Providers will not be able to check eligibility via the Change Healthcare platform. Participating MetroPlus Health providers can check eligibility through the provider portal. All providers can check eligibility for Medicaid members through ePaces.

Claims processing

MetroPlusHealth has partnered with Availity for claims processing and claims have been flowing through our system since March 11, 2024.

Electronic Remittance Advices (ERA)

Electronic Remittance Advice (ERAs) are being sent through Availity for claims paid February 21, 2024 and forward. If you are currently set up to submit electronic claims (i.e., 837s) via Availity, you can register directly with Availity to receive 835s or, if you are using another clearinghouse, you just need to notify your clearinghouse that MetroPlusHealth 835’s will be available through Availity

Availity Clearinghouse

Providers can access and submit electronic claims through the Availity Clearinghouse. Information on how to register can be found in the Availity Portal Registration Guide below. You will need the following to get started:

• Physical and billing addresses
• Tax ID (EIN or SSN)
• NPI (if you have one)
• Primary specialty/taxonomy
• MetroPlus Payor ID is 13265

See information and instructions for how to register with Availity below: