Coverage profile
Work Healthfirst (Health Insurance for New Yorkers) 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 Healthfirst (Health Insurance for New Yorkers).
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Healthfirst (Health Insurance for New Yorkers).
Other aliases
Also known as
- 10674
- HFRST
- Health First Insurance
2027 maternity billing research
When does Healthfirst (Health Insurance for New Yorkers) change OB/GYN billing?
Beginning June 1, 2026, apply Healthfirst's updated routine prenatal billing requirements when antepartum care begins on or after that date or the estimated due date is January 1, 2027 or later. Bill affected routine prenatal visits with the appropriate E/M code for the setting, patient status and documented service, modifier TH, and pregnancy-related O or Z ICD-10 diagnoses. For MMC and HARP, report 0500F for the initial prenatal visit and 0503F for postpartum care on separate, real-time, no-charge informational claims, not bundled with payment claims.
- Transition start
- 2026-06-01
- Billing start
- 2026-06-01
- Published
- 2026-04
- Current As Of
- August 2026
Scope: Healthfirst plan-specific reimbursement policy for professional obstetrical services in its expressly listed medical lines of business, including MMC and HARP. This record is supported for the applicable medical Medicaid product, not dental services.
PO-RE-132 Obstetric Billing Guidelines. Verify the payer source before claim submission.
Frequently asked questions
Healthfirst (Health Insurance for New Yorkers) payer FAQs
How do I check claim status with Healthfirst (Health Insurance for New Yorkers)?
Providers check Healthfirst (Health Insurance for New Yorkers) via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
What is the payer ID for Healthfirst (Health Insurance for New Yorkers)?
The primary payer ID for Healthfirst (Health Insurance for New Yorkers) is HFRST. 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 270 payer ID for Healthfirst (Health Insurance for New Yorkers)?
The 270 payer IDs for Healthfirst (Health Insurance for New Yorkers) are HFRST via Stedi and HFRST via Availity.
What is the 276 payer ID for Healthfirst (Health Insurance for New Yorkers)?
The 276 payer IDs for Healthfirst (Health Insurance for New Yorkers) are HFRST via Stedi and HFRST via Availity.
What state does Healthfirst (Health Insurance for New Yorkers) operate in?
Healthfirst (Health Insurance for New Yorkers) operates in NY.
Routing reference
Healthfirst (Health Insurance for New Yorkers) 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 | Healthfirst (Health Insurance for New Yorkers)Source: Substrate payer directory · data last changed |
|---|---|
| Operating states | NYSource: Substrate payer directory · data last changed |
| 270 eligibility payer IDStedi | HFRSTSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | HFRSTSource: Availity payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDStedi | HFRSTSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDAvaility | HFRSTSource: 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: Healthfirst (Health Insurance for New Yorkers). 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: HEALTH FIRST INSURANCE. 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.