How to check SummaCare 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.
95202Real-time 270/271Commercial · MedicareThree ways to verify SummaCare 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 your whole schedule — not one patient at a time.
From $0.50 per check, pay-as-you-go.
SummaCare Health Plan at a glance
What billers need before running a check.
95202Supported transactions
What can be exchanged electronically with SummaCare 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 | ~$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
SummaCare Health Plan uses payer ID 95202. It also appears as 10294, 1755, 589, 95202MA in some systems.
Yes. SummaCare 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.
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 SummaCare Health Plan eligibility check
From $0.50 per check, pay-as-you-go. No annual contract, no implementation project.
Billing more than SummaCare Health Plan? — upload it and see which of your payers run automatically.
