Northwell Direct
Northwell Direct is a payer organization operating in New York. For an ASC, what matters isn't the logo. It's how Northwell Direct 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 Northwell Direct analysis
Tell us where to send it. Our team will prepare an analysis of Northwell Direct 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 Northwell Direct pays
See how Northwell Direct 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
Northwell Direct's presence spans New York. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Northwell Direct and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Northwell Direct'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 Northwell Direct up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Northwell Direct
- Payer ID
- 88987 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Northwell Direct through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Northwell Direct members are verified before the date of service, through a clearinghouse using payer ID 88987or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Northwell Direct directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Northwell Direct the way it pays.
- What is Northwell Direct's payer ID?
- Northwell Direct's electronic payer ID is 88987. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Northwell Direct through a clearinghouse.
- How do ASCs verify eligibility for Northwell Direct members?
- Eligibility and benefits for Northwell Direct members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 88987) or through the payer's provider portal.
- Does Northwell Direct require prior authorization for ASC procedures?
- Prior-authorization requirements for Northwell Direct are set per plan and per procedure. Confirm whether an authorization is required with Northwell Direct directly before the date of service.
- What type of payer is Northwell Direct?
- Northwell Direct is a payer organization operating in New York.
- How does Northwell Direct compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Northwell Direct pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Northwell Direct paying my ASC below market?
- Put your own Northwell Direct 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.