Benchmark Insurance
Benchmark Insurance is a payer organization. For an ASC, what matters isn't the logo. It's how Benchmark Insurance 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 Benchmark Insurance analysis
Tell us where to send it. Our team will prepare an analysis of Benchmark Insurance 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 Benchmark Insurance pays
See how Benchmark Insurance 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 Benchmark Insurance concentrates and how its presence shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Benchmark Insurance and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Benchmark Insurance'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 Benchmark Insurance up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Benchmark Insurance
- Payer ID
- J1257 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Benchmark Insurance through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Benchmark Insurance members are verified before the date of service, through a clearinghouse using payer ID J1257or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Benchmark Insurance directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Benchmark Insurance the way it pays.
- What is Benchmark Insurance's payer ID?
- Benchmark Insurance's electronic payer ID is J1257. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Benchmark Insurance through a clearinghouse.
- How do ASCs verify eligibility for Benchmark Insurance members?
- Eligibility and benefits for Benchmark Insurance members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID J1257) or through the payer's provider portal.
- Does Benchmark Insurance require prior authorization for ASC procedures?
- Prior-authorization requirements for Benchmark Insurance are set per plan and per procedure. Confirm whether an authorization is required with Benchmark Insurance directly before the date of service.
- What type of payer is Benchmark Insurance?
- Benchmark Insurance is a payer organization.
- How does Benchmark Insurance compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Benchmark Insurance pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Benchmark Insurance paying my ASC below market?
- Put your own Benchmark Insurance 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.