Payer Directory

How to check iCare Health Options TPA eligibility

A portal or phone check takes a front-desk staffer 10–15 minutes per patient. iCare Health Options TPA has no eligibility API — so instead of your staff doing that, our screen agent runs the portal check for you, on your schedule.

  • Payer ID 26054
  • Screen agent · setup required
  • Commercial

Three ways to verify iCare Health Options TPA coverage

  1. Payer portal — free, but one patient at a time and 10–15 minutes each with logins.
  2. Phone (IVR) — hold times vary; no written record for the chart.
The third way

Automated portal check

Medman's screen agent signs in to the iCare Health Options TPA portal with your practice's own login and checks your whole schedule before the day starts. Results are waiting at check-in instead of being looked up one patient at a time.

Setup required: we connect your portal login during onboarding.

Payer facts

iCare Health Options TPA at a glance

What billers need before running a check.

  • Payer ID

    26054Also known as 5299

  • Real-time eligibility

    Via screen agentiCare Health Options TPA has no eligibility API, so our screen agent runs the portal check for you on your schedule. Setup required.

  • Coverage

    medical, visionCommercial

  • Operating area

    Not published

  • Payer website

    www.myicarehealth.com
Transactions

Supported transactions

What can be exchanged electronically with iCare Health Options TPA today.

  • Eligibility (270/271)

    NOT AVAILABLEReal-time benefit and coverage checks

  • Claim status (276/277)

    NOT AVAILABLEWhere a submitted claim stands

  • Professional claims (837P)

    ENROLLMENT REQUIREDPhysician and outpatient claims

  • Institutional claims (837I)

    NOT AVAILABLEFacility claims

  • Dental claims (837D)

    NOT AVAILABLEDental claims

  • Remittance (835 ERA)

    ENROLLMENT REQUIREDElectronic remittance advice

  • Coordination of benefits

    NOT AVAILABLESecondary-payer routing

  • Claim attachments (275)

    NOT AVAILABLESupporting documentation
Compare

Portal vs. phone vs. automated

The same verification, three ways.

MeasurePayer portalPhone / IVRAutomated portal check
Time per patient10–15 min15–30 minSeconds
Cost per checkStaff time, one login per patient~$8.57 in staff time*from $0.50
Record for the chartScreenshotNoneFull audit trail
Whole-day scheduleOne at a timeOne at a timeBatched overnight

*A manual eligibility check costs a medical practice $8.57; an electronic one costs $2.00. Source: 2024 CAQH Index.

In production

What Medman does in practices today

  • 65%

    fewer denials at Valley Diabetes & Obesity

  • 90%

    of eligibility checks fully automated

  • $107–149K

    annual savings, small specialty practice

  • 24 mo

    in production

Questions

Frequently asked questions

What is the payer ID for iCare Health Options TPA?

iCare Health Options TPA uses payer ID 26054. It also appears as 5299 in some systems.

Does iCare Health Options TPA support real-time eligibility verification?

iCare Health Options TPA has no eligibility API, so there is no 270/271 transaction to send. Checks still run automatically: our screen agent performs the portal check for you on your schedule, rather than a staff member doing it per patient. Setup is required.

How long does a iCare Health Options TPA eligibility check take?

A portal check takes 10–15 minutes of staff time per patient. A screen agent runs the same check without occupying anyone — scheduled ahead of the day's appointments, so results are waiting rather than being fetched one patient at a time.

Directory

More payers

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Run your first iCare Health Options TPA eligibility check

Our screen agent runs the iCare Health Options TPA portal check with your practice's own login, for the whole schedule. No annual contract, no implementation project.

How the eligibility agent worksSee pricing

Billing more than iCare Health Options TPA? — upload it and see which of your payers run automatically.