How to check Prism Univera eligibility
A portal or phone check takes a front-desk staffer 10–15 minutes per patient. Prism Univera has no eligibility API — so instead of your staff doing that, our screen agent runs the portal check for you, on your schedule.
37315Screen agent · setup requiredThree ways to verify Prism Univera 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.
Prism Univera at a glance
What billers need before running a check.
37315Supported transactions
What can be exchanged electronically with Prism Univera today.
| Transaction | Status |
|---|---|
Eligibility (270/271) Real-time benefit and coverage checks | NOT AVAILABLE |
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 | NOT AVAILABLE |
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
Prism Univera uses payer ID 37315. It also appears as 5159 in some systems.
Prism Univera 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. Claims can be submitted electronically.
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.
Run your first Prism Univera eligibility check
From $0.50 per check, pay-as-you-go. No annual contract, no implementation project.
Billing more than Prism Univera? — upload it and see which of your payers run automatically.
