Verdegard
Verdegard is a payer organization. For an ASC, what matters isn't the logo. It's how Verdegard 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 Verdegard analysis
Tell us where to send it. Our team will prepare an analysis of Verdegard 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 Verdegard pays
See how Verdegard 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 Verdegard concentrates and how its presence shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Verdegard and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Verdegard'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 Verdegard up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Verdegard
- Payer ID
- 86066 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Verdegard through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Verdegard members are verified before the date of service, through a clearinghouse using payer ID 86066or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Verdegard directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Verdegard the way it pays.
- What is Verdegard's payer ID?
- Verdegard's electronic payer ID is 86066. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Verdegard through a clearinghouse.
- How do ASCs verify eligibility for Verdegard members?
- Eligibility and benefits for Verdegard members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 86066) or through the payer's provider portal.
- Does Verdegard require prior authorization for ASC procedures?
- Prior-authorization requirements for Verdegard are set per plan and per procedure. Confirm whether an authorization is required with Verdegard directly before the date of service.
- What type of payer is Verdegard?
- Verdegard is a payer organization.
- How does Verdegard compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Verdegard pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Verdegard paying my ASC below market?
- Put your own Verdegard 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.