Supported transactions
| Transaction | Status |
|---|---|
| Eligibility & benefits (270/271) | Supported |
| Claim status (276/277) | 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) | Supported |
| Attachments (275) | Not supported |
Other payer IDs and names
- Payer ID
00114 - Payer ID
04298 - Payer ID
04298MA - Payer ID
10379 - Payer ID
170558746 - Payer ID
2438 - Payer ID
8504 - Also listed as Point32Health
Coverage states
Massachusetts, Maine, New Hampshire, Rhode Island, Vermont.
Enrollment requirements
- Electronic remittance (ERA 835): multi step enrollment, typically takes weeks
Workflow considerations
- Use 270/271 for eligibility and benefits, and 276/277 to check claim status electronically.
- Submit 837P for professional claims and 837I for institutional claims, matching the transaction to the claim type.
- Complete payer enrollment before expecting 835 ERA files through this connection.
- Plan a separate payer-supported workflow for dental claims, EFT, combined ERA and EFT, or electronic attachments.
- Do not substitute a professional or institutional claim format for an unsupported dental claim.
Common questions
Does this payer support electronic eligibility verification?
Yes. Use 270/271 transactions for eligibility and benefits, including the available 271 coordination-of-benefits transaction when applicable.
Can I submit professional and institutional claims electronically?
Yes. This payer supports 837P professional claims and 837I institutional claims.
Can I check claim status electronically?
Yes. Claim status is supported through 276/277 transactions.
How do I receive electronic remittance advice from this payer?
ERA 835 is supported after the practice completes payer enrollment. EFT, combined ERA and EFT, and electronic attachments are not available through this connection.
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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