Coverage profile
Work Centene (Medical) across every published route
Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.
Claim status
EDI 276/277The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Centene (Medical).
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Centene (Medical).
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Centene (Medical).
Other aliases
Also known as
- 10451
- 10466
- 10560
- 10561
- 10562
- 10564
- 10565
- 10566
- 10586
- 10587
- 10589
- 10590
- 10592
- 10620
- 10704
- 10756
- 10759
- 10760
- 10761
- 10763
- 10764
- 10765
- 10771
- 10865
- 10866
- 11034
- 11057
- 11070
- 11082
- 11120
Payer intelligence
Observed adjudication timing
How long completed claims in Substrate’s aggregate network took from payer receipt to the 835 payment date.
Median time to payment
8 days- 10% of adjudications by
- 1 day
- 90% of adjudications by
- 11 days
- Applicable state coverage
- CA
- Current As Of
- June 2026
Five-month median trend
Days to 835 paymentA trend needs at least two qualified service months.
View chart data as a table
| Service month | Median | 10% of adjudications by | 90% of adjudications by | Completed claims | Coverage |
|---|---|---|---|---|---|
| Apr | No qualified data | ||||
| May | No qualified data | ||||
| Jun | 8 days | 1 day | 11 days | 107 | CA |
| Jul | No qualified data | ||||
| Aug | No qualified data | ||||
2027 maternity billing research
When does Centene (Medical) change OB/GYN billing?
CC.PP.016 describes global maternity bundling and prepayment code review. It applies to adopting health plans on their own effective dates and contains no 2027 code-deletion implementation instructions.
- Transition start
- No 2027 transition date stated in cited policy
- Billing start
- No 2027 billing date stated in cited policy
- Published
- Not stated in source
- Current As Of
- August 2026
Scope: Centene corporate template for medical maternity services; individual health-plan adoption and effective dates require verification. No dental or vision billing application is established.
CC.PP.016 Reporting the Global Maternity Package. Verify the payer source before claim submission.
Frequently asked questions
Centene (Medical) payer FAQs
How do I check claim status with Centene (Medical)?
Providers check Centene (Medical) via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
Can I automate Centene (Medical) 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 Centene (Medical)?
The primary payer ID for Centene (Medical) is 68069. 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 Centene (Medical)?
The provider portal for Centene (Medical) is https://apps.availity.com/. Available features depend on the payer and your account.
What are the 837 payer IDs for Centene (Medical)?
The 837P and 837I payer ID for Centene (Medical) is 68069 via Stedi.
What is the 835 payer ID for Centene (Medical)?
The 835 payer ID for Centene (Medical) is 68069 via Stedi.
What is the 270 payer ID for Centene (Medical)?
The 270 payer IDs for Centene (Medical) are 68069 via Stedi and 68069 via Availity.
What is the 276 payer ID for Centene (Medical)?
The 276 payer IDs for Centene (Medical) are 68069 via Stedi and 68069 via Availity.
Routing reference
Centene (Medical) 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 | Centene (Medical)Source: Substrate payer directory · data last changed |
|---|---|
| 837P professional claims payer IDStedi | 68069Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | 68069Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | 68069Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 68069Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | 68069Source: Availity payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDStedi | 68069Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDAvaility | 68069Source: Availity payer catalog · catalog dated · matched by payer ID |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed ; checked .Open payer website ↗
- Stedi payer catalogMatched by payer ID; matched record: Centene (Medical). 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 records: AMBETTER FROM BUCKEYE COMMUNITY HEALTH PLAN, AMBETTER FROM CELTICARE HEALTH, AMBETTER FROM COORDINATED CARE, Ambetter from Health Net, AMBETTER FROM HEALTH NET, AMBETTER FROM MAGNOLIA HEALTH PLAN, AMBETTER FROM MANAGED HEALTH SERVICES, AMBETTER FROM PEACH STATE HEALTH PLAN, AMBETTER FROM SUNSHINE HEALTH, AMBETTER FROM SUPERIOR HEALTHPLAN, AMBETTER OF ARKANSAS, ASCENSION COMPLETE, BRIDGEWAY HEALTH SOLUTIONS, CALIFORNIA HEALTH AND WELLNESS, Care1st Health Plan Arizona (AHCCS Complete Care), Care1st Health Plan Arizona (RHBA), CELTICARE HEALTH, CENTENE, CENTENE MEDICARE, FIDELIS SECURE LIFE, HEALTH NET MEDICARE ADVANTAGE, MICHIGAN COMPLETE HEALTH (FIDELIS SECURE LIFE), SANDATA, TRILLIUM MEDICARE 2016, WESTERN SKY COMMUNITY CARE. 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 ↗
- United Clearinghouse payer catalogMatched by payer name; matched record: Centene (Medical). The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗
Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.