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Sutter health plus payer id See Resources. Your employer pays the portion of your health care costs not paid by you. Title: Provider Electronic Health Net Seniority Plus. Payer ID Lookup helps providers comply with industry regulations and payer requirements by ensuring accurate and up-to-date payer ID information is used for claims submission. Continuity of care (Opens in a New Tab) With Sutter Health Plan, you have access to a network of high-quality doctors and hospitals. Access information for providers, medical office staff, third party billers, Sutter’s business associates and other covered entities requiring access to Sutter Health’s clinical data. Once you have selected a PCP, include their Sutter Health Plus Provider ID number and the provider’s name on your enrollment form. Detailed payer for Sutter Health Plus in None, None. As CEO, Jeb is responsible for building and leading one of the most innovative, digitally enabled, payer-provider organizations serving the Northern California market. It operates 24 acute care hospitals and over 200 clinics in Northern California. Cancel and return to Sutter Health Cancel and return to Sutter Health. Member Services is available Monday through Friday, 8 a. Alignment Health Plan, including Sutter Advantage HMO (Medicare Advantage) 3 Sutter Health’s integrated, not-for-profit system of aligned doctors and clinicians, Health Net Seniority Plus: Medicare Advantage HMO: Not contracted effective 1/1/2025: Health Net Smart Care/Canopy Health: HMO: Health Plan of San Joaquin (referrals only) Medi-Cal HMO and San Joaquin County employees: To get care from UCSF covered by insurance, your health plan must first authorize a referral. Surest payer ID and address. Vendors. Important Note . Phil Jackson, CEO of Health Plan Products, Sutter Health. Simply include the Sutter Health Plus Provider ID number (available on the Provider Locator and provider directory) and check that you’re a current patient on your enrollment form. Do not include your application with your payment; it may delay your application process. ID Theft Protection; Business Travel Accident ; Tools & Resources . coverage with Sutter Health Plus. The Sutter Health Plus Provider Portal offers our network providers access to patient eligibility and benefits, claims, forms, the provider manual and provider updates. Sutter Health Going forward, this payer list will include indication where remits are processing for customers. Making Health Care Better contact Sutter Health Plus Member Services at 1-855-315-5800 (TTY 1-855-830-3500), Monday through Friday from 8 a. Humana Attn: Grievance and Appeal Department P. SUTTERSELECT CHOICE PLUS (Choose if SUTTER HEALTH NATIONAL is in the upper-right corner on the front of the ID card. We can answer any In an ongoing effort to keep you aware of the Sutter Health Plus payer negotiations and renewal progress throughout the year, please note that the following health plan provider agreements are renewed for 2024: Aetna; Alignment Health Plan, including Sutter Advantage HMO (Medicare Advantage) Anthem Blue Cross; Chinese Community Health Plan An Employer Identification Number (EIN) is also known as a Federal Tax Identification Number, and is used to identify a business entity. Sacramento, CA. Search by health plan, medical group or facility. Plan C / VA03 12/12/12 Acupuncture and Chiropractic plan ID. m. Aetna Choice POS II. Sutter Health Plus S. For assistance or if you have difficulty accessing the information you need, please contact Sutter Health Plan Customer Service, weekdays, 8:00 am – 7:00 pm at (855) 315-5800 or TTY: (855) 830-3500 . The website you have selected is an external one located on another server. Sutter Health Plus 2024 Premium Reporting For Employers The Consolidated Appropriations Act of 2021 (Section 204) requires insurance companies and employer-based health plans to submit information to the federal government about premiums and cost-sharing. Find billing and insurance information at Sutter, including payment options, financial assistance and guidance to help you navigate your medical bills. NPI or Tax ID: Enter Email Address. UMR is a UnitedHealthcare company. Sutter Health Plus remains in active negotiations with UnitedHealthcare and Health Net (including Wellcare by Health Net). Missing information may delay processing your application. Alignment Health’s Patient 360 is a provider-facing dashboard that presents a snapshot of a member’s health and treatment history to help providers facilitate care coordination. If you're unsure if your health plan covers mental-health services, call 650-988-8275 and speak to a financial counselor who can help determine your coverage. Click here for details! 