Simply Healthcare

Summary

Simply Healthcare is a Medicaid managed care organization, part of Elevance Health, offering medical and vision coverage operating in 22 states. Claims route under payer ID SMPLY, with 6 alternate IDs in use across clearinghouses. Provider enrollment typically takes 60-120 days, with applications through Wellpoint 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 takes a few days.

At a glance

Payer ID

SMPLYAlso seen as 10826, 1096, 27094, 8124, SMPLH, SMPLYMA

Also known as

Simply Healthcare Plans, Inc., Wellpoint

Uses CAQH

YesApplication route: Payer portal application

Service area

22 states

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 Simply Healthcare?

The payer ID for Simply Healthcare is SMPLY. Alternate IDs seen across clearinghouses include 10826, 1096, 27094, 8124.

How long does Simply Healthcare provider enrollment take?

Simply Healthcare provider enrollment typically takes 60-120 days from application to effective date. Timelines vary by state, plan, and how complete the application is.

Does Simply Healthcare require CAQH?

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

Does Simply Healthcare require ERA enrollment?

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

What states does Simply Healthcare cover?

Simply Healthcare operates in 22 states. Coverage can differ by plan and product line, so confirm the specific plan before you file.

Related payers