Supported transactions
| Transaction | Status |
|---|---|
| Eligibility & benefits (270/271) | Supported |
| Claim status (276/277) | Supported |
| Professional claims (837P) | Supported |
| Institutional claims (837I) | Supported |
| Dental claims (837D) | Not supported |
| Electronic remittance (ERA 835) | Enrollment required |
| Electronic funds transfer (EFT) | Enrollment required |
| ERA + EFT combined | Not supported |
| Coordination of benefits (271) | Supported |
| Attachments (275) | Not supported |
Other payer IDs and names
- Payer ID
100842 - Payer ID
10488 - Payer ID
10510 - Payer ID
10511 - Payer ID
10512 - Payer ID
10513 - Payer ID
10515 - Payer ID
10576 - Payer ID
10921 - Payer ID
10944 - Payer ID
1119 - Payer ID
11216 - Payer ID
14163MA - Payer ID
14164 - Payer ID
16559 - Payer ID
1844 - Payer ID
48055 - Payer ID
57116 - Payer ID
59608 - Payer ID
8041 - Also listed as American Progressive
- Also listed as Central Senior Care
- Also listed as Easy Choice Health Plan California
- Also listed as Fidelis Care New Jersey
- Also listed as First Choice Health Plans of Connecticut
- Also listed as Fresenius Medical Care
- Also listed as Generations
- Also listed as Golden Triangle Physician Alliance SelectCare Texas
- Also listed as Harmony Health Plan
- Also listed as HealthEase
- Also listed as HealthEase Kids
- Also listed as Heritage Physician Network (Houston)
Enrollment requirements
- Electronic remittance (ERA 835): multi step enrollment, typically takes weeks
Plan your workflow
- Verify eligibility and benefits with 270/271 before visits, and use the supported 271 coordination-of-benefits transaction when payer-order information is needed.
- Send medical claims through 837I or 837P as appropriate; do not use the electronic dental-claim format, 837D, for dental billing.
- Complete this payer’s enrollment before expecting EFT or ERA 835 transactions to be available in your workflow.
- Use 276/277 claim-status transactions to follow submitted claims; do not plan to send attachments through 275.
- Keep payment and remittance procedures separate because this payer does not support a combined ERA/EFT transaction.
Common questions
Which medical claim formats can I send to this payer electronically?
You can send institutional claims using 837I and professional claims using 837P. Dental claims using 837D are not available.
Do I need enrollment to receive ERA or EFT from this payer?
Yes. ERA (835) and EFT are supported after the practice completes payer enrollment.
Can I check eligibility and claim status electronically?
Yes. Eligibility and benefits use 270/271, coordination of benefits is supported through 271, and claim status uses 276/277.
Can this payer receive attachments or a combined ERA/EFT transaction?
No. Attachments (275) and a combined ERA/EFT transaction are unavailable, although ERA and EFT are each supported after 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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