Availity Eligibility and Claim Inquiry Update
MetroPlusHealth is continuing to offer additional resources to meet the needs of our provider network. We are expanding our partnership with Availity® to serve as an additional trading partner for provider 270/271 (Member Eligibility Inquiry/Response) and 276/277 (Claim Inquiry/Response) transactions. For those using clearinghouses or vendors to submit health care 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.
As of April 28, 2025, the following transaction types are available via Availity for all MetroPlusHealth products. 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.
MetroPlusHealth providers can enroll in Electronic Remittance Advice (ERA) through the following clearinghouses:
- Availity – 1-800-282-4548 or visit www.availity.com
- Relay Health/OPTUM – 1-800-527-8133 or email [email protected]
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