Presbyterian Health Plan
Also covers / subsidiaries: PHP, Presbyterian, myPRES
Core Payer & Clearinghouse Profile
Electronic Payer ID
10646
Standard EDI claims use PREHP; the Medicaid 'Turquoise Claims' process requires Payer ID 77048 in segment GS03.
Timely Filing Limit (TFL)
Varies — confirm via portal / clearinghouse
Appeal Window
One year (12 months) from date of service to file a provider claim appeal
Clearinghouse Gateway
Availity; Claim.MD
Provider Services
888-923-5757
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Presbyterian Health Plan, P.O. Box 27489, Albuquerque, NM 87125-7489
Provider Portal
https://www.phs.org/providers
New Mexico's largest locally-owned not-for-profit plan (commercial, Medicare Advantage, and Medicaid/Centennial Care).
National EDI Clearinghouse Capabilities
Direct ANSI X12 electronic transaction support verified for Presbyterian Health Plan.
Associated Clearinghouse Payer IDs
National clearinghouse networks maintain dedicated routing IDs for specific transaction lines or subsidiaries under Presbyterian Health Plan.
| Clearinghouse Name | Electronic Payer ID | Status | Enrollment | Supported Services |
|---|---|---|---|---|
| Presbyterian Health Plan | 10646 | Non-Par | None | 837P837I270/271Dental |
| Presbyterian Health Plan | PREHP | Non-Par | Required | 837P837I835 ERA |
Resolution Tools for Presbyterian Health Plan 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 Presbyterian Health Plan Denials & Delayed Payments?
Aethera's billing specialists work Presbyterian Health Plan every day — handling EDI clearinghouse rejects, prior authorizations, payment posting, and 30-day AR aging recovery.