Ambetter Health
Also covers / subsidiaries: Ambetter, Ambetter from Superior HealthPlan, Ambetter from Sunshine Health
Core Payer & Clearinghouse Profile
Electronic Payer ID
68069
Consistent across several state QRGs but state-specific by design — can vary by state/clearinghouse; verify on the card and state quick-reference guide.
Timely Filing Limit (TFL)
Commonly 180 days from date of service for participating providers (varies by state)
Appeal Window
Reconsideration generally within 180 days of EOP; appeal windows vary by state
Clearinghouse Gateway
Availity (preferred)
Provider Services
877-687-1197
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Varies — confirm via portal / clearinghouse
Provider Portal
https://www.availity.com
Centene's ACA marketplace brand sold through state subsidiaries. Payer ID, timely filing, addresses, and phones all vary by state plan.
National EDI Clearinghouse Capabilities
Direct ANSI X12 electronic transaction support verified for Ambetter Health.
Associated Clearinghouse Payer IDs
National clearinghouse networks maintain dedicated routing IDs for specific transaction lines or subsidiaries under Ambetter Health.
| Clearinghouse Name | Electronic Payer ID | Status | Enrollment | Supported Services |
|---|---|---|---|---|
| Absolute Total Care | 68069 | Non-Par | None | |
| Advantage By Bridgeway Health Solutions | 68069 | Non-Par | None | 837P837I835 ERA |
| Advantage By Buckeye Community Health Plan | 68069 | Non-Par | None | 837P837I835 ERA |
| Advantage By Managed Health Services | 68069 | Non-Par | None | 837P837I835 ERA |
| Advantage By Superior Healthplan | 68069 | Non-Par | None | 837P837I835 ERA |
| Advantage Health Solutions | 68069 | Par | None | 837P837I270/271Dental |
Resolution Tools for Ambetter Health Claims
Values vary by plan, line of business, and provider agreement. Confirm in the payer portal or with your clearinghouse gateway before submitting electronic claims.
Tired of Chasing Ambetter Health Denials & Delayed Payments?
Aethera's billing specialists work Ambetter Health every day — handling EDI clearinghouse rejects, prior authorizations, payment posting, and 30-day AR aging recovery.