Providence Health Plan
Also covers / subsidiaries: PHP, Providence
Core Payer & Clearinghouse Profile
Electronic Payer ID
10172
Clearinghouse-dependent: SX133 (Optum/Change, SSI Group) or PHP01 (Office Ally, Trizetto, VisibilEDI).
Timely Filing Limit (TFL)
365 days from date of service
Appeal Window
Varies — confirm via portal / clearinghouse
Clearinghouse Gateway
Optum/Change Healthcare; Office Ally; SSI Group; Trizetto
Provider Services
800-878-4445
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Providence Health Plan, P.O. Box 4327, Portland, OR 97208-4327
Provider Portal
https://phpprovider.providence.org/portal/login
Oregon-based plan serving OR and WA. Payer ID is clearinghouse-specific (SX133 or PHP01).
National EDI Clearinghouse Capabilities
Direct ANSI X12 electronic transaction support verified for Providence Health Plan.
Associated Clearinghouse Payer IDs
National clearinghouse networks maintain dedicated routing IDs for specific transaction lines or subsidiaries under Providence Health Plan.
| Clearinghouse Name | Electronic Payer ID | Status | Enrollment | Supported Services |
|---|---|---|---|---|
| Providence Health Plan | 10172 | Non-Par | None | 837P837I270/271Dental |
| Providence Health Plan | SX133 | Non-Par | Required | 837P837I835 ERA |
Resolution Tools for Providence 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 Providence Health Plan Denials & Delayed Payments?
Aethera's billing specialists work Providence Health Plan every day — handling EDI clearinghouse rejects, prior authorizations, payment posting, and 30-day AR aging recovery.