Insurance Providers’ Pass Thru Fees

Below is a list of fees that various insurance providers may charge during transactions.
This list is updated periodically, please check with your clearinghouse for the most up to date charges.

 

CARRIER_NAMECARRIER_CODELEGACY_CARRIER_CODEPAYER_IDTRANSACTION GROUP NAMEPASS_THROUGH_FEE_AMT
MEDICAID FL36FLMEDAID01ELIGIBILITY$0.0400
MEDICAID FL36FLMEDAID01CLAIM INQUIRY$0.0400
MEDICAID FL36FLMEDAID01HEALTHCARE SERVICES$0.0400
NEW YORK BLUE CROSS BLUE SHIELD NORTHEASTERN800800800ELIGIBILITY$0.0700
NEW YORK BLUE CROSS BLUE SHIELD NORTHEASTERN800800800HEALTHCARE SERVICES$0.0700
NEW YORK BLUE CROSS BLUE SHIELD NORTHEASTERN800800800CLAIM INQUIRY$0.0700
ALLWAYS HEALTH PARTNERS429342934293ELIGIBILITY$0.0500
MONTEFIORE CONTRACT MANAGEMENT ORGANIZATION131741317413174ELIGIBILITY$0.0700
BOSTON MEDICAL CENTER HEALTH NET PLAN133371333713337ELIGIBILITY$0.0100
THE LOOMIS COMPANY232232322323223ELIGIBILITY$0.0200
STATE FARM INSURANCE COMPANIES310533105331053ELIGIBILITY$0.0155
QUALCHOICE OF ARKANSAS351743517435174ELIGIBILITY$0.0100
AUTOMATED BENEFIT SERVICES382593825938259ELIGIBILITY$0.0700
SUTTER AND AETNA INSURANCE COMPANY606246062460624ELIGIBILITY$0.0200
HEALTHSCOPE BENEFITS710637106371063ELIGIBILITY$0.0100
BOON CHAPMAN ADMIN742387423874238ELIGIBILITY$0.0100
MEDICAID HIAID53AID53AID53ELIGIBILITY$0.0300
MEDICAID HIAID53AID53AID53CLAIM INQUIRY$0.0300
MEDICAID HIAID53AID53AID53HEALTHCARE SERVICES$0.0300
ALASKA MEDICAIDAKMCDAKMCDAKMCDELIGIBILITY$0.0600
ACCESS MED+AMPMEDPLUS29ELIGIBILITY$0.0450
ACCESS MED+AMPMEDPLUS29CLAIM INQUIRY$0.0450
ACCESS MED+AMPMEDPLUS29HEALTHCARE SERVICES$0.0450
BCBS ARBCARCBCBSARBCARCHEALTHCARE SERVICES$0.1000
BCBS ARBCARCBCBSARBCARCELIGIBILITY$0.1000
BCBS ARBCARCBCBSARBCARCCLAIM INQUIRY$0.1000
BCBS MIBCMICBCMICBCMICELIGIBILITY$0.0600
BCBS MIBCMICBCMICBCMICCLAIM INQUIRY$0.0600
BCBS MIBCMICBCMICBCMICHEALTHCARE SERVICES$0.0600
BC OF NORTHEASTERN PABCNPCBCNEPABCNPCELIGIBILITY$0.1000
BC OF NORTHEASTERN PABCNPCBCNEPABCNPCCLAIM INQUIRY$0.1000
BC OF NORTHEASTERN PABCNPCBCNEPABCNPCHEALTHCARE SERVICES$0.1000
BC WA PREMERABCWACBCWACBCWACHEALTHCARE SERVICES$0.1000
BC WA PREMERABCWACBCWACBCWACCLAIM INQUIRY$0.1000
BC WA PREMERABCWACBCWACBCWACELIGIBILITY$0.1000
BOSTON MEDICAL CENTER HEALTHNET PLANBMCHLTBMCHLTBMCHLTELIGIBILITY$0.0100
BRIGHT HEALTH - MEDICARE ADVANTAGEBRT01BRT01BRT01ELIGIBILITY$0.0200
CAREMORE HEALTH PLANCARMOCARMOCARMOELIGIBILITY$0.0100
MS CHIPCHIPBCBSMSC89CLAIM INQUIRY$0.0450
MS CHIPCHIPBCBSMSC89ELIGIBILITY$0.0450
MS CHIPCHIPBCBSMSC89HEALTHCARE SERVICES$0.0450
