Sutter Health
Sutter Health is a payer organization operating in California. For an ASC, what matters isn't the logo. It's how Sutter Health 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 Sutter Health analysis
Tell us where to send it. Our team will prepare an analysis of Sutter Health 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 Sutter Health pays
See how Sutter Health 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
Sutter Health'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 Sutter Health and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Sutter Health'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 Sutter Health up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Sutter Health
- Payer ID
- J1512 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Sutter Health through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Sutter Health members are verified before the date of service, through a clearinghouse using payer ID J1512or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Sutter Health directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Sutter Health the way it pays.
- What is Sutter Health's payer ID?
- Sutter Health's electronic payer ID is J1512. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Sutter Health through a clearinghouse.
- How do ASCs verify eligibility for Sutter Health members?
- Eligibility and benefits for Sutter Health members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID J1512) or through the payer's provider portal.
- Does Sutter Health require prior authorization for ASC procedures?
- Prior-authorization requirements for Sutter Health are set per plan and per procedure. Confirm whether an authorization is required with Sutter Health directly before the date of service.
- What type of payer is Sutter Health?
- Sutter Health is a payer organization operating in California.
- How does Sutter Health compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Sutter Health pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Sutter Health paying my ASC below market?
- Put your own Sutter Health 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.