Prime Health Services
Prime Health Services is a payer organization. For an ASC, what matters isn't the logo. It's how Prime Health Services 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 Prime Health Services analysis
Tell us where to send it. Our team will prepare an analysis of Prime Health Services 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 Prime Health Services pays
See how Prime Health Services 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 Prime Health Services concentrates and how its presence shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Prime Health Services and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Prime Health Services'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 Prime Health Services up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Prime Health Services
- Payer ID
- 23287 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Prime Health Services through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Prime Health Services members are verified before the date of service, through a clearinghouse using payer ID 23287or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Prime Health Services directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Prime Health Services the way it pays.
- What is Prime Health Services's payer ID?
- Prime Health Services's electronic payer ID is 23287. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Prime Health Services through a clearinghouse.
- How do ASCs verify eligibility for Prime Health Services members?
- Eligibility and benefits for Prime Health Services members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 23287) or through the payer's provider portal.
- Does Prime Health Services require prior authorization for ASC procedures?
- Prior-authorization requirements for Prime Health Services are set per plan and per procedure. Confirm whether an authorization is required with Prime Health Services directly before the date of service.
- What type of payer is Prime Health Services?
- Prime Health Services is a payer organization.
- How does Prime Health Services compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Prime Health Services pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Prime Health Services paying my ASC below market?
- Put your own Prime Health Services 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.