Availity Eligibility and Claim Inquiry Update
Effective on April 28, 2025, MetroPlusHealth starts a strategic partnership with Availity® to serve as our 270/271 (Member Eligibility Inquiry/Response) and 276/277 (Claim Inquiry/Response) transactions. We are committed to ensuring our providers receive continued quality service, and as part of that commitment, will provide you with transparency throughout this transition. This migration to Availity will be seamless to most of our providers. For those using clearinghouses or vendors to submit healthcare transactions, this will all happen behind the scenes, and you will only need to register with Availity if you want to take advantage of additional tools available to you.
Starting April 28, 2025, the following transaction types will be migrated to Availity. MetroPlusHealth Payer Names and Payer IDs are not changing.
| Payer Name | Payer ID | Transactions | Date Available |
|---|---|---|---|
| MetroPlus | 13265 | 270/271 Eligibility and Benefits | April 28, 2025 |
| MetroPlus | 13265 | 276/277 Claim Status | April 28, 2025 |
Existing Availity Trading Partners
Reminder: If you are currently sending EDI Transactions for other Health Plans via a secure FTP account with Availity, follow your standard business process to work with MetroPlusHealth. If you need assistance, please refer to the resources in this EDI Quick Start Guide for Availity.
Updated submission information
After the transition to Availity, Providers should use the listed payer information above to update Management Systems.
New to Availity?
If you do not already have an Availity Account, we encourage you to register now and beat the rush.
- Go to availity.com
- Click Register and complete the process. For registration guidance or tips, we recommend you refer to the following resource prior to starting your registration application:
To learn more about Availity, please access the welcome page for more information.
Thank you in advance for your commitment to a smooth transition. If you have any questions, please contact Availity Client Services at 1.800.282.4548, Option 1, Monday-Friday 8am – 8pm EST.
Thank you.
MetroPlusHealth