What is the Stedi payer ID for CalOptima?

The Stedi payer ID for CalOptima is BNGIM.

What is the primary payer ID for CalOptima?

The primary payer ID for CalOptima is CALOP.

What payer IDs does CalOptima use?

In addition to its primary payer ID CALOP, CalOptima uses several other payer IDs, including 059, 101160, 10972, 2903, 4221, 5914, CALOP, and CALOPMA.

What transactions does CalOptima support?

CalOptima supports the following transactions: 270/271 eligibility checks, 837P professional claims, 837I institutional claims, 835 Electronic Remittance Advices (ERAs), and 276/277 real-time claim status.

What transaction types require transaction enrollment with CalOptima?

CalOptima requires transaction enrollment for 835 Electronic Remittance Advices (ERAs). Other supported transactions don't require enrollment. Stedi handles transaction enrollment steps for you.

What is transaction enrollment?

Transaction enrollment is a process required by some payers before you can send or receive certain transactions. Stedi handles this process for you.

What is a coordination of benefits (COB) check?

A COB checks determines if a member has coverage from more than one payer. CalOptima supports COB checks through Stedi.

What other names does CalOptima go by?

CalOptima is also known as CalOptima Direct and CalOptima Health.

All payers

PAYER

CalOptima

This page contains information you can use to exchange healthcare transactions with CalOptima using Stedi.

Use any of the following payer IDs to send transactions to CalOptima using Stedi APIs or SFTP. Read the docs

Primary Payer ID

CALOP

Stedi Payer ID

BNGIM

Payer ID aliases

059, 101160, 10972, 2903, 4221, 5914, CALOP, CALOPMA

Coverage types

Dental, Medical

Operating states

AKALARASAZCACOCTDCDEFLGAGUHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVIVTWAWIWVWY

Covered

Not covered

Supported transactions

Use Stedi to exchange the following transactions with CalOptima 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 CalOptima.

Not supported

Coordination of benefits checks

(COB)

Submit coordination of benefit checks to CalOptima to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.

Claims processing

Supported

Real-time claim status

(276/277)

Check on the status of a claim previously submitted to CalOptima in real-time by sending a claim status check (276/277).

Supported

Professional claims

(837P)

Submit professional claims to CalOptima and receive 277 claim acknowledgments asynchronously.

Supported

Institutional claims

(837I)

Submit institutional claims to CalOptima and receive 277 claim acknowledgments asynchronously.

Supported, enrollment required

Claim payments

(835 ERA)

Receive electronic remittance advice (ERAs) from CalOptima to review full payment details.

Not supported

Dental claims

(837D)

Submit dental claims to CalOptima and receive 277 claim acknowledgments asynchronously.

Not supported

Unsolicited claim attachments

(275)

Receive unsolicited attachments for claims submitted to CalOptima.

Get started

Use Stedi's APIs to get fast and reliable connectivity to CalOptima and start processing healthcare claims and eligibility checks within minutes.

Start processing healthcare claims and eligibility checks with Stedi and CalOptima today.

Other names

Alternative known names, networks, or health plans for this payer that may appear on insurance cards, claims, or other correspondence.

CalOptima Direct
CalOptima Health

Payer Network

All payers

PAYER

CalOptima

This page contains information you can use to exchange healthcare transactions with CalOptima using Stedi.

Use any of the following payer IDs to send transactions to CalOptima using Stedi APIs or SFTP. Read the docs

Primary Payer ID

CALOP

Stedi Payer ID

BNGIM

Payer ID aliases

059, 101160, 10972, 2903, 4221, 5914, CALOP, CALOPMA

Coverage types

Dental, Medical

Operating states

AKALARASAZCACOCTDCDEFLGAGUHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVIVTWAWIWVWY

Covered

Not covered

Supported transactions

Use Stedi to exchange the following transactions with CalOptima 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 CalOptima.

Not supported

Coordination of benefits checks

(COB)

Submit coordination of benefit checks to CalOptima to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.

Claims processing

Supported

Real-time claim status

(276/277)

Check on the status of a claim previously submitted to CalOptima in real-time by sending a claim status check (276/277).

Supported

Professional claims

(837P)

Submit professional claims to CalOptima and receive 277 claim acknowledgments asynchronously.

Supported

Institutional claims

(837I)

Submit institutional claims to CalOptima and receive 277 claim acknowledgments asynchronously.

Supported, enrollment required

Claim payments

(835 ERA)

Receive electronic remittance advice (ERAs) from CalOptima to review full payment details.

Not supported

Dental claims

(837D)

Submit dental claims to CalOptima and receive 277 claim acknowledgments asynchronously.

Not supported

Unsolicited claim attachments

(275)

Receive unsolicited attachments for claims submitted to CalOptima.

Get started

Use Stedi's APIs to get fast and reliable connectivity to CalOptima and start processing healthcare claims and eligibility checks within minutes.

Start processing healthcare claims and eligibility checks with Stedi and CalOptima today.

Other names

Alternative known names, networks, or health plans for this payer that may appear on insurance cards, claims, or other correspondence.

CalOptima Direct
CalOptima Health