10-03 | YESPaid plan; allowance or transaction fees may apply | YESPaid plan; allowance or transaction fees may apply | Available; response detail depends on the payerPaid plan | Use the payer’s authorization routeNot handled here | YESPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | YES | YES — ERA viewer/download | YES — electronic appeals; paper/fax may carry submission charge |
| UnitedHealthcare / OptumCommercial / Behavioral | Check the current Availity payer listReviewed 2026-10-03 | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| UnitedHealthcare / OptumCommercial / Behavioral | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| UnitedHealthcare / OptumCommercial / Behavioral | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| UnitedHealthcare / OptumCommercial / Behavioral | UHC/Optum route applies; verify the member’s specific productReviewed 2026-10-03 | YES — UHC/Optum ecosystem; product route still verifyPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Aetna CommercialCommercial | Listed on the current payer listReviewed 2026-10-03 | YESPaid plan; allowance or transaction fees may apply | YESPaid plan; allowance or transaction fees may apply | Available; response detail depends on the payerPaid plan | Use the payer’s authorization routeNot handled here | YESPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | YES | YES — ERA viewer/download | YES — electronic appeals; paper/fax may carry submission charge |
| Aetna CommercialCommercial | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Aetna CommercialCommercial | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Aetna CommercialCommercial | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Aetna CommercialCommercial | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Cigna / Evernorth BehavioralCommercial / Behavioral | Listed on the current payer listReviewed 2026-10-03 | YESPaid plan; allowance or transaction fees may apply | YESPaid plan; allowance or transaction fees may apply | Available; response detail depends on the payerPaid plan | Use the payer’s authorization routeNot handled here | YESPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Not listed in the public payer directory | YES — ERA viewer/download | YES — electronic appeals; paper/fax may carry submission charge |
| Cigna / Evernorth BehavioralCommercial / Behavioral | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Cigna / Evernorth BehavioralCommercial / Behavioral | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Cigna / Evernorth BehavioralCommercial / Behavioral | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Cigna / Evernorth BehavioralCommercial / Behavioral | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Kaiser Permanente Mid-AtlanticMid-Atlantic | Listed on the current payer listReviewed 2026-10-03 | YESPaid plan; allowance or transaction fees may apply | YESPaid plan; allowance or transaction fees may apply | Available; response detail depends on the payerPaid plan | Use the payer’s authorization routeNot handled here | Not listed in the public payer directoryPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Not listed in the public payer directory | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| Kaiser Permanente Mid-AtlanticMid-Atlantic | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Kaiser Permanente Mid-AtlanticMid-Atlantic | Documented route; verify current transaction availabilityReviewed 2026-10-03 | YES — explicit route; verify enrollmentSome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Kaiser Permanente Mid-AtlanticMid-Atlantic | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Kaiser Permanente Mid-AtlanticMid-Atlantic | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Anthem Blue Cross and Blue Shield VirginiaCommercial | Listed on the current payer listReviewed 2026-10-03 | YESPaid plan; allowance or transaction fees may apply | YESPaid plan; allowance or transaction fees may apply | Available; response detail depends on the payerPaid plan | Use the payer’s authorization routeNot handled here | YESPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | YES | YES — ERA viewer/download | YES — electronic appeals; paper/fax may carry submission charge |
| Anthem Blue Cross and Blue Shield VirginiaCommercial | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Anthem Blue Cross and Blue Shield VirginiaCommercial | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Anthem Blue Cross and Blue Shield VirginiaCommercial | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Anthem Blue Cross and Blue Shield VirginiaCommercial | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Sentara Health PlansCommercial / Medicaid family | Check current payer-list availabilityReviewed 2026-10-03 | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan | Use the payer’s authorization routeNot handled here | Verify current availabilityPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Verify current availability | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| Sentara Health PlansCommercial / Medicaid family | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Sentara Health PlansCommercial / Medicaid family | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Sentara Health PlansCommercial / Medicaid family | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Sentara Health PlansCommercial / Medicaid family | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Virginia Medicaid / Cardinal CareMedicaid | Listed on the current payer listReviewed 2026-10-03 | YESPaid plan; allowance or transaction fees may apply | YESPaid plan; allowance or transaction fees may apply | Available; response detail depends on the payerPaid plan | Use the payer’s authorization routeNot handled here | YESPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Not listed in the public payer directory | YES — ERA viewer/download | YES — electronic appeals; paper/fax may carry submission charge |
