Provider Online Services and EDI Information

access|RMHP

access|RMHP is a Web-based service that participating providers can use to access eligibility, claims status and much more. access|RMHP provides:

  • Free and secure access 24/7.  Except for scheduled maintenance (access|RMHP may be intermittently unavailable on Thursday nights between 10:00 p.m. - 12:00 p.m. for scheduled maintenance)
  • A HIPAA-compliant application
  • Eligibility and benefits verifications, including copays and deductibles
  • Claim summary, detail and status
  • Ability to check authorizations
  • Ability to search participating providers
Register for access|RMHP now

Electronic Data Interchange (EDI)


Our EDI system allows providers to submit claims, retrieve remittance advice and claim file acknowledgements from the insurance carrier or clearinghouse.

Rocky Mountain Health Plans promotes fast claims turnaround by accepting electronic claims submission directly from provider offices as well as from many clearinghouses.

To enroll in electronic claims submission to RMHP:

1)  Download and complete the Electronic Data Interchange Transaction Request Form.

2)  Email the completed form to supports@rmhp.org or fax it to 970-244-7880; Attention: IT/EDI.
 
3)  Once set-up is complete, an EDI representative from RMHP will contact you. If you use a clearinghouse, the payor ID will be provided once enrollment is complete.

If you have questions about electronic claims submission, please contact our EDI representative at 970-244-7893 or edicoordinator@rmhp.org.

The following preferred clearinghouses currently send electronic claims data to Rocky Mountain Health Plans.  This is not an all-inclusive list:

  • ClaimLogic
  • Cortex EDI
  • CPSI
  • Healthcare Administration Technologies, Inc
  • McKesson (Also known as Relay Health)
  • Navicure
  • NDCHealth (Also known as Relay Health)
  • Practice Insight
  • QuadraMed (Also known as Health Fusion)
  • The SSI Group
  • ViaTrack Systems

To all EDI Trading Partners:


To comply with changes in the Health Insurance Portability & Accountability Act (HIPPA) security standards, Rocky Mountain Health Plans (RMHP) is required to convert our Electronic Data Interchange (EDI) website to a more secure file transfer protocol (SFTP).


To meet these standards, RMHP will be transferring our Legacy Provider EDI website to an SFTP on June 15, 2016.

If you have questions about electronic claims submission or this transition, please contact our EDI representative by calling 970-244-7893 or emailing edicoordinator@rmhp.org.