PHC California
PHC California is a payer organization operating in California. For an ASC, what matters isn't the logo. It's how PHC California 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 PHC California analysis
Tell us where to send it. Our team will prepare an analysis of PHC California 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 PHC California pays
See how PHC California 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
PHC California's presence spans California. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for PHC California and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive PHC California'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 PHC California up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with PHC California
- Payer ID
- 95422 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to PHC California through a clearinghouse.
- Eligibility verification
- Coverage and benefits for PHC California members are verified before the date of service, through a clearinghouse using payer ID 95422or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with PHC California directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of PHC California the way it pays.
- What is PHC California's payer ID?
- PHC California's electronic payer ID is 95422. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to PHC California through a clearinghouse.
- How do ASCs verify eligibility for PHC California members?
- Eligibility and benefits for PHC California members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 95422) or through the payer's provider portal.
- Does PHC California require prior authorization for ASC procedures?
- Prior-authorization requirements for PHC California are set per plan and per procedure. Confirm whether an authorization is required with PHC California directly before the date of service.
- What type of payer is PHC California?
- PHC California is a payer organization operating in California.
- How does PHC California compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where PHC California pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is PHC California paying my ASC below market?
- Put your own PHC California 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.