1/9/2025 10:56:25 AM: 1/9/2025 10:57:02 AM : Fallon Community Health Plan Eligibility : Sutter Health Plus Employer Resources and Information. Decline Decline Sutter’s Cost Estimator Tool provides out-of-pocket estimates for more than 200 frequently used medical services provided by Sutter care centers and more than 300 services provided in Sutter hospitals. TexanPlus North Texas Area: CR543 : None Sutter Health Plan – CORE Companion Guide January 2025 005010 Version 1. Sutter Health is an award-winning, Find out which health plans are accepted by Sutter Medical Group of the Redwoods. Browse Care. WORKING WITH SUTTER HEALTH Plan. If you have questions, call Sutter Health Plan Customer Service at 855-315-580 0. Sutter Health Plan is required to annually report premium costs by average monthly premium and premiums impacted by rebates, fees, and any remuneration to the Departments of Health and Sansum Clinic, founded in 1921, is one of the oldest non-profit outpatient clinics in California. DBA Berkley East Conv. Mail your first month’s premium and completed Remittance Slip to: Sutter Health Plan P. TRICARE UnitedHealthcare: 800-4SUTTER. Online Contact Form. Content Created by Individual Healthcare Professionals at Sutter Health: My Health Online and Sutter Health’s websites may contain content created or written by individual healthcare professionals at Sutter Health, including answers to frequently asked questions, blogs, other written material or content of streaming audio lectures. Idaho Medicaid Eligibility : Processing through backup payer. Jacqueline Jayan, M. Wellcare by HealthNet Provider Appeal P. Find a Provider. Decline. support List additional payer IDs if needed (submit all payer ID’s on one form) – Sutter Health IS/RCPM EDI Dept. Sutter Health Plus includes the claims submission address for all other services on the back of the member’s identification card. Sutter Health Plus is required to provide IRS Form 1095-B to the IRS with a copy to you. The Provider Portal ofers powerful resources to help you navigate your journey with Sutter Health Plus. Arizona & 21st Corp. advanced analytics to power 100+ cloud-based solutions that enable improved clinical outcomes and economics across the healthcare ecosystem. Electronic Services Available (EDI) Professional/1500 Claims. Sutter Health Plus covers COVID-19 screening for members in accordance with state and federal guidelines during this public health emergency. Payer Name: Payer ID: Alta Bates Medical Center: S8300: American Income Life Insurance Company: With Sutter Health Plus, you have access to a network of high-quality doctors and hospitals. D. Data Cloud Overview; payer name payer id 1000: seaview ipa: svipa: 1000: ojai valley community medical group\t: svipa: 1002 sutter connect - east bay medical foundation: 94269: 1707: medadmin solutions (ads) 58202: banner health choice plus hmo: 12x42: 6610: banner health select 500 ppo: 12x42: 6610: banner health arizona: 12x42: 6611: Sutter Health Find a Claim: Current SutterLink users can view additional claim details, by logging in here. Use our convenient online Medical Record Request form to submit your request more quickly. A PCP is your healthcare advocate— providing or coordinating most of your care such as routine exams, preventive care and treatment for illnesses and minor injuries. Data Cloud. Login portal for employees, spouses, domestic partners or former employees who aren’t connected to the Sutter network. This frequently asked questions (FAQs) provides information on the upcoming changes to the Sutter Health Plus network. Your behavioral health insurance may access a “carve out” network or third-party insurer. practices in Elk Grove, CA Sutter Health Plus . Accessing Care. Robert C. Payor ID: Payor Name: Payor Type: Transaction Type: CAPHP: Caprock HealthPlans, Inc: Non-Participating Payor: Professional Institutional: 77082: Care Improvement Plus Quickly search for insurance payer IDs with Office Ally's easy-to-use payer ID lookup tool & access our updated payer ID list to simplify your billing process. Humana. Find a You can also print a temporary ID card from the Member Dashboard page, Sutter Health Plus Service Area6 . In these situations you will need to pay the Provider and file a claim for reimbursement (unless the Provider agrees to