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Provider Partners Health Plan Illinois

This page contains information you can use to exchange healthcare transactions with Provider Partners Health Plan Illinois using Stedi.
Use any of the following payer IDs to send transactions to Provider Partners Health Plan Illinois using Stedi APIs or SFTP. Read the docs
Primary Payer ID
31401
Stedi Payer ID
DRDTR
Payer ID aliases
16555, 3053, 31401, 8412, PPHP_IL
Parent group
Provider Partners Health Group
Coverage types
Medical

Supported transactions

Use Stedi to exchange the following transactions with Provider Partners Health Plan Illinois using APIs or SFTP. Send transactions as JSON or raw EDI files.
Eligibility & benefit verification
Supported

Eligibility checks

(270/271)
Verify member coverage and benefits by sending real-time and batch eligibility checks to Provider Partners Health Plan Illinois.
Not supported

Coordination of benefits checks

(COB)
Submit coordination of benefit checks to Provider Partners Health Plan Illinois to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.
Claims processing
Not supported

Real-time claim status

(276/277)
Check on the status of a claim previously submitted to Provider Partners Health Plan Illinois in real-time by sending a claim status check (276/277).
Supported

Professional claims

(837P)
Submit professional claims to Provider Partners Health Plan Illinois and receive 277 claim acknowledgments asynchronously.
Supported

Institutional claims

(837I)
Submit institutional claims to Provider Partners Health Plan Illinois and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required

Claim payments

(835 ERA)
Receive electronic remittance advice (ERAs) from Provider Partners Health Plan Illinois to review full payment details.
Not supported

Dental claims

(837D)
Submit dental claims to Provider Partners Health Plan Illinois and receive 277 claim acknowledgments asynchronously.
Not supported

Unsolicited claim attachments

(275)
Receive unsolicited attachments for claims submitted to Provider Partners Health Plan Illinois.
Get started
Use Stedi's APIs to get fast and reliable connectivity to Provider Partners Health Plan Illinois and start processing healthcare claims and eligibility checks within minutes.
Start processing healthcare claims and eligibility checks with Stedi and Provider Partners Health Plan Illinois today.
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