How To Submit Claims To Providence Health Plan

Coverage: Providence Health Plan regional networks and products; verify current member coverage and delegated responsibility.

Providence Health Plan claims guidance from the reviewed sources: Electronic claims through a clearinghouse using the official electronic claims instructions. Confirm the member plan and claim type before using a payer ID or paper address.

At a glance

• Use electronic claims through the listed clearinghouse workflow; payment services are separate.

Submission channels

• Electronic claims through a clearinghouse using the official electronic claims instructions.

Electronic claims payer IDs

• Not clearly published in the researched sources.

Paper claims addresses

• Not clearly published in the researched sources.

Corrected claims and follow-up

• Not clearly published in the researched sources.

• No direct topic-specific link was captured in the current research set.

Caveats

• Confirm the product, network and clearinghouse routing. Zelis check, EFT and EOP services concern payment, not claim submission; do not treat payment enrollment as EDI claims enrollment.

Provider resources

• Official provider policy or review source (official)
• Official provider policy or review source (official)
• Official provider policy or review source (official)

Sources

Update notes

Last updated: 2026-10-30.

• Reviewed the official provider hub, electronic claims page and member claims guidance. Omitted unverified filing numbers, IDs and postal destinations. Current provider contract details and product coverage notices still require confirmation.