bill Sutter Health Plus directly). Registering for the Sutter Health Plus Member Portal to view and print member identification cards, which contain important contact and or as soon as reasonably possible, at 855-315-5800. Each user needs to create their own One Healthcare ID and connect it to any applicable tax ID numbers (TINs). The illustration on the following page provides information about the SutterSelect Nov 21, 2024 Receive convenient and secure electronic healthcare claim payments from hundreds of payers on the InstaMed Integrated ERA/EFT® Payer List. Sutter Health Plus Agent ID Exp. For your convenience, we offer a secure portal that gives our network providers access to eligibility and benefits, claims, forms, the provider manual, provider updates and more. practices in San Francisco, CA Make appointments, message your doctor, view test results and more through our digital patient portal and app. My Health Dr. Due to an event at the payers EDI vendor, the payer is currently unable to process eligibility. Electronic Health Care Claim Payment/Advice Receiver Request Complete all applicable fields. Sutter Independent Physicians is an Independent Practice Association (IPA) of over 600 of the best private practice physicians in the greater Sacramento Valley and foothills area. If you are enrolling as a new member and your current Sutter Health-affiliated PCP participates in the Sutter Health Plus network, you don’t need to change PCPs—even if the practice is closed to new patients. , Bay Operating Unit, Valley Operating Unit or Sutter Health is in the upper-right corner on the front of the ID card AND office visit copays mention Tier 1 and Tier 2. Learn More. When you receive mental health services at El Camino Health, please be aware that you'll receive a separate bill for doctor's fees – psychiatrist fees are separate from hospital-program fees. Unique IDs are the only way to: Help ensure your log-in credentials remain private; Receive personalized email notifications and TrackIt reminders for your work; Customize your UnitedHealthcare Provider Portal views Create One Healthcare ID. Plan B / VA02 12/12/24 Chiropractic-only plan ID. Box 211758, Eagan, MN 55121; For more information, visit our Advance Notification and Clinical Submission Requirements page and Sutter Health Plan Formulary Drug List for HMO Members Effective January 1, 2025 This formulary is the list of prescription drugs available to Sutter Health Plan members for all plans and products Sutter Health Plan offers. 916-297-9300. Use this database to find organizations and see details like their executive compensation, revenue and expenses, as well as download tax filings going back as far as 2001. e New Member ID Cards Sutter Health Plus members will receive new member ID cards with updated prescription benefit information. Getting Started With Sutter Health Plus Page 3 of 9. Check with your PCP on availability and hours. Former payer ID 76045. Find a doctor or clinician for your life and needs. Sutter Health Plus. Chief Executive Officer Jeb Dunkelberger leads Sutter Health | Aetna, a jointly-owned healthcare company formed by Sutter Health and Aetna ®, a CVS Health company. Providers have 180 calendar days from the date of service to submit claims. What is a Payer ID? Payer ID is a 5 digit unique With Sutter Health Plan, you have access to a network of high-quality doctors and hospitals. Cigna Healthcare ; Health Net/Wellcare (Commercial and Medicare Advantage) Humana (Medicare Advantage) United Healthcare (Commercial and Medicare Advantage) Sutter Health Plus will continue their renewal discussions with Anthem Blue Cross and Chinese Health Plan and we will keep you updated on their progress. P. Payer ID: J1512. Member ID Card 7 . Sutter Health is not responsible for any loss or damage caused by your reliance on this information. Aetna Signature Administrators. Sutter Health is pleased to share that renewal negotiations are complete with all carriers for 2024. The name Sutter Health Plan more clearly and concisely communicates who we are — a health plan that is part of the Sutter Health family. Searching for a payer in a client’s Insurance info will only show the name and payer ID. For more information about Sutter Health Plan’ health plans, you may download and view the Evidence of Coverage for individuals, small and large groups. Seema P Shah, M. , M. 0 7 . Name Interchange 276 Sender ID. Phone Interchange 835 Production (ADD/NA) 270/271. If your clinician doesn’t participate in MHO or you’re a new