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GemCare

This page contains information you can use to exchange healthcare transactions with GemCare using Stedi.
Use any of the following payer IDs to send transactions to GemCare using Stedi APIs or SFTP. Read the docs
Primary Payer ID
11065
Stedi Payer ID
WTZRG
Payer ID aliases
11065, 4607, 6100, GMCARE, MCS01, MCS03
Coverage types
Medical

Supported transactions

Use Stedi to exchange the following transactions with GemCare 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 GemCare.
Not supported

Coordination of benefits checks

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

Professional claims

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

Institutional claims

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

Claim payments

(835 ERA)
Receive electronic remittance advice (ERAs) from GemCare to review full payment details.
Not supported

Dental claims

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

Unsolicited claim attachments

(275)
Receive unsolicited attachments for claims submitted to GemCare.
Get started
Use Stedi's APIs to get fast and reliable connectivity to GemCare and start processing healthcare claims and eligibility checks within minutes.
Start processing healthcare claims and eligibility checks with Stedi and GemCare 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.
  • Dignity Health Medical Network (Santa Cruz)
  • GemCare Health Plan
  • GemCare Medical Group (Managed Care Systems)
  • Independence Medical Group (Tulare County)
  • Independence Medical Group - Kern County
  • Managed Care Systems (Gemcare)
  • QualCare (Managed Care Systems)
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