Providence Health Plan
dentalmedicalvision
Summary
Providence Health Plan is a dental, medical, and vision payer operating in California, Oregon, and Washington. Claims route under payer ID PHP01, with 11 alternate IDs in use across clearinghouses. Through clearinghouses it supports eligibility checks, claim status inquiries, professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and takes a few days.
At a glance
- Payer ID
PHP01Also seen as 101039, 10172, 1540, 4498, 4498MA, 8798 and 5 more- Also known as
- NP PHP medicare, PeaceHealth Laboratories, Providence Choice Option
- Service area
- CA, OR, WA
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 |
| Claim status (276/277) | Not required | Immediate |
| Professional claims (837P) | Not required | Immediate |
| Institutional claims (837I) | Not required | Immediate |
| ERA / remittance (835) | Required | A few days |
Common questions
- What is the payer ID for Providence Health Plan?
- The payer ID for Providence Health Plan is PHP01. Alternate IDs seen across clearinghouses include 101039, 10172, 1540, 4498.
- Does Providence Health Plan require ERA enrollment?
- Yes. Providence Health Plan requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes a few days.
- What states does Providence Health Plan cover?
- Providence Health Plan operates in CA, OR, WA. Coverage can differ by plan and product line, so confirm the specific plan before you file.
- What types of coverage does Providence Health Plan offer?
- Providence Health Plan covers dental, medical, and vision.
- Can I submit claims to Providence Health Plan electronically?
- Yes. Providence Health Plan is reachable through clearinghouses for eligibility checks, claim status inquiries, 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 Spot something out of date?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.