Payer Information
Candid Health supports most payers. You can find a list of supported payers with their respective payer_id, primary_name, ‘availity_claims_professional_id’, and ‘availity_claims_institutional_id’ here.
The payer_id and primary_name should be used in the payer_id and payer_name fields of the subscriber’s insurance card information and when you use the Encounters endpoint.
When denoting a claim as self-pay, please use the responsible party field on the Encounters endpoint.
When submitting claims to Candid, ensure you are using the exact primary_name and payer_id from the provided CSV. The relationship between primary_name and payer_id is not one-to-one, meaning that certain payer_ids are used for multiple payers. As such, Candid has to do a match on a combination of primary_name and payer_id to determine the right destination for the claim.