Transactions this payer supports
| Transaction | Status |
|---|---|
| Eligibility & benefits (270/271) | Supported |
| Claim status (276/277) | Supported |
| Professional claims (837P) | Supported |
| Institutional claims (837I) | Supported |
| Dental claims (837D) | 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 |
Workflow guidance
- Choose 837P, 837I, or 837D according to the claim type before submission.
- Run a 270/271 eligibility and benefits check when coverage information is needed; confirm returned details before billing.
- Use 276/277 to check claim status instead of expecting remittance data to show payment details.
- Set up a separate process for 835 remittance and EFT because neither is available electronically through this payer connection.
- If coordination of benefits or attachments are required, handle those through the payer's designated process outside these transactions.
Common questions
Which claim types can I send electronically to this payer?
You can send professional claims through 837P, institutional claims through 837I, and dental claims through 837D.
Can I verify eligibility and benefits electronically?
Yes. The connection supports the 270/271 eligibility and benefits exchange, but coordination-of-benefits (271) transactions are not available.
Can I receive ERA or EFT from this payer?
No. ERA 835, EFT, and a combined ERA/EFT transaction are not available through this connection, so payment posting needs a separate process.
How can I check claim status electronically?
Use the 276/277 claim-status exchange. Claim attachments through 275 are not available through this connection and must be handled separately if required.
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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