Alignment Healthcare at a glance
| Legal name | Alignment Healthcare USA, LLC |
|---|---|
| Also known as | Alignment Health Plan |
| Category | Medicare Advantage |
| Parent organization | Alignment Healthcare, Inc. (NASDAQ: ALHC) |
| Claims payer ID | CCHPC — registry reference; verify the member product, transaction and clearinghouse |
| Eligibility (270/271) payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| ERA (835) payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This pass did not verify an ERA payer ID. CCHPC is sourced as a claims ID and must not be copied into remittance routing; confirm the current enrollment and clearinghouse route. |
| NAIC company code | Not established in this registry |
| States covered | California, Nevada, Arizona, North Carolina, Florida, Texas |
| Members covered | ~170k members |
| Provider resource entry point | https://www.alignmenthealthplan.com/providers/provider-resources |
| Provider phone | 1-844-361-47121-844-361-4712 is Network Management and Provider Relations, not a universal claims, member-services or utilization-management line. Use the relevant product/service route. |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Alignment Healthcare
The currently linked Provider Operations Manual uses 90 days from date of service for initial claims unless the provider agreement differs. Confirm delegation and claim type before calculating a deadline; do not apply this default to appeals or assume the manual overrides the contract.
| Submission type | Window |
|---|---|
| Initial claim reference | 90 days from service unless the provider agreement differs |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for Alignment Healthcare. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: Alignment Healthcare provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Alignment Healthcare
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify Alignment Healthcare electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for Alignment Healthcare. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for Alignment Healthcare
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Alignment Healthcare volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | CCHPC — registry reference; verify the member product, transaction and clearinghouse |
| 270 / 271 eligibility | Listed in registry; verify current scope | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This pass did not verify an ERA payer ID. CCHPC is sourced as a claims ID and must not be copied into remittance routing; confirm the current enrollment and clearinghouse route. |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
What revenue cycle teams should verify before submitting claims
- The linked manual distinguishes fee-for-service claims CCHPC from encounters CCHP2; confirm the responsible entity and clearinghouse before transmission.
- AHP01 was not verified for eligibility or ERA. Provider resources describe separate 270/271 setup; portal authorization or a proprietary-format example is not proof of universal X12 278 support.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
provider_phone, field_status.provider_phone
Source comparison: 2026-09-18
The former 1-844-310-2247 value is Corporate Headquarters. The registry now uses 1-844-361-4712 with its explicit Network Management and Provider Relations purpose; it is not a universal claims, member-services or utilization-management line. Locator: named contact sections; page last updated June 20, 2025.
Primary source for provider_phone, field_status.provider_phonepayer_ids.claims, payer_ids.eligibility, payer_ids.era, era_payer_id
Source comparison: 2026-09-18
The currently linked R4 manual distinguishes fee-for-service claims CCHPC from encounters CCHP2. Claims use the described clearinghouse route; copied AHP01 eligibility/ERA values were not substantiated and were withdrawn as unverified. Do not copy the claims ID into another transaction. Locators: printed/PDF pages 59, 64 and 66; pages 59 and 66 visually inspected. The page 66 authorization example uses proprietary format; that is not a universal finding about X12 278 availability.
Primary source for payer_ids.claims, payer_ids.eligibility, payer_ids.era, era_payer_idtimely_filing_days, filing_rule, timely_filing_source_url
Source comparison: 2026-09-18
The linked manual gives a 90-day initial-claim default from service unless the provider agreement differs. The scalar remains 90 with explicit scope, not a universal appeal or secondary-claim deadline. Locator: printed/PDF page 59, visually inspected.
Primary source for timely_filing_days, filing_rule, timely_filing_source_urlsource version provenance
Source comparison: 2026-09-18
The current official manual landing links R4. PDF page 2 identifies the January 1, 2026 edition. Hidden/extracted cover text contains a 2024 date, while the visually inspected cover shows no date. This discrepancy is retained; the filename alone does not establish effectiveness or approval.
Primary source for source version provenanceportal_url, supports_279_271, supports_278
Source comparison: 2026-09-18
Current provider resources link AVA and describe separate 270/271 setup. Portal access does not establish universal X12 278 support, and no stored capability boolean was promoted to verified availability. Locator: Provider Relations, AVA and EDI eligibility inquiry sections; resource page last updated August 17, 2026.
Primary source for portal_url, supports_279_271, supports_278manual effective-date and contract precedence
Source comparison: 2026-09-18
The official manual notice announces January 1, 2026 effectiveness, or the notification timing in the provider contract, and says the agreement prevails over conflicting manual terms. This is publisher provenance, not a new QuickIntell approval or a date refresh. Locator: Provider Operations Manual update notice.
Primary source for manual effective-date and contract precedence
Not checked in this pass: Exact legal underwriting entity/NAIC, current enrollment and product-complete geographic coverage unless expressly scoped above; Complete initial, corrected, secondary, appeal and dispute requirements, agreements, delegation exceptions and effective dates; Every eligibility, ERA and authorization identifier and capability; a claims ID or portal does not certify other transactions; Current clinical criteria, prior-authorization code samples and medical decisions; QuickIntell integrations/outcomes and historical April 2026 DataForSEO demand; Accountable whole-record editorial approval; all last_reviewed dates remain unchanged.
State coverage
Alignment Healthcare operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.
Evaluate QuickIntell workflow fit for Alignment Healthcare
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for Alignment Healthcare; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for Alignment Healthcare; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for Alignment Healthcare before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about Alignment Healthcare
Where is the Alignment Healthcare provider portal?
Use https://www.alignmenthealthplan.com/providers/provider-resources as a starting point for Alignment Healthcare provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for Alignment Healthcare?
The currently linked Provider Operations Manual uses 90 days from date of service for initial claims unless the provider agreement differs. Confirm delegation and claim type before calculating a deadline; do not apply this default to appeals or assume the manual overrides the contract.
What is the Alignment Healthcare payer ID?
Claims: CCHPC — registry reference; verify the member product, transaction and clearinghouse. Eligibility (270/271): No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. ERA (835): No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately. Clearinghouse-specific: This pass did not verify an ERA payer ID. CCHPC is sourced as a claims ID and must not be copied into remittance routing; confirm the current enrollment and clearinghouse route.. Do not substitute a claims ID for an unverified transaction ID. Check current source findings and the member ID card before submitting.
Does Alignment Healthcare accept electronic claims?
Verify Alignment Healthcare electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a Alignment Healthcare denial?
This registry has not established a payer-specific appeal ladder for Alignment Healthcare. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do Alignment Healthcare prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
What is the Alignment Healthcare provider phone number?
This registry lists 1-844-361-4712 as a contact reference for Alignment Healthcare. 1-844-361-4712 is Network Management and Provider Relations, not a universal claims, member-services or utilization-management line. Use the relevant product/service route.
For revenue-cycle teams
Connect payer lookups to your revenue-cycle workflow
Do staff repeatedly move between payer references, eligibility checks, claim status and remittance follow-up?
- Keep this payer's official reference available to the team.
- Identify one repeated administrative task and measure its handling time.
- Evaluate the required access, exceptions and reviewer handoff before expanding automation.
Alignment Healthcare is an operational reference. Payer decisions remain with the payer. Confirm plan coverage, system access and supported actions during a scoped evaluation.
Download the illustrative workflow worksheet (PDF) · Explore the AI RCM evaluation toolkit · Model the workload and costs
Automate workflows around Alignment Healthcare requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Alignment Healthcare's current published documents before submission. CPT® is a registered trademark of the American Medical Association.