Coverage profile
Work Simply Healthcare 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 Simply Healthcare.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Simply Healthcare.
Enhanced claim status
Availity ECSPortal claim status
Browser automationThe Substrate Claim Status Agent can check claim status via the payer portal for Simply Healthcare.
Other aliases
Also known as
- 10826
- 1096
- 27094
- 8124
- SMPLH
- SMPLY
- SMPLYMA
- Simply Healthcare Plans, Inc.
- Wellpoint
- SIMPLYHC
Frequently asked questions
Simply Healthcare payer FAQs
How do I check claim status with Simply Healthcare?
Providers check Simply Healthcare via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
Can I automate Simply Healthcare 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 Simply Healthcare?
The primary payer ID for Simply Healthcare is SMPLY. 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 Simply Healthcare?
The provider portal for Simply Healthcare is https://apps.availity.com/. Available features depend on the payer and your account.
What are the 837 payer IDs for Simply Healthcare?
The 837P and 837I payer ID for Simply Healthcare is SMPLY via Stedi.
What is the 835 payer ID for Simply Healthcare?
The 835 payer ID for Simply Healthcare is SMPLY via Stedi.
What is the 270 payer ID for Simply Healthcare?
The 270 payer IDs for Simply Healthcare are SMPLY via Stedi and SMPLY via Availity.
What is the 276 payer ID for Simply Healthcare?
The 276 payer IDs for Simply Healthcare are SMPLY via Stedi and SMPLY via Availity.
What state does Simply Healthcare operate in?
Simply Healthcare operates in FL.
Routing reference
Simply Healthcare 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 | Simply HealthcareSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | FLSource: Substrate payer directory · data last changed |
| 837P professional claims payer IDStedi | SMPLYSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 837I institutional claims payer IDStedi | SMPLYSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 835 ERA payer IDStedi | SMPLYEnrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | SMPLYSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | SMPLYSource: Availity payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDStedi | SMPLYSource: Stedi payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDAvaility | SMPLYSource: 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: Simply Healthcare. 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: SIMPLY HEALTHCARE. 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: Simply Healthcare. 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.
Payer contact directory
Simply Healthcare 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
- (800) 243-1401SUPERIOR VISION
| Channel and number | Payer Notes | Department | Specialties |
|---|---|---|---|
| phone(800) 243-1401 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Vision (Optometry) |
| phone(800) 454-3730 | Eligibility / benefits, Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Co-Payment |
| Hospital, Pharmacy |
| phone(800) 848-3555 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Chiropractic |
| phone(800) 888-1965 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Mental Health |
| phone(844) 405-4296 | Eligibility / benefits, Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Co-Payment |
| Chiropractic, Chiropractic, Physician Visit - Office: Well, Hospital, Pharmacy |
| phone(844) 405-4297Phone menu guide → | Eligibility / benefits, Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Co-Payment |
| Chiropractic, Chiropractic, Physician Visit - Office: Well, Pharmacy |
| phone(844) 870-3979 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Vision (Optometry) |
| phone(855) 208-6334 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Dental Care |
| phone(855) 373-7627 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Vision (Optometry) |
| phone(877) 468-5581 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Dental Care |
| phone(877) 711-3662 | Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information |
| Dental Care |
| phone(410) 581-3535 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 244-6224 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 352-2583 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 521-2227 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 733-8387 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 828-7622 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(800) 880-2583 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(866) 251-1689 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(877) 392-9865 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
| phone(877) 535-2128 | Other stated contextBenefit context: Other or Additional Payor |
| Health Benefit Plan Coverage |
Phone and fax numbers sourced directly from the payer response
Phone menu guides
- (844) 405-4297Simply Healthcare Plans Provider Line