Supported Transactions
| Transaction | Status |
|---|---|
| Eligibility & benefits (270/271) | Supported |
| Claim status (276/277) | Not supported |
| Professional claims (837P) | Supported |
| Institutional claims (837I) | Supported |
| Dental claims (837D) | Not supported |
| Electronic remittance (ERA 835) | Enrollment required |
| Electronic funds transfer (EFT) | Not supported |
| ERA + EFT combined | Not supported |
| Coordination of benefits (271) | Not supported |
| Attachments (275) | Not supported |
Other payer IDs and names
- Payer ID
3558 - Payer ID
4716 - Payer ID
SX075 - Payer ID
Z95397 - Also listed as AmeriHealth Insurance Company of New Jersey
- Also listed as AmeriHealth Non-HMO (PPO) New Jersey
- Also listed as AmeriHealth Non-Health Maintenance Organization (Preferred Provider Organization) New Jersey
- Also listed as AmeriHealth PPO
- Also listed as Comprehensive Major Medical
Coverage states
New Jersey.
Enrollment requirements
- Electronic remittance (ERA 835): multi step enrollment, typically takes hours
Workflow by Transaction Type
- Submit institutional claims as 837I and professional claims as 837P through the supported electronic workflows.
- Run eligibility and benefits inquiries using 270/271, but do not expect coordination-of-benefits data through this payer connection.
- Complete payer enrollment before expecting ERA (835) delivery in Hero EMR.
- Use your established payer process to follow claims because 276/277 claim-status transactions are unavailable.
- Reconcile payments outside Hero EMR because EFT and combined ERA/EFT are not supported.
Common questions
Can I submit 837I and 837P claims to this payer through Hero EMR?
Yes. Hero EMR supports electronic institutional claims using 837I and professional claims using 837P for this payer.
Does Hero EMR support eligibility verification for this payer?
Yes, eligibility and benefits inquiries and responses use the 270/271 transaction set. Coordination-of-benefits 271 transactions are not available.
Do I need payer enrollment to receive ERA from this payer?
Yes. ERA (835) is supported, but the practice must complete payer enrollment before using that transaction.
Can I check claim status or receive EFT through Hero EMR?
No. Claim status (276/277) and EFT are not available through this payer connection, and ERA/EFT combined processing is also unavailable.
Run this payer inside Hero EMR
Hero EMR submits claims, checks eligibility, and posts remittances automatically for the payers it connects to. The first physician is free.
See a demo