Coverage profile
Work Geisinger Health Plan Gold 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.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Geisinger Health Plan Gold.
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Geisinger Health Plan Gold.
Other aliases
Also known as
- 10612
- GHP Gold
- Geisinger Health Plan-Gold
- GEISINGER HEALTH PLAN
2027 maternity billing research
When does Geisinger Health Plan Gold change OB/GYN billing?
GHP is preparing for the 2027 maternity CPT changes and expects consistent application across its plan offerings once implemented. Continue current maternity billing until formally notified by GHP. Contracts and reimbursement methodologies are unchanged by these coding updates; no Gold-specific implementation date is announced.
- Transition start
- See guidance
- Billing start
- Not announced
- Published
- 2026-05-15
- Current As Of
- August 2026
Scope: Geisinger Gold Medicare Advantage medical maternity services, within GHP's stated expectation of consistent application across all plan offerings once implemented. No separate dental or vision billing applicability is established.
Maternity CPT coding modernization. Verify the payer source before claim submission.
Frequently asked questions
Geisinger Health Plan Gold payer FAQs
Can I automate Geisinger Health Plan Gold 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 Geisinger Health Plan Gold?
The primary payer ID for Geisinger Health Plan Gold is 10612. 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 Geisinger Health Plan Gold?
The provider portal for Geisinger Health Plan Gold is https://apps.availity.com/. Available features depend on the payer and your account.
What are the 837 payer IDs for Geisinger Health Plan Gold?
The 837P and 837I payer ID for Geisinger Health Plan Gold is 75273 via Stedi.
What is the 835 payer ID for Geisinger Health Plan Gold?
The 835 payer ID for Geisinger Health Plan Gold is 75273 via Stedi.
What is the 270 payer ID for Geisinger Health Plan Gold?
The 270 payer IDs for Geisinger Health Plan Gold are 75273 via Stedi and 75273 via Availity.
What is the 276 payer ID for Geisinger Health Plan Gold?
The 276 payer ID for Geisinger Health Plan Gold is 75273 via Stedi.
What state does Geisinger Health Plan Gold operate in?
Geisinger Health Plan Gold operates in PA.
Routing reference
Geisinger Health Plan Gold 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 | Geisinger Health Plan GoldSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | PASource: Stedi payer catalog · catalog dated · matched by payer nameSource: United Clearinghouse payer catalog · matched by payer name |
| 837P professional claims payer IDStedi | 75273Source: Stedi payer catalog · catalog dated · matched by payer name |
| 837I institutional claims payer IDStedi | 75273Source: Stedi payer catalog · catalog dated · matched by payer name |
| 835 ERA payer IDStedi | 75273Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer name |
| 270 eligibility payer IDStedi | 75273Source: Stedi payer catalog · catalog dated · matched by payer name |
| 270 eligibility payer IDAvaility | 75273Source: Availity payer catalog · catalog dated · matched by payer name |
| 276 claim status payer IDStedi | 75273Source: Stedi payer catalog · catalog dated · matched by payer name |
Routing sources and verification
- Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Data last changed ; checked .
- Stedi payer catalogMatched by payer name; matched record: Geisinger Health Plan. 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 name; matched record: GEISINGER HEALTH PLAN. 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: Geisinger Health Plan Gold. 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.