Prairie States
Prairie States is a payer organization. For an ASC, what matters isn't the logo. It's how Prairie States 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 Prairie States analysis
Tell us where to send it. Our team will prepare an analysis of Prairie States 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 Prairie States pays
See how Prairie States 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 Prairie States concentrates and how its presence shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Prairie States and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Prairie States'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 Prairie States up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Prairie States
- Payer ID
- 36373 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Prairie States through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Prairie States members are verified before the date of service, through a clearinghouse using payer ID 36373or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Prairie States directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Prairie States the way it pays.
- What is Prairie States's payer ID?
- Prairie States's electronic payer ID is 36373. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Prairie States through a clearinghouse.
- How do ASCs verify eligibility for Prairie States members?
- Eligibility and benefits for Prairie States members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 36373) or through the payer's provider portal.
- Does Prairie States require prior authorization for ASC procedures?
- Prior-authorization requirements for Prairie States are set per plan and per procedure. Confirm whether an authorization is required with Prairie States directly before the date of service.
- What type of payer is Prairie States?
- Prairie States is a payer organization.
- How does Prairie States compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Prairie States pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Prairie States paying my ASC below market?
- Put your own Prairie States 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.