Supported transaction types
| Transaction | Status |
|---|---|
| Eligibility & benefits (270/271) | Not supported |
| Claim status (276/277) | Not supported |
| Professional claims (837P) | Supported |
| Institutional claims (837I) | Supported |
| Dental claims (837D) | Not supported |
| Electronic remittance (ERA 835) | Not supported |
| Electronic funds transfer (EFT) | Not supported |
| ERA + EFT combined | Not supported |
| Coordination of benefits (271) | Not supported |
| Attachments (275) | Not supported |
Coverage states
California.
Plan the remaining workflows
- Select 837I for institutional billing and 837P for professional billing before sending the claim.
- Complete eligibility checks through another available method before visits or claim submission; 270/271 is not available.
- Use a separate workflow to monitor claims because electronic claim status requests and responses (276/277) are unavailable.
- Plan to receive and post remittance information outside an ERA workflow; 835 is not available.
- Reconcile payments outside the EFT connection because EFT and combined ERA/EFT are unavailable.
Common questions
Which claim formats can I submit electronically to this payer?
Hero EMR supports institutional claims in 837I format and professional claims in 837P format. Dental claims in 837D format are not available.
Can I verify eligibility and benefits in Hero EMR for this payer?
No. The 270/271 eligibility and benefits transaction is not available, so use another process to verify coverage.
Can I check this payer claim status electronically?
No. Electronic claim status transactions, including 276/277, are not available for this payer.
Does this payer support ERA and EFT?
No. ERA (835), EFT, and combined ERA/EFT transactions are not available, so remittance and payment workflows must be handled another way.
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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