Banner Health Plans at a glance
| Legal name | Banner Health Plans |
|---|---|
| Also known as | Banner, Banner Health |
| Category | Commercial |
| Parent organization | Banner Health |
| Claims payer ID | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| 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 registry has not established one national ERA payer ID for Banner Health Plans. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment. |
| NAIC company code | Not established in this registry |
| States covered | Arizona |
| Provider resource entry point | https://www.bannerhealth.com/bhpprovider/about/contact |
| Provider phone | Plan-specific |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Banner Health Plans
For ACC/ALTCS, the July 2026 manual gives contracted initial claims 120 days after service unless the agreement differs; noncontracted initial claims use six months after service or eligibility posting, whichever is later. Secondary claims use 60 days from primary remittance, with noncontracted claims allowed the greater of that window or six months after service. This is not a universal Banner commercial/Medicare rule.
| Submission type | Window |
|---|---|
| Initial claim reference | Product specific; ACC/ALTCS contract default 120 days |
| 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 Banner Health Plans. 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: Banner Health Plans provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Banner Health Plans
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 Banner Health Plans 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 Banner Health Plans. 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 Banner Health Plans
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Banner Health Plans 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 | No single all-product identifier established in this registry; see source findings and verify the member product and transaction separately |
| 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 registry has not established one national ERA payer ID for Banner Health Plans. ERA enrollment and 835 routing are clearinghouse- and product-specific; verify in the payer portal or clearinghouse payer list before enrollment. |
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
- Keep umbrella transaction identifiers blank: the submission page separates ACC/Dual 09830, ALTCS 66901 and dental routing.
- The commercial category does not capture the checked Medicaid/Medicare product distinctions. This review is not a full insurer or product inventory.
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.
timely_filing_days, filing_rule, provider_phone, payer_ids — Banner University Family Care: ACC/ALTCS 2026 manual
Source comparison: 2026-09-18
Stored 180 days and 800-827-2464 do not establish a universal Banner plan rule or contact. The current Medicaid manual supplies useful ACC/ALTCS rules, while the contact and submission pages separate products. Source scope: ACC/ALTCS Medicaid only; agreement, participation, secondary payment and posted-eligibility clocks differ. Locator: PDF 1 cover, PDF 64 / printed 63 and PDF 66 / printed 65, Claims. Version: Effective July 9, 2026; linked manual index updated August 21, 2026.. Retrieval: content_read; Primary PDF byte download and pertinent-page text plus visual inspection. This is a partial comparison, not whole-field or whole-record approval.
Primary source for timely_filing_days, filing_rule, provider_phone, payer_ids — banner university family care: acc/altcs 2026 manualtimely_filing_days, filing_rule, provider_phone, payer_ids — Banner: product-specific provider contacts
Source comparison: 2026-09-18
Stored 180 days and 800-827-2464 do not establish a universal Banner plan rule or contact. The current Medicaid manual supplies useful ACC/ALTCS rules, while the contact and submission pages separate products. Source scope: ACC 800-582-8686; ALTCS 833-318-4146; Prime 844-549-1857; Dual 877-874-3930. These are not one universal provider line. Locator: Provider Experience Center / By Phone. Version: Last updated January 14, 2026.. Retrieval: content_read; public_web_content_read. This is a partial comparison, not whole-field or whole-record approval.
Primary source for timely_filing_days, filing_rule, provider_phone, payer_ids — banner: product-specific provider contactstimely_filing_days, filing_rule, provider_phone, payer_ids — Banner: electronic and mail submissions
Source comparison: 2026-09-18
Stored 180 days and 800-827-2464 do not establish a universal Banner plan rule or contact. The current Medicaid manual supplies useful ACC/ALTCS rules, while the contact and submission pages separate products. Source scope: Claims 09830 for ACC/Dual and 66901 for ALTCS are product-specific, not one umbrella identifier. Locator: Medicaid Plans; Medicare Plans. Version: Last updated August 30, 2024; currently served page, not a new 2026 routing certification.. Retrieval: content_read; public_web_content_read. This is a partial comparison, not whole-field or whole-record approval.
Primary source for timely_filing_days, filing_rule, provider_phone, payer_ids — banner: electronic and mail submissions
Not checked in this pass: Other fields in the immutable 43-field research inventory remain unverified unless expressly scoped in these findings; Whole-record approval, current legal entity/ownership, enrollment and complete insured geography; Every provider agreement, product, claim type, filing/appeal exception and clinical authorization policy; Current transaction-specific enrollment/capabilities and authenticated portal behavior; unknown does not mean unavailable; QuickIntell integrations/outcomes and historical April 2026 DataForSEO demand; Accountable reviewer approval; last_reviewed and reviewed_by remain unchanged.
Sources used for this guide
State coverage
Banner Health Plans 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 Banner Health Plans
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 Banner Health Plans; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for Banner Health Plans; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for Banner Health Plans before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about Banner Health Plans
Where is the Banner Health Plans provider portal?
Use https://www.bannerhealth.com/bhpprovider/about/contact as a starting point for Banner Health Plans 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 Banner Health Plans?
For ACC/ALTCS, the July 2026 manual gives contracted initial claims 120 days after service unless the agreement differs; noncontracted initial claims use six months after service or eligibility posting, whichever is later. Secondary claims use 60 days from primary remittance, with noncontracted claims allowed the greater of that window or six months after service. This is not a universal Banner commercial/Medicare rule.
Does Banner Health Plans publish a single claims payer ID?
This registry has not established one all-product claims payer ID for Banner Health Plans. See the source findings for transaction-specific references. Look up the correct ID for the member's plan and transaction in your clearinghouse directory and verify against the member ID card before submission.
Does Banner Health Plans accept electronic claims?
Verify Banner Health Plans 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 Banner Health Plans denial?
This registry has not established a payer-specific appeal ladder for Banner Health Plans. 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 Banner Health Plans 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.
How do providers contact Banner Health Plans?
This registry has not established one provider phone number for Banner Health Plans. Select the Provider Experience Center number for the actual ACC, ALTCS, Prime or Dual product. Stored 800-827-2464 was not verified as a universal provider line. Use https://www.bannerhealth.com/bhpprovider/about/contact as a starting point for Banner Health Plans 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.
Automate workflows around Banner Health Plans 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 Banner Health Plans's current published documents before submission. CPT® is a registered trademark of the American Medical Association.