Transaction support
| Transaction | Status |
|---|---|
| Eligibility & benefits (270/271) | Supported |
| Claim status (276/277) | Supported |
| Professional claims (837P) | Not supported |
| Institutional claims (837I) | Not 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) | Supported |
| Attachments (275) | Not supported |
Other payer IDs and names
- Payer ID
00325 - Payer ID
10057 - Payer ID
RP117 - Payer ID
RP122 - Also listed as Family Health Management
Coverage states
Arkansas, Georgia, Indiana, Kentucky, Michigan, North Carolina, Ohio, West Virginia.
Enrollment requirements
- Electronic remittance (ERA 835): one click enrollment, typically takes weeks
Workflow guidance
- Run a 270/271 eligibility and benefits check before visits or billing when coverage information is needed.
- Use 276/277 for claim-status inquiries, and use the 271 coordination-of-benefits response when payer-order information is needed.
- Complete this payer’s enrollment paperwork before setting up ERA 835; until enrollment is complete, plan for non-electronic remittance handling.
- Keep payment workflows separate: EFT, ERA plus EFT, and electronic attachments through 275 are not available with this payer.
Common questions
Can I verify eligibility and benefits electronically with this payer?
Yes. Hero EMR supports the 270/271 eligibility and benefits transaction for this payer.
Can I check claim status electronically?
Yes, claim status is supported through the 276/277 transaction. This does not provide electronic claim submission.
Can I submit professional, institutional, or dental claims electronically?
No. 837P, 837I, and 837D claim transactions are unavailable, so use the payer-approved alternative submission workflow.
How do I get an ERA from this payer?
ERA 835 is supported after the practice completes this payer’s enrollment process. It is not available until the enrollment paperwork is completed, and EFT is not included or supported.
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.
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