Coverage profile
How Substrate can help you with Medicare Advantage Pennsylvania
Substrate can help practices and billers with the following claims tasks for Medicare Advantage Pennsylvania.
Claim status
EDI 276/277The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Medicare Advantage Pennsylvania.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Medicare Advantage Pennsylvania.
Portal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Medicare Advantage Pennsylvania.
Appeals agent
AI appeals workflowThe Substrate Appeals Agent can submit appeals for RFIs, medical record requests, downcoding reconsiderations, and more via the payer portal for Medicare Advantage Pennsylvania.
Frequently asked questions
Medicare Advantage Pennsylvania payer FAQs
How do I check claim status with Medicare Advantage Pennsylvania?
Providers check Medicare Advantage Pennsylvania via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
Can I automate Medicare Advantage 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 Medicare Advantage Pennsylvania?
The primary payer ID for Medicare Advantage Pennsylvania is 11000. 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 Medicare Advantage Pennsylvania?
The provider portal for Medicare Advantage Pennsylvania is https://apps.availity.com/. Available features depend on the payer and your account.
What is the 270 payer ID for Medicare Advantage Pennsylvania?
The 270 payer IDs for Medicare Advantage Pennsylvania are 11000 via Stedi and 11000 via Availity.
What is the 276 payer ID for Medicare Advantage Pennsylvania?
The 276 payer ID for Medicare Advantage Pennsylvania is 11000 via Stedi.
What state does Medicare Advantage Pennsylvania operate in?
Medicare Advantage Pennsylvania operates in PA.
Routing reference
Medicare Advantage 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 | Medicare Advantage Pennsylvania |
|---|---|
| Operating states | PA |
| 270 eligibility payer IDStedi | 11000 |
| 270 eligibility payer IDAvaility | 11000 |
| 276 claim status payer IDStedi | 11000 |
Payer contact directory
Medicare Advantage Pennsylvania phone and fax numbers
Use the number associated with your task. These contacts were stated in successful eligibility responses and may apply to specific benefits, products, or departments.
- Other stated context phone
- (800) 521-6007CH2K-AMERIHEALTH CARITAS PA COMMUNITY HEALTHCHOICES
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(800) 537-8862 | Other stated context, PharmacyBenefit context: Active Coverage |
| Health Benefit Plan Coverage, Medical Care, Diagnostic X-Ray, Health Benefit Plan Coverage, Chiropractic, Dental Care, Hospital, Hospital - Inpatient, Hospital - Outpatient, Emergency Services, Pharmacy, Professional (Physician) Visit - Office, Psychotherapy, Vision (Optometry), Mental Health, Urgent Care |
| phone(888) 251-2224 | Behavioral health, Other stated contextBenefit context: Active - Services Capitated |
| Health Benefit Plan Coverage |
| phone(800) 521-6007 | Other stated contextBenefit context: Active - Services Capitated |
| Health Benefit Plan Coverage |
| phone(800) 521-6860 | Other stated contextBenefit context: Active - Services Capitated |
| Health Benefit Plan Coverage |
| phone(844) 626-6813 | Other stated contextBenefit context: Active - Services Capitated |
| Health Benefit Plan Coverage |
| phone(844) 860-9303 | Other stated contextBenefit context: Active - Services Capitated |
| Health Benefit Plan Coverage |
| phone(855) 227-1302 | Other stated contextBenefit context: Active - Services Capitated |
| Health Benefit Plan Coverage |
| phone(866) 918-1595 | Other stated contextBenefit context: Active - Services Capitated |
| Health Benefit Plan Coverage |
Phone and fax numbers sourced directly from the payer response
Other aliases
Also known as
- 11000
- BCHSC
- Z96299
- Medicare Advantage - Pennsylvania