FirstCare
FirstCare is a payer organization operating in Texas. For an ASC, what matters isn't the logo. It's how FirstCare 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 FirstCare analysis
Tell us where to send it. Our team will prepare an analysis of FirstCare 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 FirstCare pays
See how FirstCare 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
FirstCare's presence spans Texas. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for FirstCare and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive FirstCare'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 FirstCare up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with FirstCare
- Payer ID
- 94998 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to FirstCare through a clearinghouse.
- Eligibility verification
- Coverage and benefits for FirstCare members are verified before the date of service, through a clearinghouse using payer ID 94998or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with FirstCare directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of FirstCare the way it pays.
- What is FirstCare's payer ID?
- FirstCare's electronic payer ID is 94998. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to FirstCare through a clearinghouse.
- How do ASCs verify eligibility for FirstCare members?
- Eligibility and benefits for FirstCare members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 94998) or through the payer's provider portal.
- Does FirstCare require prior authorization for ASC procedures?
- Prior-authorization requirements for FirstCare are set per plan and per procedure. Confirm whether an authorization is required with FirstCare directly before the date of service.
- What type of payer is FirstCare?
- FirstCare is a payer organization operating in Texas.
- How does FirstCare compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where FirstCare pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is FirstCare paying my ASC below market?
- Put your own FirstCare 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.