Coverage profile
How Substrate can help you with Carelon Health of Pennsylvania
Substrate can help practices and billers with the following claims tasks for Carelon Health of Pennsylvania.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Carelon Health of Pennsylvania.
Enhanced claim status
Availity ECSPortal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Carelon Health of Pennsylvania.
Frequently asked questions
Carelon Health of Pennsylvania payer FAQs
Can I automate Carelon Health of Pennsylvania portal follow-up?
Yes — portal retrieval is required when 276/277 is missing or stale. See payer portal automation and learn why 276/277 is not enough.
What is the payer ID for Carelon Health of Pennsylvania?
The primary payer ID for Carelon Health of Pennsylvania is BHOPA. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.
What is the provider portal for Carelon Health of Pennsylvania?
The provider portal for Carelon Health of Pennsylvania is https://apps.availity.com/. Available features depend on the payer and your account.
What are the 837 payer IDs for Carelon Health of Pennsylvania?
The 837P and 837I payer ID for Carelon Health of Pennsylvania is BHOPA via Stedi.
What is the 270 payer ID for Carelon Health of Pennsylvania?
The 270 payer IDs for Carelon Health of Pennsylvania are BHOPA via Stedi and BHOPA via Availity.
What is the 276 payer ID for Carelon Health of Pennsylvania?
The 276 payer ID for Carelon Health of Pennsylvania is BHOPA via Availity.
What state does Carelon Health of Pennsylvania operate in?
Carelon Health of Pennsylvania operates in PA.
Routing reference
Carelon Health of Pennsylvania payer IDs and operating states
Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.
| Payer name | Carelon Health of PennsylvaniaSource: Substrate payer directory · last refreshed |
|---|---|
| Operating states | PASource: Substrate payer directory · last refreshed |
| 837P professional claims payer IDStedi | BHOPASource: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | BHOPASource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | BHOPASource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | BHOPASource: Availity payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDAvaility | BHOPASource: Availity payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Last refreshed .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: Carelon Health of Pennsylvania. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
- Availity payer catalogMatched by payer ID; matched record: CARELON HEALTH OF PENNSYLVANIA. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.
Other aliases
Also known as
- 2885
- 8089
- BHOPA