Coverage profile
Work WPS Health Plan 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 WPS Health Plan.
Eligibility
EDI 270/271The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with WPS Health Plan.
Other aliases
Also known as
- 10868
- 11181
- 39185
- 95937
- ARISE
- WPS
- Arise Health Plan
- WPS Optum Health
- Wisconsin Physicians Service Health Plan
- PREVEA
2027 maternity billing research
When does WPS Health Plan change OB/GYN billing?
WPS requests prenatal/antepartum E/M + TH for dates of service on or after 2026-09-01 and says component maternity reporting takes effect 2027-01-01.
- Transition start
- 2026-09-01
- Billing start
- 2027-01-01
- Published
- Not stated in source
- Current As Of
- September 2026
Scope: WPS provider page for WPS insurance products. Its legal notice says Wisconsin Physicians Service Insurance Corporation and its products are not connected with the federal Medicare program.
Important Update: Maternity Care Coding and Billing. Verify the payer source before claim submission.
Frequently asked questions
WPS Health Plan payer FAQs
How do I check claim status with WPS Health Plan?
Providers check WPS Health Plan via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.
What is the payer ID for WPS Health Plan?
The primary payer ID for WPS Health Plan is 39185. 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 837P payer ID for WPS Health Plan?
The 837P payer ID for WPS Health Plan is 39185 via Stedi.
What is the 270 payer ID for WPS Health Plan?
The 270 payer IDs for WPS Health Plan are 39185 via Stedi and 39185 via Availity.
What is the 276 payer ID for WPS Health Plan?
The 276 payer IDs for WPS Health Plan are 39185 via Stedi and 39185 via Availity.
What states does WPS Health Plan operate in?
WPS Health Plan operates in IL and WI.
Routing reference
WPS Health Plan 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 | WPS Health PlanSource: Substrate payer directory · data last changed |
|---|---|
| Operating states | IL, WISource: Substrate payer directory · data last changed |
| 837P professional claims payer IDStedi | 39185Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDStedi | 39185Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 270 eligibility payer IDAvaility | 39185Source: Availity payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDStedi | 39185Source: Stedi payer catalog · catalog dated · matched by payer ID |
| 276 claim status payer IDAvaility | 39185Source: 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: WPS Health Plan. 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: WPS 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 ↗
- United Clearinghouse payer catalogMatched by payer name; matched record: WPS Health Plan. 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.