P
Payer Directory
How to check Providence Health Plan 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.
Payer ID
PHP01Real-time 270/271Three ways to verify Providence Health Plan 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 the whole schedule, from $0.50 per check.
Providence Health Plan at a glance
What billers need before running a check.
Payer ID
PHP01Also known as 101039, 10172, 1540, 4498
Real-time eligibility
Available
Responses return in seconds, 24/7.
Coverage
dental, medical, vision
Operating area
California, Oregon, Washington
Payer website
www.providencehealthplan.comSupported transactions
What can be exchanged electronically with Providence Health Plan today.
| Transaction | Status |
|---|---|
Eligibility (270/271) Real-time benefit and coverage checks | SUPPORTED |
Claim status (276/277) Where a submitted claim stands | SUPPORTED |
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 | ~$6.72 staff time* | ~$6.72+ 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.
Frequently asked questions
What is the payer ID for Providence Health Plan?+–
Providence Health Plan uses payer ID PHP01. It also appears as 101039, 10172, 1540, 4498 in some systems.
Does Providence Health Plan support real-time eligibility verification?+–
Yes. Providence Health Plan 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.
How long does a Providence Health Plan eligibility check take?+–
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 Providence Health Plan eligibility check in 5 minutes
From $0.50 per check, pay-as-you-go. No contract, no implementation project.
65%
fewer denials at Valley Diabetes & Obesity
90%
of eligibility checks fully automated
$107–149K
annual savings, small specialty practice
24 mo
in production