patient, please contact your PCP’s office for video visit options. Sutter Health Plus will then collaborate with the hospital and/or providers to make appropriate payment provisions, and, if safe, transfer Payer Name State Payer ID LOB Transaction Method Info Updated (NLH) Netcare Life and Health Insurance: 66055: Dental: Claims: Unknown: 1/8/2022: 1199 National Benefit Fund Affinity Participating Health Plans Commercial HMO Plans Aetna 1-800-756-7039 Anthem Blue Cross 1-844-802-2224 Blue Shield of California 1-888-568-3560 Health Net 1-800-638-3889 Sutter Health Plus 1-855-315-5800 UnitedHealthcare 1-800-624-8822 Medicare Advantage HMO Plans Call us today at 888-309-2221, Monday-Friday, 8 am – 6 pm. Outside Network. Health (2 days ago) Call Sutter Health Plus Member Services, weekdays, 8:00 am – 7:00 pm at (855) 315-5800 or TTY: (855) 830-3500 to obtain acknowledgment of claim receipt. Providers can also call Sutter Health Plan Customer Service at (855) Abuse and Chemical Dependency benefits for Sutter Health Options PPO and Sutter Health National. ACHP is the voice of a unique approach in health care today, one that puts the patient at the center with plans and clinical teams collaborating to improve health outcomes and reduce costs. All past versions of the formulary are no longer in use. Enrollment in Alignment Health Plan depends on contract renewal. Our payer ID lookup tool helps providers find payer identifiers for claims management and eligibility. Sutter Health is a not-for-profit integrated health delivery system headquartered in Sacramento, California. Do you wish to continue? It is our goal to keep you informed on Sutter Health Plus payer negotiations and renewal progress throughout the year. Box 254707 . Box 211314. View the list of payers available on Availity. Watch video to learn more To download the app, scan the QR code or visit your app store today! To top. Some payers will require re-enrollment. Browse the list to see if your specific health plan is accepted. Tests must be purchased at the pharmacy's check-out counter and members must show their Security Health Plan ID card. 958654707- Fax (916) 854-6722 . Need Help Finding a Provider? 2024 Small Group EOC Plus HDHP HMO; 2024 Small Group EOC Plus HMO; 2024 INDIVIDUAL AND FAMILY PLAN Evidence of Payer Name (Waystar Payer ID) Related Payer Name(s) Prof Claims Inst Claims Secondary Claim LLC Agri Beef Co. Understanding behavioral health/mental health insurance benefits: Most insurance plans offer medical coverage and behavioral health/mental health coverage, however, they may not always access the same network of providers. Sutter Health Plus is required to provide IRS The Alliance of Community Health Plans (ACHP) is pleased to announce that Sutter Health Plus, OhioHealthy and Network Health have joined its growing membership. A Sutter Health Plus EDI trading partner is any business partner, i. Members must select tests that are authorized by the FDA. PLEASE NOTE: We CANNOT SEE clients with any CHIP, Medicaid, Medicare, or Medicare Advantage plans at this time, including as a secondary payer for services. Through the Sutter Health Plus Member Portal, members can access eligibility, benefits, copays, claims, member identification (ID) cards and more. Accepted Aetna Plans. to 7 p. Payer Name Eligibility Internal Payer Code Eligibility (270/271) Eligiblity Attributes MOLINA HEALTHCARE IDAHO: MOLINA_ID: MOLINA HEALTHCARE OF MISSOURI: MOLINA_MO: MOLINA IOWA: MOLINA_IA: MOLINA KENTUCKY: MOLINA_KY: SUTTER HEALTH AETNA: SUTTER_HEALTH_AETNA: TEXAS CHILDRENS HEALTH PLAN: TEXAS_CHILDRENS: Giving to Sutter is giving to your community. Some Sutter affiliated medical groups administer self-funded healthcare plans as part of benefits programs offered to medical group employees. Sutter Health provides comprehensive, award-winning ambulatory, acute and specialty care to communities across Northern and Central California. Access the forms, resources and other information you need to work with Sutter Health Plus. Additionally, watch a video to see how UMR is refreshing the look of UMR is a third-party administrator (TPA), hired by your employer, to help ensure that your claims are paid correctly so that your health care costs can be kept to a minimum and you can focus on well-being. . EMAIL . TRICARE. Contact Us. If you do not have your health plan ID card, call 1-800-826-9781. It is always important to verify and update insurance information and know which testing laboratories are in-network or If your current Sutter PCP also participates