American Plan Administrators
American Plan Administrators is a third-party administrator (TPA). For an ASC, what matters isn't the logo. It's how American Plan Administrators pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete American Plan Administrators analysis
Tell us where to send it. Our team will prepare an analysis of American Plan Administrators covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How American Plan Administrators pays
See how American Plan Administrators reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
See where American Plan Administrators concentrates and how its presence shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for American Plan Administrators and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive American Plan Administrators's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking American Plan Administrators up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with American Plan Administrators
- Payer ID
- 95606 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to American Plan Administrators through a clearinghouse.
- Eligibility verification
- Coverage and benefits for American Plan Administrators members are verified before the date of service, through a clearinghouse using payer ID 95606or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with American Plan Administrators directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of American Plan Administrators the way it pays.
- What is American Plan Administrators's payer ID?
- American Plan Administrators's electronic payer ID is 95606. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to American Plan Administrators through a clearinghouse.
- How do ASCs verify eligibility for American Plan Administrators members?
- Eligibility and benefits for American Plan Administrators members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 95606) or through the payer's provider portal.
- Does American Plan Administrators require prior authorization for ASC procedures?
- Prior-authorization requirements for American Plan Administrators are set per plan and per procedure. Confirm whether an authorization is required with American Plan Administrators directly before the date of service.
- What type of payer is American Plan Administrators?
- American Plan Administrators is a third-party administrator (TPA).
- How does American Plan Administrators compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where American Plan Administrators pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is American Plan Administrators paying my ASC below market?
- Put your own American Plan Administrators contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.