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Avera Health Plans

Avera Health Plans

This page contains information you can use to exchange healthcare transactions with Avera Health Plans using Stedi.
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Use any of the following payer IDs to send transactions to Avera Health Plans using Stedi APIs or SFTP. Read the docs
Primary Payer ID
Stedi Payer ID
Payer ID aliases
,,,,,
Coverage types
Dental, Medical
Operating states
AKALARASAZCACOCTDCDEFLGAGUHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVIVTWAWIWVWY
Covered
Not covered

Supported transactions

Use Stedi to exchange the following transactions with Avera Health Plans 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 Avera Health Plans.
Not supported

Coordination of benefits checks

(COB)
Submit coordination of benefit checks to Avera Health Plans to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.
Claims processing
Supported

Real-time claim status

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

Professional claims

(837P)
Submit professional claims to Avera Health Plans and receive 277 claim acknowledgments asynchronously.
Supported

Institutional claims

(837I)
Submit institutional claims to Avera Health Plans and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required

Claim payments

(835 ERA)
Receive electronic remittance advice (ERAs) from Avera Health Plans to review full payment details.
Enrollment process type
One-click
Activation timeframe
Weeks
Requested effective date 
Not supported
Not supported

Dental claims

(837D)
Submit dental claims to Avera Health Plans and receive 277 claim acknowledgments asynchronously.
Not supported

Unsolicited claim attachments

(275)
Receive unsolicited attachments for claims submitted to Avera Health Plans.
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Start processing healthcare transactions with Stedi and Avera Health Plans today.
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Other names
Alternative known names, networks, or health plans for this payer that may appear on insurance cards, claims, or other correspondence.
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