| Virginia Medicaid / Cardinal CareMedicaid | Check the current Availity payer listReviewed 2026-10-03 | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Virginia Medicaid / Cardinal CareMedicaid | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Virginia Medicaid / Cardinal CareMedicaid | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Virginia Medicaid / Cardinal CareMedicaid | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Maryland Medicaid / HealthChoiceMedicaid | Listed on the current payer listReviewed 2026-10-03 | YESPaid plan; allowance or transaction fees may apply | YESPaid plan; allowance or transaction fees may apply | Available; response detail depends on the payerPaid plan | Use the payer’s authorization routeNot handled here | YESPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Not listed in the public payer directory | YES — ERA viewer/download | YES — electronic appeals; paper/fax may carry submission charge |
| Maryland Medicaid / HealthChoiceMedicaid | Check the current Availity payer listReviewed 2026-10-03 | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Maryland Medicaid / HealthChoiceMedicaid | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Maryland Medicaid / HealthChoiceMedicaid | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Maryland Medicaid / HealthChoiceMedicaid | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Aetna Better Health of VirginiaCardinal Care | Check current payer-list availabilityReviewed 2026-10-03 | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan | Use the payer’s authorization routeNot handled here | Verify current availabilityPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Verify current availability | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| Aetna Better Health of VirginiaCardinal Care | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Aetna Better Health of VirginiaCardinal Care | Documented route; verify current transaction availabilityReviewed 2026-10-03 | YES — explicit route; verify enrollmentSome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Aetna Better Health of VirginiaCardinal Care | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Aetna Better Health of VirginiaCardinal Care | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Anthem HealthKeepers PlusCardinal Care | Check current payer-list availabilityReviewed 2026-10-03 | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan | Use the payer’s authorization routeNot handled here | Verify current availabilityPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Verify current availability | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| Anthem HealthKeepers PlusCardinal Care | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Anthem HealthKeepers PlusCardinal Care | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Anthem HealthKeepers PlusCardinal Care | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Anthem HealthKeepers PlusCardinal Care | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Humana Healthy Horizons of VirginiaCardinal Care | Check current payer-list availabilityReviewed 2026-10-03 | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan | Use the payer’s authorization routeNot handled here | Verify current availabilityPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Verify current availability | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| Humana Healthy Horizons of VirginiaCardinal Care | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Humana Healthy Horizons of VirginiaCardinal Care | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Humana Healthy Horizons of VirginiaCardinal Care | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Humana Healthy Horizons of VirginiaCardinal Care | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Sentara Community PlanCardinal Care | Check current payer-list availabilityReviewed 2026-10-03 | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan | Use the payer’s authorization routeNot handled here | Verify current availabilityPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Verify current availability | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| Sentara Community PlanCardinal Care | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Sentara Community PlanCardinal Care | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Sentara Community PlanCardinal Care | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Sentara Community PlanCardinal Care | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| UnitedHealthcare Community Plan of VirginiaCardinal Care | Check current payer-list availabilityReviewed 2026-10-03 | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan | Use the payer’s authorization routeNot handled here | Verify current availabilityPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Verify current availability | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| UnitedHealthcare Community Plan of VirginiaCardinal Care | Check the current Availity payer listReviewed 2026-10-03 | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| UnitedHealthcare