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Payer Directory

How to check HealthPlan Services eligibility

A portal or phone check takes a front-desk staffer 10–15 minutes per patient. HealthPlan Services has no eligibility API — so instead of your staff doing that, our screen agent runs the portal check for you, on your schedule.

Payer ID 59143Screen agent · setup requiredCommercial

Three ways to verify HealthPlan Services coverage

  1. Payer portal — free, but one patient at a time and 10–15 minutes each with logins.
  2. Phone (IVR) — hold times vary; no written record for the chart.
  3. Automated 270/271 check — full benefit detail in seconds, batched for the whole schedule, from $0.50 per check.

HealthPlan Services at a glance

What billers need before running a check.

Payer ID
59143
Also known as 6172
Real-time eligibility
Via screen agent
HealthPlan Services has no eligibility API, so our screen agent runs the portal check for you on your schedule. Setup required.
Coverage
medical
Commercial
Operating area
Not published

Supported transactions

What can be exchanged electronically with HealthPlan Services today.

TransactionStatus
Eligibility (270/271)
Real-time benefit and coverage checks
NOT AVAILABLE
Claim status (276/277)
Where a submitted claim stands
NOT AVAILABLE
Professional claims (837P)
Physician and outpatient claims
SUPPORTED
Institutional claims (837I)
Facility claims
SUPPORTED
Dental claims (837D)
Dental claims
NOT AVAILABLE
Remittance (835 ERA)
Electronic remittance advice
NOT AVAILABLE
Coordination of benefits
Secondary-payer routing
NOT AVAILABLE
Claim attachments (275)
Supporting documentation
NOT AVAILABLE

Portal vs. phone vs. automated

The same verification, three ways.

Payer portalPhone / IVRAutomated check
Time per patient10–15 min15–30 minSeconds
Cost per check~$7.97 staff time*~$7.97+ staff time*from $0.50
Record for the chartScreenshotNoneFull audit trail
Whole-day scheduleOne at a timeOne at a timeBatched overnight

*CAQH Index benchmark for a manual eligibility verification.

Frequently asked questions

What is the payer ID for HealthPlan Services?+
HealthPlan Services uses payer ID 59143. It also appears as 6172 in some systems.
Does HealthPlan Services support real-time eligibility verification?+
HealthPlan Services has no eligibility API, so there is no 270/271 transaction to send. Checks still run automatically: our screen agent performs the portal check for you on your schedule, rather than a staff member doing it per patient. Setup is required. Claims can be submitted electronically.
How long does a HealthPlan Services eligibility check take?+
A portal check takes 10–15 minutes of staff time per patient. A screen agent runs the same check without occupying anyone — scheduled ahead of the day's appointments, so results are waiting rather than being fetched one patient at a time.

Run your first HealthPlan Services eligibility check

From $0.50 per check, pay-as-you-go. No contract, no implementation project.

Billing more than HealthPlan Services? — upload it and see which of your payers run automatically.

65%
fewer denials at Valley Diabetes & Obesity
90%
of eligibility checks fully automated
$107–149K
annual savings, small specialty practice
24 mo
in production