Transaction Support
| Transaction | Status |
|---|---|
| Eligibility & benefits (270/271) | Not supported |
| Claim status (276/277) | Not supported |
| Professional claims (837P) | Not supported |
| Institutional claims (837I) | Not supported |
| Dental claims (837D) | 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
00161 - Payer ID
67498 - Also listed as SMW Local 263 Health & Welfare Fund
Enrollment requirements
- Electronic remittance (ERA 835): one click enrollment, typically takes weeks
Plan the Workflow
- Use the payer’s designated verification process for eligibility and benefits because 270/271 transactions are not supported.
- Send dental claims through 837D only; route professional and institutional claims through another supported process.
- Complete payer enrollment paperwork before expecting ERA delivery through the 835 transaction.
- While ERA enrollment is pending, follow the payer’s designated remittance process and post payments manually.
- Plan separate payment reconciliation because EFT and combined ERA/EFT transactions are unavailable.
Common questions
Can I submit claims to this payer electronically?
Yes, electronic dental claims using 837D are supported. Professional 837P and institutional 837I claims are not supported through this connection.
Does this payer support electronic remittance advice?
Yes, 835 ERA is supported after the practice completes payer enrollment. Submit the required enrollment paperwork before expecting electronic remittances.
Can I check eligibility and benefits electronically?
No, 270/271 eligibility and benefits transactions are not supported. Use the payer’s designated separate verification process.
Can I check claim status or receive EFT payments?
No, 276/277 claim status and EFT are not supported. ERA and EFT combined are 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.
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