Astrana Health
Astrana Health is a payer organization operating in California. For an ASC, what matters isn't the logo. It's how Astrana Health 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 Astrana Health analysis
Tell us where to send it. Our team will prepare an analysis of Astrana Health 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 Astrana Health pays
See how Astrana Health 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
Astrana Health's presence spans California. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Astrana Health and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Astrana Health'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 Astrana Health up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Astrana Health
- Payer ID
- PHM10 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Astrana Health through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Astrana Health members are verified before the date of service, through a clearinghouse using payer ID PHM10or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Astrana Health directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Astrana Health the way it pays.
- What is Astrana Health's payer ID?
- Astrana Health's electronic payer ID is PHM10. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Astrana Health through a clearinghouse.
- How do ASCs verify eligibility for Astrana Health members?
- Eligibility and benefits for Astrana Health members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID PHM10) or through the payer's provider portal.
- Does Astrana Health require prior authorization for ASC procedures?
- Prior-authorization requirements for Astrana Health are set per plan and per procedure. Confirm whether an authorization is required with Astrana Health directly before the date of service.
- What type of payer is Astrana Health?
- Astrana Health is a payer organization operating in California.
- How does Astrana Health compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Astrana Health pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Astrana Health paying my ASC below market?
- Put your own Astrana Health 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.