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Providers > Electronic Claims Info >

For Providers interested in reducing administrative costs while increasing the speed of claims submission and expediting claims processing and payment, PPOplus accepts electronic claims from physicians, hospitals and ancillary providers.

PPOplus’ Electronic Payer ID# is 36335. Claims sent to the PPOplus Payer ID number are received by WebMD, the nation’s largest electronic claims clearinghouse, and forwarded to PPOplus where we reprice the claims according to PPOplus’ contracted rates and then we electronically send the re-priced claims back to payers for adjudication.

Currently, PPOplus receives 82% of its claims electronically. Providers who currently send claims to any other payer electronically (e.g., Medicare, Medicaid, Commercial) can easily be linked to the PPOplus payer ID number without any additional software or hardware. If you would like assistance in setting up the PPOplus payer ID number in order to submit claims electronically, please call our office at 1-888-965-7718 and let us assist you.

Electronic claims submission benefits everyone and there is no additional cost to providers who electronically submit their claims to PPOplus. The benefits of electronic claims submission include speed of submission and processing of claims, minimized errors and omissions, elimination of double entry of claims data by both the PPO and the payer, reduction in the number of rejected claims and expedition of claims payments.

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