Payer ID 13285: Clover Health

Electronic transactions for payer ID 13285

What Clover Health accepts electronically under payer ID 13285, and which transactions need provider enrollment before they work, as listed in the Stedi payer network directory.

Support is per clearinghouse connection: a transaction listed as not supported here may still work through another clearinghouse or the payer's portal. Enrollment, where required, is done once per provider and clearinghouse.

Where payer ID 13285 goes on a claim

On an electronic professional (837P) or institutional (837I) claim, the payer is identified in loop 2010BB, the payer name loop. The NM1 segment there carries entity identifier code PR (payer), the payer's name, the qualifier PI in NM108, and the payer ID itself in NM109:

NM1*PR*2*CLOVER HEALTH*****PI*13285~

The same NM1*PR structure names the payer in loop 2100A of 270 eligibility and 276 claim status requests. Many clearinghouses use one payer ID for claims, eligibility, and claim status, but some assign a separate ID per transaction, so check the payer list for each transaction type you send.

Before you submit to payer ID 13285

1. 1

   Read the member's ID card

   The claims payer ID or claims address printed on the card is the most specific source for that member's plan. Where it differs from a directory listing, the card generally reflects how that plan wants claims sent.

2. 2

   Check whether a third-party administrator runs the plan

   Self-funded employer plans route claims to their administrator's payer ID, which is often different from the network or carrier name printed on the card.

3. 3

   Confirm the ID on your clearinghouse's payer list

   Payer IDs are assigned per clearinghouse. Large national payers tend to use the same ID nearly everywhere; regional plans and administrators often do not. Search your clearinghouse's list for 13285 and confirm it maps to Clover Health.

4. 4

   Watch the acknowledgments, not just the remittance

   A wrong payer ID fails at the clearinghouse or on the 277CA claim acknowledgment, not as a denial on the 835. A rejected claim was never received by the payer, so the timely filing clock keeps running until a corrected claim is accepted.

Other payer IDs and plan names for Clover Health

Stedi's payer network also accepts these 4 IDs for Clover Health. If your clearinghouse, an older payer list, or a remittance shows one of them instead of 13285, it most likely routes to the same payer - confirm on your clearinghouse's payer list before you submit.

• 5666
• 6433
• 13285MA
• CLOVE

Plan and payer names Stedi's network routes to Clover Health under 13285. A member card that names one of these, without its own claims payer ID, most likely belongs here.

• Clover Health LLC

Clover Health billing reference

• Clover Health writes dental, medical, vision coverage nationally. Rette indexes 106 Clover Health policy documents - coverage criteria, prior authorization requirements, and billing guidelines.

  Clover Health timely filing, prior auth, and appeals

Payer ID 13285 questions

Which insurance company uses payer ID 13285?

Payer ID 13285 belongs to Clover Health in the Stedi payer network directory. Payer IDs are assigned per clearinghouse, so check 13285 against your own clearinghouse's payer list before submitting.

What is the Clover Health payer ID?

The Clover Health electronic payer ID is 13285. It goes in loop 2010BB of the 837 claim. Payer IDs are assigned per clearinghouse, so confirm 13285 against your own clearinghouse's payer list before relying on it.

Where do I enter payer ID 13285 on an 837 claim?

In loop 2010BB, the payer name loop: the NM1 segment with entity identifier PR, qualifier PI in NM108, and 13285 in NM109. The same NM1*PR structure identifies the payer in loop 2100A of 270 eligibility and 276 claim status requests, though some clearinghouses assign a different payer ID for those transactions.

Can I check eligibility electronically with payer ID 13285?

Yes. Stedi's payer network lists real-time eligibility and benefits checks (270/271) for Clover Health under payer ID 13285, with no enrollment step.

Do I need to enroll to receive ERAs from payer ID 13285?

Yes. Stedi's payer network lists 835 electronic remittance advice from Clover Health as requiring enrollment, which typically takes weeks. ERAs are enrolled per clearinghouse, so enrolling with a new clearinghouse usually moves your 835s to it.

Does Clover Health use any payer ID other than 13285?

Stedi's payer network also accepts 5666, 6433, 13285MA and CLOVE for Clover Health. Clearinghouses and older payer lists often show one of these instead of 13285; if yours does, it most likely routes to the same payer, but confirm on your clearinghouse's payer list before you submit.

Payer IDs for related payers