Payer Setup

Even if you use the Prompt Pay card to accept payment in full at the point of service, we need you to forward the claim to us using the following guidelines.

Default format:

  • ICD submission ICD-10

For EDI:

  • Payer ID:
  • Clearinghouse:

For Paper Claims:

  • We prefer if you email us at, but if you insist on using snail mail:

For Fax:

  • It’s 2017. We are the fax free health plan! Please email us at instead.

Fee Schedule

  • [insert simple fee schedule here]