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Providence Payer ID

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LINDSAY JAQUES

Hi there, I have a client with Providence. Last year it was billed thrugh Providence Behavioral Health (PBH) but this year, it has switched over to billing directly to Providence. The address for claims the client was given is Providence Health Plan (PHP) P.O. Box 3125 Portland, OR 97208-3125 but I don't see an Electronic Payer ID available that coordinates with that address. Can you help with the correct Payer ID to use?

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6 comments

Date Votes
  • Gillian

    Hi Lindsay, I can provide clarity to your question about Providence Behavioral Health/Optum. 

    Payers can go by different names and use different payer IDs depending on the clearinghouse they're working with. On SimplePractice, the general payer ID for UnitedHealthcare/Optum Behavioral Health is Payer ID 87726. 

    For more context, electronic claims are routed based on the Payer ID only, therefore, the various plan names you see on our system aren't as important. This is similar to the address, electronic claims are sent from our clearinghouse right into the payer's database, and not to a physical address.  

    Since we have a connection with this payer, an enrollment isn't required to file electronic claims on our system. 

    If you've confirmed with the payer that the Payer ID is 87726 or if this payer ID is located on the card, you'll want to make sure that this insurance is selected under the client's profile > Edit Details > Billing & Insurance. 

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  • Mindy Feather

    @Gillian Providence has informed providers that they moved away from Optum in 2021. Can you please clarify if 87726 is still accurate? I'm seeing mixed messages ranging from advice to bill to PHP101, 87726, or even that SP cannot bill them at all now and we must use another program such as Availity.

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  • Gillian

    Hi Mindy, thanks for the additional information. We've seen clinicians having success billing Providence through PHP101 in 2021 - I'd recommend trying that Payer ID and notifying our Success team in case your claim is denied or rejected.

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  • Kristen Tryniszewski, LPC

    I just got confirmation from someone at Providence that we should now use PHP01

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  • Geralyn McNamara

    Anyone having luck getting claims paid through Providence in 2021? I have refiled several times, with both the address above and the one listed here on Simple Practice (under PHP01 after1/1/2021). What is going on? I am about to stop Providence insurance completely. The pay is the worst, so maybe this is a sign?

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  • Natalie D. Steele

    Hi, I have been told if you are out of state they now want national claims submitted to Beacon Health Options payer ID: BEACON963116116 but I'm not seeing that as an option to set up here in Simple Practice. Can someone please help me get this set up? 

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