iCare Health Options TPA
iCare Health Options TPA is a third-party administrator (TPA). For an ASC, what matters isn't the logo. It's how iCare Health Options 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 iCare Health Options TPA analysis
Tell us where to send it. Our team will prepare an analysis of iCare Health Options 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 iCare Health Options TPA pays
See how iCare Health Options 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 iCare Health Options TPA concentrates and how its presence shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for iCare Health Options TPA and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive iCare Health Options 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 iCare Health Options 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 iCare Health Options TPA
- Payer ID
- 26054 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to iCare Health Options TPA through a clearinghouse.
- Eligibility verification
- Coverage and benefits for iCare Health Options TPA members are verified before the date of service, through a clearinghouse using payer ID 26054or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with iCare Health Options TPA directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of iCare Health Options TPA the way it pays.
- What is iCare Health Options TPA's payer ID?
- iCare Health Options TPA's electronic payer ID is 26054. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to iCare Health Options TPA through a clearinghouse.
- How do ASCs verify eligibility for iCare Health Options TPA members?
- Eligibility and benefits for iCare Health Options TPA members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 26054) or through the payer's provider portal.
- Does iCare Health Options TPA require prior authorization for ASC procedures?
- Prior-authorization requirements for iCare Health Options TPA are set per plan and per procedure. Confirm whether an authorization is required with iCare Health Options TPA directly before the date of service.
- What type of payer is iCare Health Options TPA?
- iCare Health Options TPA is a third-party administrator (TPA).
- How does iCare Health Options TPA compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where iCare Health Options 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 iCare Health Options TPA paying my ASC below market?
- Put your own iCare Health Options 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.