Presbyterian Health Plan
dentalmedical
Summary
Presbyterian Health Plan is a dental and medical payer operating in New Mexico. Claims route under payer ID PREHP, with 9 alternate IDs in use across clearinghouses. Through clearinghouses it supports eligibility checks, professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and activates within hours.
At a glance
- Payer ID
PREHPAlso seen as 05003, 10646, 5242, 8908, PRESB, QYCAP and 3 more- Also known as
- Presbyterian (New Mexico), Presbyterian Health Plan (Commercial), Presbyterian Healthcare Services
- Service area
- NM
Clearinghouse transaction setup
Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.
| Transaction | Enrollment | Typical setup |
|---|---|---|
| Eligibility checks (270/271) | Not required | Immediate |
| Professional claims (837P) | Not required | Immediate |
| Institutional claims (837I) | Not required | Immediate |
| ERA / remittance (835) | Required | Same day |
Common questions
- What is the payer ID for Presbyterian Health Plan?
- The payer ID for Presbyterian Health Plan is PREHP. Alternate IDs seen across clearinghouses include 05003, 10646, 5242, 8908.
- Does Presbyterian Health Plan require ERA enrollment?
- Yes. Presbyterian Health Plan requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes a few hours.
- What states does Presbyterian Health Plan cover?
- Presbyterian Health Plan operates in NM. Coverage can differ by plan and product line, so confirm the specific plan before you file.
- What types of coverage does Presbyterian Health Plan offer?
- Presbyterian Health Plan covers dental and medical.
- Can I submit claims to Presbyterian Health Plan electronically?
- Yes. Presbyterian Health Plan is reachable through clearinghouses for eligibility checks, professional claims, institutional claims, and electronic remittance. Electronic claims are supported for professional (837P) and institutional (837I).
Compiled from public payer resources and clearinghouse catalogs. Details change often, so confirm with the payer before relying on them. Spot something out of date? Tell us and we will fix it.