Community Plan of VirginiaCardinal Care | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| UnitedHealthcare Community Plan of VirginiaCardinal Care | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| UnitedHealthcare Community Plan of VirginiaCardinal Care | UHC/Optum route applies; verify the member’s specific productReviewed 2026-10-03 | YES — UHC/Optum ecosystem; product route still verifyPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Aetna Better Health of MarylandHealthChoice | Listed on the current payer listReviewed 2026-10-03 | YESPaid plan; allowance or transaction fees may apply | YESPaid plan; allowance or transaction fees may apply | Available; response detail depends on the payerPaid plan | Use the payer’s authorization routeNot handled here | YESPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Not listed in the public payer directory | YES — ERA viewer/download | YES — electronic appeals; paper/fax may carry submission charge |
| Aetna Better Health of MarylandHealthChoice | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Aetna Better Health of MarylandHealthChoice | Documented route; verify current transaction availabilityReviewed 2026-10-03 | YES — explicit route; verify enrollmentSome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Aetna Better Health of MarylandHealthChoice | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Aetna Better Health of MarylandHealthChoice | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| CareFirst Community Health Plan of MarylandHealthChoice | Listed on the current payer listReviewed 2026-10-03 | YESPaid plan; allowance or transaction fees may apply | YESPaid plan; allowance or transaction fees may apply | Available; response detail depends on the payerPaid plan | Use the payer’s authorization routeNot handled here | YESPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Not listed in the public payer directory | YES — ERA viewer/download | YES — electronic appeals; paper/fax may carry submission charge |
| CareFirst Community Health Plan of MarylandHealthChoice | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| CareFirst Community Health Plan of MarylandHealthChoice | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| CareFirst Community Health Plan of MarylandHealthChoice | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| CareFirst Community Health Plan of MarylandHealthChoice | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Jai Medical SystemsHealthChoice | Check current payer-list availabilityReviewed 2026-10-03 | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan | Use the payer’s authorization routeNot handled here | Verify current availabilityPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Verify current availability | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| Jai Medical SystemsHealthChoice | Check the current Availity payer listReviewed 2026-10-03 | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Jai Medical SystemsHealthChoice | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Jai Medical SystemsHealthChoice | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Jai Medical SystemsHealthChoice | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Kaiser Permanente Maryland HealthChoiceHealthChoice | Check current payer-list availabilityReviewed 2026-10-03 | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan | Use the payer’s authorization routeNot handled here | Verify current availabilityPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Verify current availability | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| Kaiser Permanente Maryland HealthChoiceHealthChoice | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Kaiser Permanente Maryland HealthChoiceHealthChoice | Documented route; verify current transaction availabilityReviewed 2026-10-03 | YES — explicit route; verify enrollmentSome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Kaiser Permanente Maryland HealthChoiceHealthChoice | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Kaiser Permanente Maryland HealthChoiceHealthChoice | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Maryland Physicians CareHealthChoice | Check current payer-list availabilityReviewed 2026-10-03 | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan | Use the payer’s authorization routeNot handled here | Verify current availabilityPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Verify current availability | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| Maryland Physicians CareHealthChoice | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Maryland Physicians CareHealthChoice | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Maryland Physicians CareHealthChoice | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Maryland Physicians CareHealthChoice | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| MedStar Family Choice MarylandHealthChoice | Check current payer-list availabilityReviewed 2026-10-03 | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan | Use the payer’s authorization routeNot handled here | Verify current availabilityPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Verify current availability | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| MedStar Family Choice MarylandHealthChoice | Check the current Availity payer listReviewed 2026-10-03 | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| MedStar Family Choice MarylandHealthChoice | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| MedStar