Supported payer transactions
| 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 |
Other payer IDs and names
- Payer ID
5253 - Also listed as Preferred Health Care (PHC)
Workflow for unavailable transactions
- Confirm coverage and benefits through another payer-approved channel before scheduling care or submitting services.
- Send institutional billing as 837I and professional billing as 837P; do not use 837D for dental claims.
- Check claim progress outside Hero EMR because 276/277 status transactions are unavailable.
- Plan for remittance and payment posting outside ERA, EFT, and combined ERA/EFT transactions.
Common questions
Can I submit 837I and 837P claims to this payer?
Yes. Institutional claims use 837I and professional claims use 837P, and both are available electronically without payer enrollment.
Does Hero EMR support eligibility checks for this payer?
No, electronic eligibility and benefits transactions using 270/271 are unavailable. Verify coverage through another payer-approved method before care or billing.
Can I check claim status electronically?
No. Claim-status transactions using 276/277 are unavailable, so use another payer-approved status process and document follow-up.
Will this payer send ERA or EFT through Hero EMR?
No. ERA 835, EFT, and combined ERA/EFT are unavailable, so handle remittance and payment posting outside these electronic transactions.
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.
See a demo