Transaction Support
| 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) | Not supported |
| ERA + EFT combined | Not supported |
| Coordination of benefits (271) | Not supported |
| Attachments (275) | Not supported |
Other payer IDs and names
- Payer ID
10567 - Payer ID
10569 - Payer ID
10571 - Payer ID
10572 - Payer ID
10573 - Payer ID
10631 - Payer ID
10632 - Payer ID
10633 - Payer ID
10634 - Payer ID
10766 - Payer ID
10767 - Payer ID
10768 - Payer ID
10769 - Payer ID
10770 - Payer ID
2175 - Payer ID
2190 - Payer ID
3220 - Payer ID
3236 - Payer ID
4239 - Payer ID
4676 - Also listed as Absolute Total Care
- Also listed as Ambetter
- Also listed as Ambetter from Home State Health
- Also listed as Celtic Insurance Company
- Also listed as Cenpatico Behavioral Health
- Also listed as Envolve PeopleCare
- Also listed as Granite State Health Plan
- Also listed as Home State Health
- Also listed as MHS Behavioral Health
- Also listed as NH Healthy Families
- Also listed as New Hampshire Healthy Families
- Also listed as Sunfower State Health Plan
Enrollment requirements
- Electronic remittance (ERA 835): multi step enrollment, typically takes weeks
Workflow Guidance
- Submit 837P professional claims and 837I institutional claims through the this payer connection, then use 276/277 to monitor claim status.
- Run 270/271 eligibility checks for benefits, but handle coordination-of-benefits information outside this payer workflow.
- Complete enrollment for this payer before relying on 835 ERA; until activation, use your approved non-ERA process to reconcile payments.
- Do not plan an ERA and EFT combined workflow; use enrollment for ERA and an alternative process for EFT.
- Route dental claims and attachments through an alternative process because 837D and 275 transactions are unavailable.
Common questions
Can this payer receive both professional and institutional claims electronically?
Yes. Hero EMR supports 837P professional claims and 837I institutional claims for this payer.
Can I check eligibility and claim status electronically?
Yes, use 270/271 for eligibility and benefits and 276/277 for claim status. Coordination-of-benefits 271 transactions are not supported.
Does this payer support ERA 835?
Yes, but only after the practice completes the enrollment process for this payer. ERA access should not be expected before enrollment is completed.
Can I use EFT, dental claims, or attachments with this payer?
No, this support profile does not include 837D dental claims, EFT, combined ERA and EFT processing, or 275 attachments.
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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