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Healthfirst provider portal, phone and payer ID

Healthfirst, Inc. · A Healthfirst, Inc. (sponsored by NYC hospitals) company

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Updated

TL;DR

Healthfirst, a Healthfirst, Inc. (sponsored by NYC hospitals) subsidiary, is a medicaid mco payer covering roughly 1.9 million members operating in 2 states. Provider phone is 1-888-801-1660. Claims payer ID is 80141. Standard timely filing is 90 days from date of service for participating providers. Electronic claims (837), eligibility (270/271), prior auth (278), and ERA (835) are supported. Use the provider portal for eligibility, claims status, prior authorization, and appeal workflows.

Healthfirst provider portal, phone and payer ID quick facts

Provider portalhttps://hfdocs.healthfirst.org
Provider phone1-888-801-1660
Claims payer ID80141
Eligibility payer ID80141
ERA payer ID80141
Timely filing90 days
Prior auth routeX12 278 plus provider portal
Last reviewed2026-04-23

Healthfirst at a glance

Legal nameHealthfirst, Inc.
Also known asHealthfirst NY, HF
CategoryMedicaid MCO
Parent organizationHealthfirst, Inc. (sponsored by NYC hospitals)
Claims payer ID80141
Eligibility (270/271) payer ID80141
ERA (835) payer ID80141
NAIC company codeNot published
States coveredNew York, New Jersey
Members covered~1.9 million members
Provider portalhttps://hfdocs.healthfirst.org
Provider phone1-888-801-1660

Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.

Timely filing & appeals for Healthfirst

Healthfirst's standard timely filing window for participating providers is 90 days from the date of service. Plan-specific products (Medicare Advantage, Medicaid, employer groups, secondary claims) may have shorter or longer windows — always confirm against the policy linked below before disputing a TFL denial.

Submission typeWindow
In-network initial claim90 days
Out-of-network initial claim90 days (verify per plan)
Secondary / coordination of benefits90 days from primary EOB
Corrected / appeal90 days from denial

Appeal levels

  1. Level 1: First-Level ReconsiderationFile within 90 days

    Written request for claim reconsideration with supporting documentation, filed within the stated window of the denial notification.

  2. Level 2: Second-Level Formal AppealFile within 60 days

    Formal appeal reviewed by a party not involved in the initial determination; typically requires the first-level decision letter.

  3. Level 3: External / Independent ReviewFile within 120 days

    External Independent Review Organization (IRO) review per ACA §2719 and applicable state law.

Source: Healthfirst provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.

Prior authorization with Healthfirst

Healthfirst accepts X12 278 prior-authorization transactions electronically. The procedures most commonly subject to prior authorization include advanced imaging, inpatient admissions, specialty pharmacy, and certain outpatient surgical procedures. Use the payer's authorization tool below to confirm requirements per CPT before scheduling a service.

Healthfirst maintains a live prior-authorization code lookup tool that supersedes any cached list. Use the provider portal or the policy documents below to confirm the current PA list before rendering a service.

Top denial reasons for Healthfirst

Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Healthfirst volume. Until then, see the broader CARC reference for industry-wide remediation guides.

Electronic claims, eligibility & ERA

TransactionSupportedPayer ID
837P / 837I claimsYes80141
270 / 271 eligibilityYes80141
278 prior authorizationYes80141
835 ERAYes80141

Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.

State coverage

Healthfirst operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.

QuickIntell coverage for Healthfirst

  • QuickRCM

    End-to-end claim lifecycle automation tuned to Healthfirst's edits and adjudication patterns.

  • QuickAuth

    Automated prior-authorization submissions and status checks for Healthfirst services that require PA.

  • QuickERA

    Automated 835 ERA posting from Healthfirst with payment reconciliation and denial routing.

Frequently asked questions about Healthfirst

Where is the Healthfirst provider portal?

The Healthfirst provider portal is available at https://hfdocs.healthfirst.org. Use it for eligibility checks, claim status, prior authorization workflows, appeals, and payer-specific routing updates. QuickIntell links to the payer's provider-facing portal as a reference and is not the official payer portal.

What is the timely filing limit for Healthfirst?

Healthfirst's standard timely filing limit for participating providers is 90 days from the date of service. Plan-specific products (Medicare Advantage, Medicaid managed care, employer groups) may have different windows — confirm against the payer's provider manual before disputing a TFL denial.

What is the Healthfirst payer ID?

The primary claims payer ID for Healthfirst is 80141. Eligibility (270/271) uses 80141 and ERA (835) uses 80141. Always verify against the member ID card and your clearinghouse payer list before submitting.

Does Healthfirst accept electronic claims?

Yes — Healthfirst accepts ANSI X12 837P and 837I electronic claims through standard clearinghouses. Real-time eligibility (270/271) is supported and X12 278 prior authorization is supported.

How do I appeal a Healthfirst denial?

Healthfirst uses a 3-level appeal process. Level 1 (First-Level Reconsideration) must be filed within 90 days of the denial. Each escalation level requires the prior decision letter and supporting clinical or coding documentation. See the appeal-levels block above for deadlines and process.

How long do Healthfirst prior authorization approvals take?

Healthfirst's prior-authorization decision turnaround typically follows standard industry windows: 72 hours for urgent requests and up to 14 calendar days for non-urgent requests. Specialty drugs and high-cost imaging may extend further. Submit through X12 278 or the Healthfirst provider portal for the fastest turnaround.

What is the Healthfirst provider phone number?

Providers can reach Healthfirst at 1-888-801-1660 for claims status, eligibility verification, and authorization questions. Have the member ID, date of service, and tax ID ready before calling. Most operational tasks are faster through the provider portal at https://hfdocs.healthfirst.org.

Run cleaner claims to Healthfirst with QuickIntell

QuickAuth, QuickRCM, and QuickERA are validated against Healthfirst's EDI behavior — eligibility, prior auth, claim scrubbing, and ERA posting all run on real payer rules.

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 Healthfirst's current published documents before submission. CPT® is a registered trademark of the American Medical Association.