Payer ID
72128
72128 supports Professional (CMS-1500) and Institutional (UB-04); ERA available with pre-enrollment.
Timely Filing Limit (TFL)
Varies — confirm via portal / clearinghouse
Appeal Window
Varies — confirm via portal / clearinghouse
Clearinghouse
Varies — confirm via portal / clearinghouse
Provider Services
888-823-1910
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Vantage Health Plan, Inc., 130 DeSiard St., Suite 300, Monroe, LA 71201
Provider Portal
https://providers.vantagehealthplan.com/
Louisiana-based commercial HMO (Monroe, LA). Address shown is corporate — verify claims address.
Values vary by plan, region, and contract and can change. Confirm in the payer portal or with your clearinghouse before filing.
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