in the Sutter Health Plus network, you don’t need to change PCPs—even if the practice is closed to new patients. Get financial support when you need it. PAYER ID # your practice is credentialed with. Welcome to Sutter Independent Physicians. Sutter Health Plan includes the PPG and claims submission address on the member’s identification (ID) card. Box 211553 Eagan, MN 55121 Sutter Health Plus Agency ID Exp. The longitudinal patient record allows care providers to access the health plan’s view of information associated with a member including gaps in care, Tethys Health Ventures: 20212 : None : Texan Plus (Kelsey-Sebold) 14163 : None : Effective 6/1/2019 plan administered by WellCare either Payer ID 14163 14163 : 835: Click Here : Effective 6/1/2019 plan administered by WellCare either Payer ID 14163 FFS or 59354 Encounters. Filter Type: All Symptom Treatment Nutrition Providers - Sutter Health Plus. Cookie Policy. practices in Danville, CA. If requesting for someone other than yourself, you may be asked to upload supporting documentation in addition to your Photo ID to verify your authority to request medical records No. Please eail, fax or mail the completed form and supporting documentation, including a receipt that shows them d ate within the current plan year to: EMAIL FAX Sutter Health Plan Attn: Claims 916-736-5426. For questions relating to Sutter Health Plus 835 Health Care Claim Remittance Advice Transaction or testing, send an email to the Sutter Health Plus EDI Department at . Be sure to stay up-to-date on these important health screenings. Valley Health Plan. Plus, asking a few key questions can help you find the right primary care physician. Yes. For questions about benefits, eligibility or claims, please contact the number on the member’s ID card. Plus, you'll have access to our online tools and resources that'll help you get the most out of your health care. Enrollment in a plan may be limited to certain times of the year unless you qualify for a special enrollment period or you’re in your Medicare Initial Enrollment Period. You can perform an expanded search by navigating to Settings > Client billing and insurance > Payers and clicking Search available payers. Hospital AVIR Inc. for the 835 ERA. To obtain a copy, contact your broker or call Sutter Health Plus Account Services 1-855-315-5800 (TTY 1-855-830-3500). This formulary is subject to change. AllCare Advantage MRCHP 837 Former payer ID 26160 Allcare Health CCO MRIPA 835 Experian Health Payer List Page 7 of 149. The following health agreements are renewed for 2024: Abburi brings nearly 25 years of healthcare experience, including leadership roles at Cigna, Centene, and UnitedHealth Group, where she developed a proven track record of improving results and Alignment Health Plan is an HMO, HMO POS, HMO C-SNP, HMO D-SNP and PPO plan with a Medicare contract and a contract with the California, Nevada, North Carolina and Texas Medicaid programs. Click here for more information. Eagan, MN 55121. Use the following specific information for paying your premiums. The Insurance Payer ID list is a unique identification number assigned to each insurance company. Important Note The Affordable Care Act (ACA) requires Sutter Health Plus to collect the Social Security numbers (SSN) for all enrolled family members. The Sutter Health Plus Member Portal provides 24/7 access to member ID cards and important information about eligibility, benefits, cost sharing and claims. Sutter Single Sign On. support@sutterhealth. Sutter Hospital Association was founded in 1921 as a response to the 1918 flu pandemic. Acupuncture-only plan ID. For guidelines, please call Sutter Health Plan Customer Service at 855-315-5800. Find out which health plans are accepted by Sutter Medical Group, Solano. For questions relating to the Sutter Health Plan 276/277 Healthcare Claim Status Request and Response Transaction or testing, please email your questions to . Interchange 270 Sender ID Request Submitted by. Find resources on credentialing, secure email, accounts payable and other vendor information. Payer ID: SC004, SC008, SC050 www. By Payer Id, every provider and insurance company r payer connect electronically with each other. Members impacted by the LA-area fires and windstorms, we are here to help ensure you get the care and support you need. Phone Email. ) SUTTERSELECT OPTIONS PPO . O. Additional information will be provided on the next page regarding the benefits of utilizing SutterLink and how to request access. MAIL Sutter Health Plan Attn: Claims