First Medical Health Plan
First Medical Health Plan is a regional health plan operating in Puerto Rico. For an ASC, what matters isn't the logo. It's how First Medical Health Plan 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 First Medical Health Plan analysis
Tell us where to send it. Our team will prepare an analysis of First Medical Health Plan 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 First Medical Health Plan pays
See how First Medical Health Plan 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
First Medical Health Plan's presence spans Puerto Rico. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for First Medical Health Plan and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive First Medical Health Plan'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 First Medical Health Plan up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with First Medical Health Plan
- Payer ID
- 37624 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to First Medical Health Plan through a clearinghouse.
- Eligibility verification
- Coverage and benefits for First Medical Health Plan members are verified before the date of service, through a clearinghouse using payer ID 37624or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with First Medical Health Plan directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of First Medical Health Plan the way it pays.
- What is First Medical Health Plan's payer ID?
- First Medical Health Plan's electronic payer ID is 37624. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to First Medical Health Plan through a clearinghouse.
- How do ASCs verify eligibility for First Medical Health Plan members?
- Eligibility and benefits for First Medical Health Plan members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 37624) or through the payer's provider portal.
- Does First Medical Health Plan require prior authorization for ASC procedures?
- Prior-authorization requirements for First Medical Health Plan are set per plan and per procedure. Confirm whether an authorization is required with First Medical Health Plan directly before the date of service.
- What type of payer is First Medical Health Plan?
- First Medical Health Plan is a regional health plan operating in Puerto Rico.
- How does First Medical Health Plan compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where First Medical Health Plan pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is First Medical Health Plan paying my ASC below market?
- Put your own First Medical Health Plan 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.