Transaction support
| Transaction | Status |
|---|---|
| Eligibility & benefits (270/271) | Not 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 |
Enrollment requirements
- Electronic remittance (ERA 835): one click enrollment, typically takes days
Plan the workflow
- Verify coverage and benefits through your usual non-270/271 process before sending a claim.
- Submit institutional claims as 837I and professional claims as 837P, matching the format to the encounter.
- Complete payer enrollment paperwork before expecting electronic remittance advice, then monitor for incoming 835 files.
- Plan manual follow-up for claim status, dental claims, EFT, combined ERA and EFT, and coordination-of-benefits requests.
- Use another payment-posting process if ERA enrollment is incomplete or EFT is unavailable.
Common questions
Which electronic claim formats are supported?
This payer supports institutional claims through 837I and professional claims through 837P. Dental claims through 837D are not supported.
Can I receive electronic remittance advice from this payer?
Yes, ERA through 835 is supported after the practice completes payer enrollment. Until enrollment is complete, use a different remittance workflow.
Are eligibility and benefits checks available electronically?
No, eligibility and benefits transactions through 270/271 are not supported. Use a separate verification process before services or billing.
Can this payer send EFT with ERA?
EFT and combined ERA plus EFT are not supported. Standalone ERA is available only after payer enrollment.
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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