Payer ID 95202: SummaCare Health Plan
95202 is the electronic payer ID for SummaCare Health Plan, according to the Stedi payer network directory. Enter 95202 in loop 2010BB of an 837 claim - the payer name segment, with qualifier PI in NM108 and the ID in NM109 - to route the claim to SummaCare Health Plan. Payer IDs are assigned per clearinghouse, so confirm 95202 on your own clearinghouse's payer list before you submit.
Payer ID 95202 at a glance
- Electronic payer ID
- 95202
- Claim location
- 837 loop 2010BB, NM109
Where payer ID 95202 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*SUMMACARE HEALTH PLAN*****PI*95202~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 95202
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.
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.
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 95202 and confirm it maps to SummaCare Health Plan.
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.
SummaCare Health Plan billing reference
SummaCare Health Plan writes dental, medical coverage in 1 state (OH). Rette indexes 113 SummaCare Health Plan policy documents - coverage criteria, prior authorization requirements, and billing guidelines.
SummaCare Health Plan timely filing, prior auth, and appeals
Payer ID 95202 questions
- Which insurance company uses payer ID 95202?
- Payer ID 95202 belongs to SummaCare Health Plan in the Stedi payer network directory. Payer IDs are assigned per clearinghouse, so check 95202 against your own clearinghouse's payer list before submitting.
- What is the SummaCare Health Plan payer ID?
- The SummaCare Health Plan electronic payer ID is 95202. It goes in loop 2010BB of the 837 claim. Payer IDs are assigned per clearinghouse, so confirm 95202 against your own clearinghouse's payer list before relying on it.
- Where do I enter payer ID 95202 on an 837 claim?
- In loop 2010BB, the payer name loop: the NM1 segment with entity identifier PR, qualifier PI in NM108, and 95202 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.
Payer IDs for related payers
Every payer ID in the directoryPayer IDs come from the payer network directory named above and are assigned per clearinghouse. Always confirm the ID with your clearinghouse and the member's card before submitting a claim.