Simplified Benefits Administrators
Simplified Benefits Administrators is a third-party administrator (TPA). For an ASC, what matters isn't the logo. It's how Simplified Benefits Administrators 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 Simplified Benefits Administrators analysis
Tell us where to send it. Our team will prepare an analysis of Simplified Benefits Administrators 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 Simplified Benefits Administrators pays
See how Simplified Benefits Administrators 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 Simplified Benefits Administrators concentrates and how its presence shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Simplified Benefits Administrators and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Simplified Benefits Administrators'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 Simplified Benefits Administrators up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Simplified Benefits Administrators
- Payer ID
- 89789 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Simplified Benefits Administrators through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Simplified Benefits Administrators members are verified before the date of service, through a clearinghouse using payer ID 89789or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Simplified Benefits Administrators directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Simplified Benefits Administrators the way it pays.
- What is Simplified Benefits Administrators's payer ID?
- Simplified Benefits Administrators's electronic payer ID is 89789. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Simplified Benefits Administrators through a clearinghouse.
- How do ASCs verify eligibility for Simplified Benefits Administrators members?
- Eligibility and benefits for Simplified Benefits Administrators members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 89789) or through the payer's provider portal.
- Does Simplified Benefits Administrators require prior authorization for ASC procedures?
- Prior-authorization requirements for Simplified Benefits Administrators are set per plan and per procedure. Confirm whether an authorization is required with Simplified Benefits Administrators directly before the date of service.
- What type of payer is Simplified Benefits Administrators?
- Simplified Benefits Administrators is a third-party administrator (TPA).
- How does Simplified Benefits Administrators compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Simplified Benefits Administrators pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Simplified Benefits Administrators paying my ASC below market?
- Put your own Simplified Benefits Administrators 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.