P. For questions relating to Sutter Health Plan 270/271 Healthcare Eligibility Status Request and Response transaction or testing, contact the EDI department by email at questions to . Generally, businesses need an EIN. The website you have selected is Detailed payer for Sutter Health Plus in None, None. Check to see if your employer provides coverage for Tava. For general claim inquiries, call 1-800-826-9781. Please check payer listing daily for remit processing updates. S. Box 3060 Farmington, MO 63640-3822. To improve your website experience, We will send you a new ID card within 10 calendar days after changing your PCP. Call us 24/7 at 1-833-242-2223 (TTY: 711). Review the complete list of health plans to see if your specific plan is accepted. Thank you! Your submission has been received! 5 Working with Sutter Health Plus . Please have your tax identification (ID) number and national provider ID number available. To complete the application Sutter Health Plus must receive a binder check. Ask us how to automate this for you! Skip to main content. Date of Birth. I. Jeb Dunkelberger M. Aetna Select EPO. The UMR app, a smarter, simpler, faster way for members to stay connected to their health care benefits information, on demand, anytime, anywhere. Giving to Sutter is giving to your community. Learn More Listing Websites about Sutter Health Plus Payer Id. To obtain a copy, contact your broker or call Sutter Health Plus Account Services at 1-855-325-5200 (TTY 1-855-830-3500). Aetna Select Open Access. Named for nearby Sutter's Fort, its first hospital opened in 1923. This website may contain links to third party sites. Browse by specialty and location to find Sutter providers who match your unique preferences. Sutter Health. You can use this insurance payer id lookup tool to search the verified latest payer ID information of all insurances in United States! Use the search bar to easily search by insurance name OR payer ID number. Large Group Plan Employer Healthcare Coverage Application Page 4 of 5 . For accommodation of persons with special needs at onsite events, call 1-800-478-8837 (TTY 711). Located in Santa Barbara, it is also one of the largest healthcare providers on the south and central coast of California. Many payers will not require action by clients on the Exchange for remit processing if they were receiving remits prior to February 21, 2024. please contact Sutter at: 800-611-5191. Group, member (including any heirs or assigns) and Sutter Health Plus agree and understand that any and all disputes by and between Finding information at a moment’s notice has become increasingly easier through smart technology — and that ease includes health plan information. com 2020-03-02 . Our Locations. practices in Sacramento, CA and Dixon, CA Never leave home without your health plan ID card. Find a Doctor. Sutter SeniorCare PACE (Program of All-Inclusive Care for the Elderly) is a health plan for adults 55 and older in Sacramento County. Mandatory Arbitration . Find out which health plans are accepted by Sutter West Bay Medical Group. Dr. For Patients. Box 278136 Sacramento, CA 95827-8136 UMR is a third-party administrator (TPA), hired by your employer, to help ensure that your claims are paid correctly so that your health care costs can be kept to a minimum and you can focus on well-being. The Affordable Care Act (ACA) requires Sutter Health Plus to collect the Social Security numbers (SSNs) for all enrolled members. UnitedHealthcare. Business Name: SUTTER HEALTH- MEMORIAL MEDICAL CENTER: Conformed submission company name, business name, organization name, etc CIK: N/S (NOT SPECIFIED) Understanding behavioral health/mental health insurance benefits: Most insurance plans offer medical coverage and behavioral health/mental health coverage, however, they may not always access the same network of providers. 1 . What to ask (opens in new window) Top Screenings You Need. Select the . With Sutter Health Plus, you have access to a network of high-quality doctors and hospitals. Find out which health plans are accepted by Sutter Medical Group. Get care at your fingertips. 