This page contains information you can use to exchange healthcare transactions with Provider Partners Health Plan of Maryland using Stedi.
Use any of the following payer IDs to send transactions to Provider Partners Health Plan of Maryland using Stedi APIs or SFTP. Read the docs
Primary Payer ID
31118
Stedi Payer ID
SGCPY
Payer ID aliases
16556, 1845, 31118, 4505, PPHP_MD
Coverage types
Medical
Supported transactions
Use Stedi to exchange the following transactions with Provider Partners Health Plan of Maryland 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 of Maryland.
Not supported
Coordination of benefits checks
(COB)
Submit coordination of benefit checks to Provider Partners Health Plan of Maryland 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 of Maryland in real-time by sending a claim status check (276/277).
Supported
Professional claims
(837P)
Submit professional claims to Provider Partners Health Plan of Maryland and receive 277 claim acknowledgments asynchronously.
Supported
Institutional claims
(837I)
Submit institutional claims to Provider Partners Health Plan of Maryland and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required
Claim payments
(835 ERA)
Receive electronic remittance advice (ERAs) from Provider Partners Health Plan of Maryland to review full payment details.
Not supported
Dental claims
(837D)
Submit dental claims to Provider Partners Health Plan of Maryland and receive 277 claim acknowledgments asynchronously.
Not supported
Unsolicited claim attachments
(275)
Receive unsolicited attachments for claims submitted to Provider Partners Health Plan of Maryland.
Get started
Use Stedi's APIs to get fast and reliable connectivity to Provider Partners Health Plan of Maryland and start processing healthcare claims and eligibility checks within minutes.
Start processing healthcare claims and eligibility checks with Stedi and Provider Partners Health Plan of Maryland today.