Guardian

Summary

Guardian is a specialty plan, part of The Guardian Life Insurance Co., offering dental, medical, and vision coverage across all 50 states + DC. Claims route under payer ID 64246, with 7 alternate IDs in use across clearinghouses. Provider enrollment typically takes 30-60 days, with applications through Guardian Provider Portal, and CAQH is not used. Through clearinghouses it supports eligibility checks, professional claims, institutional claims, dental claims, and electronic remittance (ERA); ERA enrollment is required and takes several weeks.

At a glance

Payer ID

64246Also seen as 00159, 00410, 10788, 4517, 6409, KHXPG and 1 more

Also known as

First Commonwealth, Guardian Dental, Guardian Managed Dentalguard, Managed Dental Care, The Guardian Life Insurance Company of America

Uses CAQH

NoApplication route: Payer's own application

Service area

All 50 states + DC

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 Guardian?

The payer ID for Guardian is 64246. Alternate IDs seen across clearinghouses include 00159, 00410, 10788, 4517.

How long does Guardian provider enrollment take?

Guardian provider enrollment typically takes 30-60 days from application to effective date. Timelines vary by state, plan, and how complete the application is.

Does Guardian require CAQH?

No. Guardian does not use CAQH. Applications go through its own enrollment process.

Does Guardian require ERA enrollment?

Yes. Guardian requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes several weeks.

What states does Guardian cover?

Guardian operates in All 50 states + DC. Coverage can differ by plan and product line, so confirm the specific plan before you file.

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