Transaction support
| Transaction | Status |
|---|---|
| Eligibility & benefits (270/271) | Supported |
| Claim status (276/277) | 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 |
Enrollment requirements
- Electronic remittance (ERA 835): one click enrollment, typically takes days
Workflow guidance
- Use the 270/271 eligibility workflow for benefits checks, but handle coordination-of-benefits requests through a non-electronic or alternate process.
- Submit dental claims electronically. Route professional and institutional claims through your established alternate submission method.
- Use the supported claim-status transaction to follow claims when status data is available.
- Complete payer enrollment before expecting ERA (835); until enrollment is active, use the remittance workflow already available to your practice.
- Do not plan on EFT, combined ERA/EFT, or electronic attachments; assign separate payment and documentation workflows.
Common questions
Does this payer support electronic eligibility and benefits checks?
Yes. Eligibility and benefits inquiries use the 270/271 transaction, but coordination-of-benefits information is not supported electronically.
Can I submit professional or institutional claims electronically?
No. Professional (837P) and institutional (837I) claims are not available through this support profile; dental claims (837D) are supported.
How can my practice receive ERA from this payer?
ERA (835) is supported after your practice completes the payer enrollment process. Do not expect electronic remittance before enrollment is completed.
Are EFT and electronic attachments supported?
EFT, combined ERA/EFT, and attachments (275) are not available. Plan payment and documentation workflows accordingly.
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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