Essence Healthcare

Summary

Essence Healthcare is a regional health plan, part of Essence Group Holdings, offering dental and medical coverage operating in Missouri and Illinois. Claims route under payer ID 20818, with 7 alternate IDs in use across clearinghouses. Provider enrollment typically takes 60-90 days, with applications through Essence Provider Portal, and CAQH is used for credentialing data. Through clearinghouses it supports eligibility checks, claim status inquiries, professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and activates within hours.

At a glance

Payer ID

20818Also seen as 10601, 20818MA, 2274, 57082, 8993, ESSNC and 1 more

Uses CAQH

YesApplication route: CAQH application only

Service area

MO, IL (St. Louis metro)

Clearinghouse transaction setup

Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.

Common questions

What is the payer ID for Essence Healthcare?

The payer ID for Essence Healthcare is 20818. Alternate IDs seen across clearinghouses include 10601, 20818MA, 2274, 57082.

How long does Essence Healthcare provider enrollment take?

Essence Healthcare provider enrollment typically takes 60-90 days from application to effective date. Timelines vary by state, plan, and how complete the application is.

Does Essence Healthcare require CAQH?

Yes. Essence Healthcare uses CAQH for credentialing data, so keep the provider's CAQH profile current and attested before applying.

Does Essence Healthcare require ERA enrollment?

Yes. Essence Healthcare requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes a few hours.

What states does Essence Healthcare cover?

Essence Healthcare operates in MO, IL (St. Louis metro). Coverage can differ by plan and product line, so confirm the specific plan before you file.