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Provider Partners Health Plan of North Carolina

Provider Partners Health Plan of North Carolina

This page contains information you can use to exchange healthcare transactions with Provider Partners Health Plan of North Carolina using Stedi.
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Use any of the following payer IDs to send transactions to Provider Partners Health Plan of North Carolina using Stedi APIs or SFTP. Read the docs
Primary Payer ID
Stedi Payer ID
Payer ID aliases
Parent group
Provider Partners Health Group
Operating states
AKALARASAZCACOCTDCDEFLGAGUHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVIVTWAWIWVWY
Covered
Not covered

Supported transactions

Use Stedi to exchange the following transactions with Provider Partners Health Plan of North Carolina using APIs or SFTP. Send transactions as JSON or raw EDI files.
Eligibility & benefit verification
Not supported

Eligibility checks

(270/271)
Verify member coverage and benefits by sending real-time and batch eligibility checks to Provider Partners Health Plan of North Carolina.
Not supported

Coordination of benefits checks

(COB)
Submit coordination of benefit checks to Provider Partners Health Plan of North Carolina 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 North Carolina in real-time by sending a claim status check (276/277).
Supported

Professional claims

(837P)
Submit professional claims to Provider Partners Health Plan of North Carolina and receive 277 claim acknowledgments asynchronously.
Supported

Institutional claims

(837I)
Submit institutional claims to Provider Partners Health Plan of North Carolina and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required

Claim payments

(835 ERA)
Receive electronic remittance advice (ERAs) from Provider Partners Health Plan of North Carolina to review full payment details.
Enrollment process type
One-click
Activation timeframe
Days
Not supported

Dental claims

(837D)
Submit dental claims to Provider Partners Health Plan of North Carolina and receive 277 claim acknowledgments asynchronously.
Not supported

Unsolicited claim attachments

(275)
Receive unsolicited attachments for claims submitted to Provider Partners Health Plan of North Carolina.
Get started
Use Stedi's APIs to get fast and reliable connectivity to Provider Partners Health Plan of North Carolina 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 North Carolina 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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