How to check Banner Medicare Advantage Prime HMO eligibility
A portal or phone check takes a front-desk staffer 10–15 minutes per patient. A real-time 270/271 check returns plan status, copays, deductibles, and out-of-pocket maximums in seconds.
12X42Real-time 270/271MedicareThree ways to verify Banner Medicare Advantage Prime HMO coverage
- Payer portal — free, but one patient at a time and 10–15 minutes each with logins.
- Phone (IVR) — hold times vary; no written record for the chart.
Automated 270/271 check
Full benefit detail in seconds, batched for your whole schedule — not one patient at a time.
From $0.50 per check, pay-as-you-go.
Banner Medicare Advantage Prime HMO at a glance
What billers need before running a check.
12X42Supported transactions
What can be exchanged electronically with Banner Medicare Advantage Prime HMO today.
| Transaction | Status |
|---|---|
Eligibility (270/271) Real-time benefit and coverage checks | SUPPORTED |
Claim status (276/277) Where a submitted claim stands | NOT AVAILABLE |
Professional claims (837P) Physician and outpatient claims | SUPPORTED |
Institutional claims (837I) Facility claims | SUPPORTED |
Dental claims (837D) Dental claims | NOT AVAILABLE |
Remittance (835 ERA) Electronic remittance advice | ENROLLMENT REQUIRED |
Coordination of benefits Secondary-payer routing | NOT AVAILABLE |
Claim attachments (275) Supporting documentation | NOT AVAILABLE |
Portal vs. phone vs. automated
The same verification, three ways.
| Payer portal | Phone / IVR | Automated check | |
|---|---|---|---|
| Time per patient | 10–15 min | 15–30 min | Seconds |
| Cost per check | ~$7.97 staff time* | ~$7.97+ staff time* | from $0.50 |
| Record for the chart | Screenshot | None | Full audit trail |
| Whole-day schedule | One at a time | One at a time | Batched overnight |
*CAQH Index benchmark for a manual eligibility verification.
FAQ
Frequently asked questions
Banner Medicare Advantage Prime HMO uses payer ID 12X42. It also appears as 12X42MA, 16664, 3845, 5046 in some systems.
Yes. Banner Medicare Advantage Prime HMO accepts real-time 270/271 eligibility transactions, so a check returns plan status and benefit detail in seconds instead of the 10–15 minutes a portal login takes.
A portal check takes 10–15 minutes of staff time per patient. An automated real-time check returns in seconds and can run for an entire day's schedule overnight.
Run your first Banner Medicare Advantage Prime HMO eligibility check
From $0.50 per check, pay-as-you-go. No annual contract, no implementation project.
Billing more than Banner Medicare Advantage Prime HMO ? — upload it and see which of your payers run automatically.