MEDICAID DCDCDCMEDAID52ELIGIBILITY$0.0325
MEDICAID DCDCDCMEDAID52CLAIM INQUIRY$0.0325
MEDICAID DCDCDCMEDAID52HEALTHCARE SERVICES$0.0325
DELAWARE MEDICAID (RELAY)DWMCDDWMCDDWMCDELIGIBILITY$0.0500
DELAWARE MEDICAID (RELAY)DWMCDDWMCDDWMCDCLAIM INQUIRY$0.0500
DELAWARE MEDICAID (RELAY)DWMCDDWMCDDWMCDHEALTHCARE SERVICES$0.0500
HEALTH ALLIANCE PLANHAPMCHAPHAPMCELIGIBILITY$0.0500
HEALTH ALLIANCE PLAN OF MICHIGANHAPMIHAPMIHAPMIELIGIBILITY$0.0500
MEDICAID HIHIHIMEDAID53HEALTHCARE SERVICES$0.0300
MEDICAID HIHIHIMEDAID53CLAIM INQUIRY$0.0300
MEDICAID HIHIHIMEDAID53ELIGIBILITY$0.0300
HORIZON NJHNJHHNJHHNJHELIGIBILITY$0.0300
HARVARD PILGRIM HEALTH CAREHPHCHPHCHPHCHEALTHCARE SERVICES$0.1000
HARVARD PILGRIM HEALTH CAREHPHCHPHCHPHCCLAIM INQUIRY$0.1000
HARVARD PILGRIM HEALTH CAREHPHCHPHCHPHCELIGIBILITY$0.1000
MEDICAID IAIAIAMEDAID36CLAIM INQUIRY$0.0800
MEDICAID IAIAIAMEDAID36ELIGIBILITY$0.0800
MEDICAID IAIAIAMEDAID36HEALTHCARE SERVICES$0.0800
MEDICAID KSKSKSMEDAID22ELIGIBILITY$0.0400
MEDICAID KSKSKSMEDAID22HEALTHCARE SERVICES$0.0400
MEDICAID KSKSKSMEDAID22CLAIM INQUIRY$0.0400
MERIDIAN COMPLETE ILLINOISMCCILMCCILMCCILELIGIBILITY$0.0200
MANAGED CARE OF AMERICAMGDCAMGDCAMGDCACLAIM INQUIRY$0.0500
MANAGED CARE OF AMERICAMGDCAMGDCAMGDCAELIGIBILITY$0.0500
MANAGED CARE OF AMERICAMGDCAMGDCAMGDCAHEALTHCARE SERVICES$0.0500
MEDICAID MSMSMSMEDAID20HEALTHCARE SERVICES$0.0525
MEDICAID MSMSMSMEDAID20CLAIM INQUIRY$0.0525
MEDICAID MSMSMSMEDAID20ELIGIBILITY$0.0525
MEDICAID MTMTMTMEDAID57HEALTHCARE SERVICES$0.0325
MEDICAID MTMTMTMEDAID57CLAIM INQUIRY$0.0325
MEDICAID MTMTMTMEDAID57ELIGIBILITY$0.0325
ALLWAYS HEALTH PARTNERSNGHBHPNGHBHPNGHBHPELIGIBILITY$0.0400
MEDICAID NHNHNHMEDAID47CLAIM INQUIRY$0.0500
MEDICAID NHNHNHMEDAID47ELIGIBILITY$0.0500
MEDICAID NHNHNHMEDAID47HEALTHCARE SERVICES$0.0500
MEDICAID NMNMNMMEDAID27ELIGIBILITY$0.0325
MEDICAID NMNMNMMEDAID27CLAIM INQUIRY$0.0325
MEDICAID NMNMNMMEDAID27HEALTHCARE SERVICES$0.0325
MEDICAID PRODSIODSIMEDAID60ELIGIBILITY$0.0900
MEDICAID PRODSIODSIMEDAID60CLAIM INQUIRY$0.0900
MEDICAID PRODSIODSIMEDAID60HEALTHCARE SERVICES$0.0900
MEDICAID OKOKOKMEDAID32ELIGIBILITY$0.0200
MEDICAID OKOKOKMEDAID32HEALTHCARE SERVICES$0.0200
MEDICAID OKOKOKMEDAID32CLAIM INQUIRY$0.0200
PARTNERSHIP HEALTH PLAN OF CAPRTHPPRTHPPRTHPELIGIBILITY$0.0100
ROCKY MOUNTAIN HEALTH PLANRMHPRMHP347ELIGIBILITY$0.0300
ROCKY MOUNTAIN HEALTH PLANRMHPRMHP347CLAIM INQUIRY$0.0300
ROCKY MOUNTAIN HEALTH PLANRMHPRMHP347HEALTHCARE SERVICES$0.0300
BCBS OF WESTERN NYSB801SB801SB801ELIGIBILITY$0.0900
MS SEHPSEHPMSEMPOY82HEALTHCARE SERVICES$0.0450
