Supported Transactions and Limits
| 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 |
Other payer IDs and names
- Payer ID
1106 - Payer ID
3945
Coverage states
California.
Enrollment requirements
- Electronic remittance (ERA 835): multi step enrollment, typically takes weeks
Workflow for This Payer
- Select 837P for professional claims and 837I for institutional claims, and review the claim type before submission.
- Complete payer enrollment before relying on ERA (835); meanwhile, maintain a separate process for receiving and posting remittances.
- Verify benefits outside Hero EMR because electronic eligibility and benefits transactions (270/271) are unavailable.
- Check claim progress through a payer-approved external process because 276/277 claim status transactions are unavailable.
- Plan payment reconciliation outside the connection because EFT and combined ERA plus EFT are unavailable.
Common questions
Can I submit professional claims to this payer electronically?
Yes. Hero EMR supports professional claim submission in the 837P format for this payer.
Can I submit institutional claims to this payer electronically?
Yes. Institutional claims can be submitted electronically in the 837I format.
How do I receive ERA files from this payer?
ERA (835) is supported, but the practice must complete payer enrollment first. Until enrollment is complete, use your established remittance process rather than expecting ERA files in Hero EMR.
Can I check eligibility, claim status, or EFT through Hero EMR?
No. Eligibility and benefits, claim status, and EFT are unavailable through this payer connection.
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