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MetroPlusHealth

Primary payer ID
13265Compare transaction IDs ↓
Last successful claim statusWithin the past weekObserved across Substrate's claim-status network.
SupportedEDI 276/277EDI 270/271

Is your practice experiencing high volumes of no response claims or denials from MetroPlusHealth? Try Substrate Denial Intelligence here -->.

Coverage profile

How Substrate can help you with MetroPlusHealth

Substrate can help practices and billers with the following claims tasks for MetroPlusHealth.

Claim status

EDI 276/277

The Substrate Claim Status Agent can check clearinghouse claim status for your practice with MetroPlusHealth.

Available

Eligibility

EDI 270/271

The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with MetroPlusHealth.

Available

Frequently asked questions

MetroPlusHealth payer FAQs

How do I check claim status with MetroPlusHealth?

Providers check MetroPlusHealth via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.

What is the payer ID for MetroPlusHealth?

The primary payer ID for MetroPlusHealth is 13265. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.

What are the 837 payer IDs for MetroPlusHealth?

The 837P and 837I payer ID for MetroPlusHealth is 13265 via Stedi.

What is the 835 payer ID for MetroPlusHealth?

The 835 payer ID for MetroPlusHealth is 13265 via Stedi.

What is the 270 payer ID for MetroPlusHealth?

The 270 payer IDs for MetroPlusHealth are 13265 via Stedi and 13265 via Availity.

What is the 276 payer ID for MetroPlusHealth?

The 276 payer IDs for MetroPlusHealth are 13265 via Stedi and 13265 via Availity.

What state does MetroPlusHealth operate in?

MetroPlusHealth operates in NY.

Resource library

Routing reference

MetroPlusHealth 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.

MetroPlusHealth payer name, operating states, and transaction-specific payer IDs
Payer nameMetroPlusHealth
Operating statesNY
837P professional claims payer IDStedi13265
837I institutional claims payer IDStedi13265
835 ERA payer IDStedi13265Enrollment required
270 eligibility payer IDStedi13265
270 eligibility payer IDAvaility13265
276 claim status payer IDStedi13265
276 claim status payer IDAvaility13265

Payer contact directory

MetroPlusHealth 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.

Eligibility / benefits phone
(855) 656-0361CVS CAREMARK
Eligibility / benefits fax
(516) 228-9571HEALTHPLEX, INC.
MetroPlusHealth payer phone and fax directory
Channel and numberPayer NotesDepartmentSpecialties
fax(516) 228-9571Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • HEALTHPLEX, INC.
Dental Care
phone(855) 656-0361Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS CAREMARK
Pharmacy
phone(888) 468-2183Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • HEALTHPLEX, INC.
Dental Care

Phone and fax numbers sourced directly from the payer response

Other aliases

Also known as

  • 10846
  • 13265
  • 13265MA
  • 2296
  • METPL
  • MetroPlus Health Plan
  • METROPLUSHEALTHPLAN