Coastal TPA
Coastal TPA is a third-party administrator (TPA). For an ASC, what matters isn't the logo. It's how Coastal TPA 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 Coastal TPA analysis
Tell us where to send it. Our team will prepare an analysis of Coastal TPA 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 Coastal TPA pays
See how Coastal TPA 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 Coastal TPA concentrates and how its presence shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Coastal TPA and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Coastal TPA'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 Coastal TPA up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Coastal TPA
- Payer ID
- 77052 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Coastal TPA through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Coastal TPA members are verified before the date of service, through a clearinghouse using payer ID 77052or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Coastal TPA directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Coastal TPA the way it pays.
- What is Coastal TPA's payer ID?
- Coastal TPA's electronic payer ID is 77052. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Coastal TPA through a clearinghouse.
- How do ASCs verify eligibility for Coastal TPA members?
- Eligibility and benefits for Coastal TPA members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 77052) or through the payer's provider portal.
- Does Coastal TPA require prior authorization for ASC procedures?
- Prior-authorization requirements for Coastal TPA are set per plan and per procedure. Confirm whether an authorization is required with Coastal TPA directly before the date of service.
- What type of payer is Coastal TPA?
- Coastal TPA is a third-party administrator (TPA).
- How does Coastal TPA compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Coastal TPA pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Coastal TPA paying my ASC below market?
- Put your own Coastal TPA 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.