Supported transactions
| Transaction | Status |
|---|---|
| Eligibility & benefits (270/271) | 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
1232 - Payer ID
4549 - Payer ID
84131MA
Coverage states
Colorado.
Enrollment requirements
- Electronic remittance (ERA 835): multi step enrollment, typically takes hours
Workflow considerations
- Match each submission to the correct format: use 837I for institutional claims and 837P for professional claims.
- Run a 270/271 eligibility inquiry before visits when coverage information is needed electronically.
- Complete payer enrollment before relying on ERA 835; keep a manual remittance process until ERA is active.
- Do not use 276/277 for claim status; record follow-up needs and use your established non-electronic process.
- Route dental claims, attachments, EFT, and coordination-of-benefits work through a non-electronic or alternate process.
Common questions
Can I submit professional or institutional claims to this payer electronically?
Yes. Professional claims use 837P, and institutional claims use 837I.
Can I check eligibility and benefits electronically?
Yes, eligibility and benefits inquiries are supported through 270/271 transactions. This does not include coordination-of-benefits 271 transactions.
Does this payer support electronic remittance advice?
Yes, ERA 835 is supported after your practice completes payer enrollment. Submit the enrollment paperwork before expecting electronic remittance.
Can I check claim status electronically?
No. Claim-status transactions using 276/277 are not supported for this payer.
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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