Innovation Health
Innovation Health is a payer organization operating in District of Columbia, Maryland, and Virginia. For an ASC, what matters isn't the logo. It's how Innovation 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 Innovation Health analysis
Tell us where to send it. Our team will prepare an analysis of Innovation 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 Innovation Health pays
See how Innovation 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
Innovation Health's presence spans District of Columbia, Maryland, and Virginia. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Innovation Health and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Innovation 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 Innovation 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 Innovation Health
- Payer ID
- 40025 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Innovation Health through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Innovation Health members are verified before the date of service, through a clearinghouse using payer ID 40025or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Innovation Health directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Innovation Health the way it pays.
- What is Innovation Health's payer ID?
- Innovation Health's electronic payer ID is 40025. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Innovation Health through a clearinghouse.
- How do ASCs verify eligibility for Innovation Health members?
- Eligibility and benefits for Innovation Health members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 40025) or through the payer's provider portal.
- Does Innovation Health require prior authorization for ASC procedures?
- Prior-authorization requirements for Innovation Health are set per plan and per procedure. Confirm whether an authorization is required with Innovation Health directly before the date of service.
- What type of payer is Innovation Health?
- Innovation Health is a payer organization operating in District of Columbia, Maryland, and Virginia.
- How does Innovation Health compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Innovation 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 Innovation Health paying my ASC below market?
- Put your own Innovation 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.