Updated September 1, 2026
Verify Avera Health Plans eligibility in real time.
Avera Health Plans supports electronic real-time eligibility. Send the check to payer ID 10869 and the full benefits picture comes back in seconds, before the patient sits down.
Also billed as: Dakotacare · First Choice Health
Seconds
The same Avera Health Plans check that takes 15 to 25 minutes on the phone. Ten patients tomorrow: ten checks, or three hours on hold.
3 billing names
Avera Health Plans shows up on cards under 3 names. Every one routes to payer ID 10869, and so do 5 older payer IDs still printed on cards. No guessing which card this is.
IA, NE, SD
Avera Health Plans covers dental, medical. Sign in and check any patient in one click before they arrive.
From $39/mo
Per location, billed yearly. Found checks are billed once a month, $2.50 each and less as you run more. No seat fees, no processing fees.
The phone way
Call, hold, transcribe, repeat.
Verifying Avera Health Plans by phone means a menu, a hold queue, and 15 to 25 minutes per patient while someone at the desk reads benefits back by hand. Ten patients on tomorrow's schedule is half a workday on hold.
The real-time way
Payer ID 10869, in seconds.
The same check, sent electronically. Sign in and run it for any patient in one click, and Valian flags the ones that need a human look.
| By phone | In Valian | |
|---|---|---|
| Time per patient | 15 to 25 minutes on hold | Seconds |
| When it happens | Day of, squeezed between patients | Any time before the visit, in one click |
| What you get | Notes scribbled while someone reads benefits aloud | The full breakdown, saved to the patient |
What a Avera Health Plans eligibility check returns
- Whether coverage is active, with plan and group details
- Deductible, and how much of it is already met this year
- Annual maximum, and how much of it is left to work with
- Coverage percentages by category: preventive, basic, major
- Frequency limits on cleanings, exams, and X-rays
- Waiting periods, where Avera Health Plans reports them electronically
Eligibility result
Sample data- Status
- Active
- Plan
- PPO · Group 8823
- Deductible
- $50 · $0 met
- Annual max
- $1,500 remaining
- Preventive
- 100%
- Basic
- 80%
- Major
- 50%
- Cleanings
- 2 / year
Returned in seconds · payer ID 10869
How practices handle this today, in their own words
Verbatim from recorded calls to dental offices. Names withheld.
We call the insurance, or I go on their website and do it. Yeah, we manually do it.
We have a third party insurance verification team that does it for us. I’m not too sure, maybe like seven, ten minutes.
Our system does it, and the ones that are not set up for electronic, we do ourselves.
How getting set up works
Book a discovery call
A 15-minute call with our team: we show you a check and size your plan. Then you sign up from the link we send you: create the account, sign the agreement, and put a card on file.
Save your carriers and codes
Pick the insurance carriers you take and the codes you check.
Run a check in one click
Sign in, pick a patient and see their coverage in seconds before the visit, Avera Health Plans included. No hold music, no portal logins.
Under half an hour of your time all in. See how the software compares, how a real-time check works, or what outsourcing costs.
What Avera Health Plans supports through our network
- Real-time eligibility (270/271)
- Yes, in seconds
- Enrollment for eligibility
- None, checks work day one
- Dental claims (837D)
- Not through our network
- Claim status (276/277)
- Yes
- Electronic remittance (835)
- Yes, after a multi-step enrollment, typically a few weeks
- Electronic funds transfer
- Not through our network
- Claim attachments
- Not through our network
Names and IDs this payer goes by
Avera Health Plans · Dakotacare · First Choice Health. Older cards may show payer ID 1786, 46045, 7120, 8561 and AH002. All of them route to payer ID 10869.
Payer site: www.averahealthplans.com
How to verify Avera Health Plans, step by step
Get the member ID and date of birth from the card or the patient.
Send the electronic eligibility request (a 270) to payer ID 10869.
Read the response (the 271): status, deductible, max, percentages, frequencies.
Save the breakdown to the patient. With Valian, all four take one click and a few seconds.
Avera Health Plans, quick answers
Does Avera Health Plans support real-time eligibility?
Yes. Eligibility checks to Avera Health Plans clear electronically in seconds through payer ID 10869.
What payer ID do I use for Avera Health Plans?
10869 for eligibility transactions. The same payer also appears on cards as Dakotacare, First Choice Health.
What does a check cost with Valian?
Plans from $39 a month per location, billed yearly, or from $49 month to month. Plus $2.50 or less per check we find — $0 when we can’t find the insurance. No setup fee and no seat fees. Sign in and run each check in one click before the visit.
Does Avera Health Plans require enrollment before I can check eligibility?
No. Eligibility checks work from day one, with no payer enrollment paperwork.
Can I get Avera Health Plans remittances electronically?
Yes. Avera Health Plans sends electronic remittance advice (835) after a multi-step enrollment, typically a few weeks.
What if the patient's card shows a different Avera name?
Alternate billing names route to the same payer ID, 10869. The same check covers them.
More questions about verifying Avera Health Plans? Schedule 15 minutes with us and bring your toughest plan.
Check any Avera Health Plans patient in one click, before they walk in.
Plans from $39 a month per location, billed yearly, or from $49 month to month. Plus $2.50 or less per check we find — $0 when we can’t find the insurance. No setup fee and no seat fees.
Book 15 minutes, demo or onboarding
Pick a time, then tell us on the form whether it is a demo or an onboarding call.
Other Iowa dental payers
20 other payers operating in Iowa also verify in real time.
- Allegiance Benefit Plan Management Incorporated81040
- Delta Dental of IowaCDIA1
- Delta Dental of Iowa - Dental Wellness Plan (DWP)CDIAM
- Devoted HealthDEVOT
- Medica94265
- Medica Individual and Family12422
- Medical Associates Health Plan Health ChoicesMASHP
- Medical Associates Health PlansMAHC1
- Molina Healthcare of IowaMLNIA
Other Nebraska dental payers
14 other payers operating in Nebraska also verify in real time.
Other South Dakota dental payers
9 other payers operating in South Dakota also verify in real time, 2 of them with Medicaid plans.
- Allegiance Benefit Plan Management Incorporated81040
- Blue Shield of California100935
- Delta Dental of South Dakota54097
- Delta Dental of South Dakota (Medicare Advantage)SDCMS
- Medica94265
- Medicaid South DakotaSD
- Sanford Health Plan Medicare AdvantageRP035
- TRICARE West Region99726
- Wellmark88848
Medicaid plans in South Dakota: Blue Shield of California, Medicaid South Dakota.
Related payers
- Verify Allegiance Benefit Plan Management Incorporated eligibility
- Verify Delta Dental of Iowa eligibility
- Verify Delta Dental of Iowa - Dental Wellness Plan (DWP) eligibility
- Verify Devoted Health eligibility
- Verify Medica eligibility
- Verify Medica Individual and Family eligibility
More payers operating in Iowa · More payers operating in Nebraska · More payers operating in South Dakota
Payer names and marks belong to their owners and identify the insurance company a practice can verify. Sample result shown for illustration; real results reflect the patient's actual plan. Payer capabilities can change between network updates.