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Carelon Health of Pennsylvania

This page contains information you can use to exchange healthcare transactions with Carelon Health of Pennsylvania using Stedi.
Use any of the following payer IDs to send transactions to Carelon Health of Pennsylvania using Stedi APIs or SFTP. Read the docs
Primary Payer ID
BHOPA
Stedi Payer ID
QYJKS
Payer ID aliases
2885, 8089, BHOPA
Parent group
Anthem
Coverage types
Medical

Supported transactions

Use Stedi to exchange the following transactions with Carelon Health of Pennsylvania 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 Carelon Health of Pennsylvania.
Not supported

Coordination of benefits checks

(COB)
Submit coordination of benefit checks to Carelon Health of Pennsylvania 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 Carelon Health of Pennsylvania in real-time by sending a claim status check (276/277).
Supported

Professional claims

(837P)
Submit professional claims to Carelon Health of Pennsylvania and receive 277 claim acknowledgments asynchronously.
Supported

Institutional claims

(837I)
Submit institutional claims to Carelon Health of Pennsylvania and receive 277 claim acknowledgments asynchronously.
Not supported

Claim payments

(835 ERA)
Receive electronic remittance advice (ERAs) from Carelon Health of Pennsylvania to review full payment details.
Not supported

Dental claims

(837D)
Submit dental claims to Carelon Health of Pennsylvania and receive 277 claim acknowledgments asynchronously.
Not supported

Unsolicited claim attachments

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