Payer ID PHP01: Providence Health Plan
PHP01 is the electronic payer ID for Providence Health Plan, according to the Stedi payer network directory. Enter PHP01 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 Providence Health Plan. Payer IDs are assigned per clearinghouse, so confirm PHP01 on your own clearinghouse's payer list before you submit.
Payer ID PHP01 at a glance
- Electronic payer ID
- PHP01
- Claim location
- 837 loop 2010BB, NM109
Where payer ID PHP01 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*PROVIDENCE HEALTH PLAN*****PI*PHP01~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 PHP01
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 PHP01 and confirm it maps to Providence 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.
Providence Health Plan billing reference
Providence Health Plan writes dental, medical, vision coverage in 3 states (CA, OR, WA). Rette indexes 411 Providence Health Plan policy documents - coverage criteria, prior authorization requirements, and billing guidelines.
Providence Health Plan timely filing, prior auth, and appeals
Payer ID PHP01 questions
- Which insurance company uses payer ID PHP01?
- Payer ID PHP01 belongs to Providence Health Plan in the Stedi payer network directory. Payer IDs are assigned per clearinghouse, so check PHP01 against your own clearinghouse's payer list before submitting.
- What is the Providence Health Plan payer ID?
- The Providence Health Plan electronic payer ID is PHP01. It goes in loop 2010BB of the 837 claim. Payer IDs are assigned per clearinghouse, so confirm PHP01 against your own clearinghouse's payer list before relying on it.
- Where do I enter payer ID PHP01 on an 837 claim?
- In loop 2010BB, the payer name loop: the NM1 segment with entity identifier PR, qualifier PI in NM108, and PHP01 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.