MS SEHPSEHPMSEMPOY82ELIGIBILITY$0.0450
MS SEHPSEHPMSEMPOY82CLAIM INQUIRY$0.0450
SAN JOAQUIN HEALTH PLANSJHPSJHPSJHPELIGIBILITY$0.0100
ALAMEDA ALLIANCE HEALTHSPAAHAAHP321CLAIM INQUIRY$0.1800
ALAMEDA ALLIANCE HEALTHSPAAHAAHP321ELIGIBILITY$0.1800
ALAMEDA ALLIANCE HEALTHSPAAHAAHP321HEALTHCARE SERVICES$0.1800
BS CASPBSCSPBSC361CLAIM INQUIRY$0.1000
BS CASPBSCSPBSC361ELIGIBILITY$0.1000
BS CASPBSCSPBSC361HEALTHCARE SERVICES$0.1000
HEALTH NET CASPHNHHLTHNTC331CLAIM INQUIRY$0.1800
HEALTH NET CASPHNHHLTHNTC331HEALTHCARE SERVICES$0.1800
HEALTH NET CASPHNHHLTHNTC331ELIGIBILITY$0.1800
HEALTH NET MEDI-CALSPHNMHLTHNTMC330ELIGIBILITY$0.1800
HEALTH NET MEDI-CALSPHNMHLTHNTMC330CLAIM INQUIRY$0.1800
HEALTH NET MEDI-CALSPHNMHLTHNTMC330HEALTHCARE SERVICES$0.1800
HEALTH NET ORSPHNOHLTHNTOR332HEALTHCARE SERVICES$0.1800
HEALTH NET ORSPHNOHLTHNTOR332CLAIM INQUIRY$0.1800
HEALTH NET ORSPHNOHLTHNTOR332ELIGIBILITY$0.1800
INTER VALLEY HEALTH PLANSPIVHIVHP334ELIGIBILITY$0.0100
LIFEGUARDSPLFGSPLFGSPLFGHEALTHCARE SERVICES$0.1800
LIFEGUARDSPLFGSPLFGSPLFGCLAIM INQUIRY$0.1800
LIFEGUARDSPLFGSPLFGSPLFGELIGIBILITY$0.1800
MEMORIAL CARE TPASPMCTMCTPA339HEALTHCARE SERVICES$0.1800
MEMORIAL CARE TPASPMCTMCTPA339ELIGIBILITY$0.1800
MEMORIAL CARE TPASPMCTMCTPA339CLAIM INQUIRY$0.1800
PARTNERSHIP HEALTH PLANSPPHPPHPC343ELIGIBILITY$0.0100
STANISLAUS CO MIASPSCMSPSCM352HEALTHCARE SERVICES$0.1800
STANISLAUS CO MIASPSCMSPSCM352ELIGIBILITY$0.1800
STANISLAUS CO MIASPSCMSPSCM352CLAIM INQUIRY$0.1800
SCAN HMOSPSCNSPSCN350CLAIM INQUIRY$0.1800
SCAN HMOSPSCNSPSCN350ELIGIBILITY$0.1800
SCAN HMOSPSCNSPSCN350HEALTHCARE SERVICES$0.1800
SIERRA HEALTH SERVICESSPSHS351SPSHSCLAIM INQUIRY$0.1800
SIERRA HEALTH SERVICESSPSHS351SPSHSHEALTHCARE SERVICES$0.1800
SIERRA HEALTH SERVICESSPSHS351SPSHSELIGIBILITY$0.1800
SAN JOAQUIN HEALTH PLANSPSJHSPSJH349ELIGIBILITY$0.0100
WESTERN HEALTH ADVANTAGESPWHASPWHA356ELIGIBILITY$0.1800
WESTERN HEALTH ADVANTAGESPWHASPWHA356CLAIM INQUIRY$0.1800
WESTERN HEALTH ADVANTAGESPWHASPWHA356HEALTHCARE SERVICES$0.1800
SELECTHEALTHSX107SX107SX107ELIGIBILITY$0.0155
SCOTT & WHITE (RELAY)TH002TH002TH002ELIGIBILITY$0.0100
MEDICAID TNCARETNTNMEDAID13ELIGIBILITY$0.0400
MEDICAID TNCARETNTNMEDAID13HEALTHCARE SERVICES$0.0400
MEDICAID TNCARETNTNMEDAID13CLAIM INQUIRY$0.0400
MEDICAID TXTXTXMEDAID05CLAIM INQUIRY$0.0750
MEDICAID TXTXTXMEDAID05ELIGIBILITY$0.0750
MEDICAID TXTXTXMEDAID05HEALTHCARE SERVICES$0.0750
MEDICAID WYWYWYMEDAID34ELIGIBILITY$0.0325
MEDICAID WYWYWYMEDAID34HEALTHCARE SERVICES$0.0325
MEDICAID WYWYWYMEDAID34CLAIM INQUIRY$0.0325