Geisinger Health Plan

Summary

Geisinger Health Plan is a regional health plan, part of Geisinger / Risant Health, offering dental, medical, and vision coverage operating in Pennsylvania. Claims route under payer ID 75273, with 10 alternate IDs in use across clearinghouses. Provider enrollment typically takes 60-90 days, with applications through Geisinger Provider Portal, and CAQH is used for credentialing data. Through clearinghouses it supports eligibility checks, claim status inquiries, professional claims, institutional claims, dental claims, and electronic remittance (ERA); ERA enrollment is required and activates within hours.

At a glance

Payer ID

75273Also seen as 10611, 10612, 2559, 5473, 75273MA, 9274 and 4 more

Also known as

GHP

Uses CAQH

YesApplication route: Payer portal application

Service area

PA (42 counties NE/Central)

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 Geisinger Health Plan?

The payer ID for Geisinger Health Plan is 75273. Alternate IDs seen across clearinghouses include 10611, 10612, 2559, 5473.

How long does Geisinger Health Plan provider enrollment take?

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

Does Geisinger Health Plan require CAQH?

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

Does Geisinger Health Plan require ERA enrollment?

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

What states does Geisinger Health Plan cover?

Geisinger Health Plan operates in PA (42 counties NE/Central). Coverage can differ by plan and product line, so confirm the specific plan before you file.