Family Choice MarylandHealthChoice | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| MedStar Family Choice MarylandHealthChoice | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Priority PartnersHealthChoice | Check current payer-list availabilityReviewed 2026-10-03 | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan | Use the payer’s authorization routeNot handled here | Verify current availabilityPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Verify current availability | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| Priority PartnersHealthChoice | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Priority PartnersHealthChoice | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Priority PartnersHealthChoice | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Priority PartnersHealthChoice | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| UnitedHealthcare Community Plan MarylandHealthChoice | Check current payer-list availabilityReviewed 2026-10-03 | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan | Use the payer’s authorization routeNot handled here | Verify current availabilityPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Verify current availability | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| UnitedHealthcare Community Plan MarylandHealthChoice | Check the current Availity payer listReviewed 2026-10-03 | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| UnitedHealthcare Community Plan MarylandHealthChoice | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| UnitedHealthcare Community Plan MarylandHealthChoice | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| UnitedHealthcare Community Plan MarylandHealthChoice | UHC/Optum route applies; verify the member’s specific productReviewed 2026-10-03 | YES — UHC/Optum ecosystem; product route still verifyPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |
| Wellpoint MarylandHealthChoice | Check current payer-list availabilityReviewed 2026-10-03 | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan; allowance or transaction fees may apply | Verify current availabilityPaid plan | Use the payer’s authorization routeNot handled here | Verify current availabilityPaid plan; allowance or transaction fees may apply | Complete EFT enrollment with the payer or payment vendorPayer-side | Available; payer enrollment may be required | Credentialing must be completed with the payer first | Verify current availability | Verify current availability | YES — electronic appeals; paper/fax may carry submission charge |
| Wellpoint MarylandHealthChoice | Documented route; verify current transaction availabilityReviewed 2026-10-03 | Available; verify the specific transactionFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availabilityFree for sponsoring payers; otherwise paid access may apply | Verify current payer-list availability; rules vary by payerFree for sponsoring payers where offered; otherwise paid access may apply | Verify current payer-list availabilityFREE if payer-sponsored; enrollment may be required | Complete EFT enrollment with the payer or payment vendorNot a universal Availity fee | YES — transaction enrollment center where payer requires enrollment | Credentialing requirements vary by payer | Verify current payer-list availability | Verify current payer-list availability / remit viewer where available | PAYER-SPECIFIC / premium |
| Wellpoint MarylandHealthChoice | Check the current Office Ally payer listReviewed 2026-10-03 | Verify current payer-list availabilitySome functions start free; transaction fees may apply | Verify current payer-list availability$10/mo first 100; $0.10 each after (public pricing) | Verify current payer-list availabilityService Center pricing or transaction fees may apply | Not a standard Service Center functionSeparate Payer Gateway/API offering | Verify current payer-list availabilityService Center; transaction fees may apply | EFT enrollment is completed with the payer; Office Ally may provide the formPayer/payment-vendor rules | YES — public payer-specific EDI enrollment forms | Network credentialing is completed with the payer | Verify current payer-list availability | YES where 835 supported | Not a standard clearinghouse feature |
| Wellpoint MarylandHealthChoice | Confirm payer availability directly with WaystarReviewed 2026-10-03 | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | Confirm availability with WaystarPaid; contact Waystar for pricing | PAYMENT/RECONCILIATION MODULE; ENROLLMENT NOT UNIVERSALPaid; contact Waystar for pricing | AUTOMATED PROVIDER ENROLLMENT AVAILABLE; payer specifics require confirm with the clearinghouseation | Network credentialing is completed with the payer | Confirm availability with Waystar | Confirm availability with Waystar | YES — paid denial/appeal module |
| Wellpoint MarylandHealthChoice | Verify payer connection and contract requirementsReviewed 2026-10-03 | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Verify payer connection under your Optum contractPaid contract | Use the payer-specific authorization processProduct-specific | Available through Core EDI when the payer is connected; verify your payerPaid contract | Free enrollment service for participating payersFREE enrollment service | YES — product/payer-specific EDI setup; ERA/EFT enrollment service available | NO — network credentialing remains payer/network-side | Availability varies by payer and product | YES via ERA where connected | Use the applicable Optum product or payer process |