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Bundled codes for maternity are deleted January 1, 2027Get ready for the change >>
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Coverage profile

Work PrimeWest Health 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 276/277

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

Currently not answering

Eligibility

EDI 270/271

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

Available

Other aliases

Also known as

  • 10494
  • 1565
  • 2786
  • 61604
  • LX049
  • PRMWST
  • PrimeWest Health Plan
  • PRIMEWEST

Payer policies

PrimeWest Health policies

The first 25 of 141 public policies Substrate tracks for PrimeWest Health, by title. Links open the payer's own document; check its current version before relying on it.

Search all 141 PrimeWest Health policies by CPT code, keyword or policy number →

Routing reference

PrimeWest Health 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.

PrimeWest Health payer name, operating states, and transaction-specific payer IDs
Payer namePrimeWest HealthSource: Substrate payer directory · data last changed
Operating statesMNSource: Substrate payer directory · data last changed
837P professional claims payer IDStedi61604Source: Stedi payer catalog · catalog dated · matched by payer ID
837I institutional claims payer IDStedi61604Source: Stedi payer catalog · catalog dated · matched by payer ID
835 ERA payer IDStedi61604Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDStedi61604Source: Stedi payer catalog · catalog dated · matched by payer ID
276 claim status payer IDStedi61604Source: Stedi payer catalog · catalog dated · matched by payer ID
276 claim status payer IDAvaility61604Source: 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: PrimeWest Health. 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: PRIMEWEST 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 ↗

Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.

Not affiliated with PrimeWest Health or BCBSA.

Confirm routing with your clearinghouse. Report an error

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.

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