Clover Health
Clover Health is a payer organization operating in Georgia, Mississippi, New Jersey, and 3 more states. For an ASC, what matters isn't the logo. It's how Clover 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 Clover Health analysis
Tell us where to send it. Our team will prepare an analysis of Clover 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 Clover Health pays
See how Clover 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
Clover Health's presence spans Georgia, Mississippi, New Jersey, and 3 more states. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Clover Health and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Clover 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 Clover 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 Clover Health
- Payer ID
- CRPHP is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Clover Health through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Clover Health members are verified before the date of service, through a clearinghouse using payer ID CRPHPor through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Clover Health directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Clover Health the way it pays.
- What is Clover Health's payer ID?
- Clover Health's electronic payer ID is CRPHP. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Clover Health through a clearinghouse.
- How do ASCs verify eligibility for Clover Health members?
- Eligibility and benefits for Clover Health members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID CRPHP) or through the payer's provider portal.
- Does Clover Health require prior authorization for ASC procedures?
- Prior-authorization requirements for Clover Health are set per plan and per procedure. Confirm whether an authorization is required with Clover Health directly before the date of service.
- What type of payer is Clover Health?
- Clover Health is a payer organization operating in Georgia, Mississippi, New Jersey, and 3 more states.
- How does Clover Health compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Clover 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 Clover Health paying my ASC below market?
- Put your own Clover 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.