Supported Electronic Transactions
| 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 |
Coverage states
District of Columbia, Iowa, Illinois, Maryland, Minnesota, Missouri, North Dakota, New Jersey, South Dakota, Wisconsin.
Enrollment requirements
- Electronic remittance (ERA 835): one click enrollment, typically takes days
Workflow With This Payer
- Submit institutional services as 837I and professional services as 837P; do not route dental claims through these transaction types.
- Complete payer enrollment paperwork before relying on ERA/835, and confirm enrollment before investigating missing remittance files.
- Verify eligibility through a non-270/271 workflow before visits or billing, since electronic eligibility transactions are unavailable.
- Use the payer's permitted non-276/277 process for claim-status follow-up and document reference details in your billing system.
- Plan payment reconciliation without EFT or combined ERA/EFT support; match ERA or other remittance information to posted payments.
Common questions
Can this payer accept both 837I and 837P claims?
Yes. This connection supports electronic institutional claims (837I) and professional claims (837P).
How do I get an ERA from this payer?
ERA/835 is supported after your practice completes the payer's enrollment process. Until enrollment is complete, do not expect ERA files through the connection.
Can I verify eligibility and benefits electronically?
No, this connection does not support eligibility and benefits transactions (270/271). Use the payer's permitted alternative workflow to verify coverage before billing.
Can I check claim status electronically?
No, electronic claim-status transactions (276/277) are not available through this connection. Follow the payer's permitted alternative process for status requests.
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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