6 Trading Partner Registration . shpedi. Sutter Select: 10941 $ Three Rivers Health Plans (Unison Health Plan) 10318 $ Thrivent: 11158 $ Trillium Community AmeriChoice NY Medicaid And Child Health Plus, AmeriChoice NY Personal Care Plus) 87726 (Formerly 86002 & 86048) (For Remits Sutter Health Plan does not accept cash or credit cards. Basic A Plus Staffing (ALL Sutter Health Plus. Turquoise Verification HIOS Issuer ID N/A Detailed payer for Sutter Health Plus in None, None. E-MK-24-053R Section D before applying for coverage with Sutter Health Plus. Aetna Open Access Elect Choice EPO. Vazquez, M. O. Sutter Health's digital patient portal, My Health Online (MHO), connects over one million patients to their doctors and health records anytime, anywhere. Column 1. Members have access to the Member Portal where they can retrieve important plan Welcome to SIP’s Physicians’ Portal. Through the Member Portal, members can also access the Health copy, contact your broker or call Sutter Health Plus Member Services at 1-855-315-5800 (TTY 1-855-830-3500). Since 2013, the IRS has released data culled from millions of nonprofit tax filings. Baker Tanks, Inc. CHECK Complete the Remittance Slip on page 10 of the enrollment form and make your check payable to Sutter Health Plan. Sutter Health Plus offers a convenient, user-friendly platform to help members manage their healthcare anytime, anywhere. Find the care you need nearby and make an appointment online or by phone. A-Broker/Agent Name Agent License Number and Expiration Date . New Business Cutoffs; An Update On Payer Negotiations with Sutter Health Plus. 855-315-5800. Aetna – through June 30, 2025 2. Sutter Connect . By signing into your account, you can: Find health care providers; Check health care account balances; View claims; when you need it. 3. Box 14165 Cancel and return to Sutter Health. Book an Appointment. 2 GETTING STARTED . Our mission at SIP is to partner with your independent practice to deliver efficient, innovative, high quality care. For digital claims, use 25463; For paper claims, mail to Surest at P. Email Role. shpsales@sutterhealth. “We are taking a fresh look at everything we do, from solutioning through technology to our relentless focus on the customer experience,” shared Rob Carnaroli, Sutter Health Plan VP of Sales. Emergency Services from a Non-Participating Provider). Sutter Health is an award-winning, innovative not-for-profit healthcare system serving diverse communities across Northern California and the Central Coast. Aetna Premier Care Network (APCN) Aetna Premier Care Network (APCN) Plus. Turquoise Verification HIOS Issuer ID N/A Find out which health plans are accepted by Alta Bates Summit Medical Center - Summit Campus. Sutter Health co-hosted events are not affiliated with eHealth or the government. The dynamic table below provides the entire list of Payer IDs that PNT is connected to. Swapna Merupula, M. Sutter Health Plan billing guidelines are not included in this document. We’re a healthcare company that brings together Sutter Health’s network of nationally recognized, high-quality † doctors and hospitals with Aetna’s leading health plan expertise, cutting-edge data, analytics and Labcorp will file claims for insured patients directly to Medicare, Medicaid, and many insurance companies and managed care plans. practices in Oakland, CA Please note, the following Northern California payer agreements are renewed for 2025: 1. esolutionsinc. We have update complete Health insurance payer ID list 2025, In certain situations a Provider of health care services may not submit your claim directly to Sutter Health Plus (e. Click here for details! 9/25/2024 10:35:52 AM: Sutter Health Plus Eligibility : Payer Unavailable. 2. Insurance or Member ID. g. In this article published in the May 4, 2017 issue of the Sacramento Business Journal and San Francisco Business Times, Phil Jackson, CEO of Health Plan Products at Sutter Health, discusses the key benefits of provider-sponsored health plans and the important role they play in improving quality and cost Other use cases cited by payer executives include case planning and care planning (63%), utilization and prior authorization (56%), population health (44%), finance management (25%) and billings You must email or fax your signed and completed form to Sutter Health Plus. Bindu Nair, M. Video Visits; Walk InstaMed offers connections to payers for all types of healthcare transactions, including eligibility Integrated ERA/EFT Payer List. C-Broker Account Manager Name Broker Account Manager Email . FAX . Sutter Health Plus provides translation services and other California Choice Network Canopy Health Network Aetna Anthem Blue Cross Blue Shield HealthNet Sutter Health Plus UnitedHealthCare Western Health Advantage HMO HMO Deductible AVN Basic HMO HMO Select HMO Priority Select HMO Access+ HMO Local Access+ HMO Trio ACO HMO HMO WholeCare SmartCare Salud HMO y Más HMO Signature Value Let us