This page contains information you can use to exchange healthcare transactions with Provider Partners Health Plan Missouri using Stedi.
Use any of the following payer IDs to send transactions to Provider Partners Health Plan Missouri using Stedi APIs or SFTP. Read the docs
Primary Payer ID
31404
Stedi Payer ID
PGKAK
Payer ID aliases
16557, 31404, 5079, 9126, PPHP_MO
Parent group
Provider Partners Health Group
Coverage types
Medical
Supported transactions
Use Stedi to exchange the following transactions with Provider Partners Health Plan Missouri 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 Missouri.
Not supported
Coordination of benefits checks
(COB)
Submit coordination of benefit checks to Provider Partners Health Plan Missouri 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 Missouri in real-time by sending a claim status check (276/277).
Supported
Professional claims
(837P)
Submit professional claims to Provider Partners Health Plan Missouri and receive 277 claim acknowledgments asynchronously.
Supported
Institutional claims
(837I)
Submit institutional claims to Provider Partners Health Plan Missouri and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required
Claim payments
(835 ERA)
Receive electronic remittance advice (ERAs) from Provider Partners Health Plan Missouri to review full payment details.
Enrollment process type
One-click
Activation timeframe
-
Not supported
Dental claims
(837D)
Submit dental claims to Provider Partners Health Plan Missouri and receive 277 claim acknowledgments asynchronously.
Not supported
Unsolicited claim attachments
(275)
Receive unsolicited attachments for claims submitted to Provider Partners Health Plan Missouri.
Get started
Use Stedi's APIs to get fast and reliable connectivity to Provider Partners Health Plan Missouri and start processing healthcare claims and eligibility checks within minutes.
Start processing healthcare claims and eligibility checks with Stedi and Provider Partners Health Plan Missouri today.