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Presbyterian Health Plan

This payer supports electronic institutional and professional claims, plus eligibility and benefits inquiries for routine coverage checks. EFT, ERA, and combined ERA/EFT are supported after enrollment, while claim status, dental claims, coordination of benefits, and attachments are not available electronically through this connection.

Primary payer IDPREHP
Directory IDRMOUC
Parent groupPresbyterian Healthcare Services Group
States1

Supported Transactions and Enrollment

TransactionStatus
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)Enrollment required
ERA + EFT combinedEnrollment required
Coordination of benefits (271)Not supported
Attachments (275)Not supported

Other payer IDs and names

Coverage states

New Mexico.

Enrollment requirements

Plan Around Transaction Gaps

Common questions

Can I submit electronic claims to this payer?

Yes. Institutional claims use 837I, and professional claims use 837P; dental claims using 837D are not supported.

Does this payer support electronic eligibility verification?

Yes, eligibility and benefits inquiries use 270/271 transactions. Coordination-of-benefits information is not supported through this connection.

How do I receive ERA or EFT from this payer?

ERA, EFT, and combined ERA/EFT are supported after the practice completes the payer's required enrollment. They are not available through this connection before enrollment is completed.

Can I check claim status or send attachments electronically?

No. Claim status transactions using 276/277 and attachments using 275 are not supported through this connection, so use your established alternate process.

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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Payer connectivity data last synced 2026-05-26. Compiled by Hero EMR from its clearinghouse network, which is built on the Stedi public payer network. Support status can change; confirm during onboarding. Back to the payer directory.