coordinate your care needs, so you can focus on living life to the fullest. The address for your premium payment varies by method of payment. If you’re a Sutter Health plan member and have questions, complete the form or call us. Contact Information9 . Jan 04, 2024 Sutter Connect - Central Valley Med Group (Claims) 77035: Professional: Centurion LLC Centurion: IHS11: American Worker Health Plus : 37322: Professional: Companion Forethought Bankers Reserve/Wellcare Thrivent HEALTH ALLIANCE P (Use payer ID 38224 for claims with a date of service 01-01-20 and MVP Care Plus) 86047; Y Y; former payer id 86001 Medicaid, Dual SNP; UnitedHealthcare Community Plan / OH 88337; Y Y; former payer id 87726 Medicaid, Dual SNP; former Payer ID 84065 Multiple Sierra Health and Life; 76342 Y; N Multiple Sierra Health and Life - A complete list of Alignment health plans accepted by Sutter Health Hospitals and Medical Groups. UMR is not an insurance company. Even if you have an existing Quantum Health account for the prior app or website, you need to register for your account again to take advantage of enhanced security features. As required by the Transparency in Coverage Rule, machine-readable files that include negotiated rates for in-network services as well as the allowed amount for out-of-network services that are incurred under their respective health Pay your first month’s premium through the Sutter Health Plan Online Payment Center. Video Visits; Walk UMR is a third-party administrator (TPA), hired by your employer, to help ensure that your claims are paid correctly so that your health care costs can be kept to a minimum and you can focus on well-being. Our advocacy focuses on providing policymakers with tested solutions, rooted in a model that is proven to deliver better value for patients, employers and taxpayers. Our physicians offer primary care for children, adults, and families, as well as advanced specialty care. When you enroll in Sutter Health Plan, you and each covered family member selects a primary care physician (PCP). Need Help Finding a Provider? Search providers and facilities by location, specialty and more. ACTIN Care Groups / Clifton Health Systems 24585 837I. This is helpful for payers that have different payer IDs associated with them, or unique claim filing rules. IMPORTANT: Be prepared to upload a copy of your Photo ID when using the online tool. For help, please call Sutter Health Plus Member Services at 1-855-315-5800 (TTY 1-855-830-3500). org. Skip to main content. Login portal for Sutter Health employees using the Sutter network. Plan Partners 8 . I P D I P D I P D I P D Payer Name Payer Code Transaction Available Enrollment COB Attachments Notes Allied Healthcare ALLCA 837 (Choose if Health Ventures, Inc. For Sutter Health Plus to process your request, you must sign and return the last page of this form. Box 278136 Sacramento, CA 95827-8136. Providers - Sutter Health Plus. H. Searching for additional payers. Our Collaboration. For additional information or for assistance in completing the application, call 1-800-611-5191 . Members will need to present their new ID card at the pharmacy for any prescriptions filled on or after January 1, 2022. Due to an event at the payers EDI vendor, the payer is currently unable to receive professional claims. 276/277. AD-COMP - Use our search tool to quickly find out if your health plan is accepted by Sutter Health. Tap Register to get started. For fastest service, please contact your customer service team by calling the toll-free number on your health plan ID card. Alta Healthcare American Furniture Warehouse American Liberty Insurance Company ANACO ANAIC Cibus Antelope Valley Ret. Health (2 days ago) Sutter Health Plus. 835; Please fill out all fields and email completed form to Sutter Health Plus at . ) With a Primary Care Physician (PCP) — Video visits with a PCP are available to members age 3 months and older for routine care to complex health issues. As a not-for-profit health system, we reinvest every extra dollar into improving care and supporting families. Effective January 1, 2021, the Sutter Health Plus network will no longer include: Brown & Toland Physicians – Primary care physicians (PCPs) in San Francisco and San Mateo counties Brown & Toland Physicians – East Bay – PCPs and specialists in your health plan and subject to the deductible and out-of-pocket maximums. These links are provided for convenience purposes and are not under the control of Sutter Health. oji ajzrbt txakk rtdgo hhi izr iryuck aomqymb ckhqnw deocjw