If you’re a medical biller or provider trying to submit a claim to Curative, the payer ID you need is CURTV. That’s the code you’ll enter into your clearinghouse or EDI system to route professional (CMS-1500), institutional (UB-04) and secondary claims correctly to Curative Health Plan.

This guide covers everything a billing office actually needs: the payer ID itself, which clearinghouses support it, mailing addresses for paper claims, timely filing rules, prior authorization quirks specific to Curative, and where claims commonly get rejected. It’s aimed at US-based provider offices and billing staff, since Curative operates as a Texas-based health plan and this isn’t a topic with a UK equivalent.

Quick Answer: Curative Health Insurance Payer ID

The Curative Health Insurance payer ID is CURTV. Use this code for both Professional/1500 claims and Institutional/UB claims, as well as for eligibility and benefits checks and secondary claims submissions. It works through most major clearinghouses, including Claim.MD, Availity Essentials and TriZetto, which Curative names directly as an allowable clearinghouse in its provider manual.\

Who Is Curative Health Plan?

Curative is a health insurance company based in Austin, Texas, known for its distinctive plan design: members who complete a Baseline Visit within the first 120 days of their plan start date get $0 copays and deductibles for in-network services. Miss that window, and standard cost-sharing applies instead.

Curative’s core network runs through First Health Network, with secondary network access through First Choice of the Midwest and Cofinity in certain states. This gives Curative members provider access beyond Texas, including specific counties in Florida, Alabama, and additional states depending on plan type, which matters if you’re billing for a patient outside Curative’s home state.

How to Submit Claims Electronically

Curative strongly prefers electronic claims submission over paper, and its provider manual is explicit about the format requirements.

Required claim format

Electronic submissions must use the HIPAA-compliant 837 format, the standard for professional and institutional claims in US healthcare billing. Paper submissions, where permitted, should use a CMS-1500 or UB-04 form (or their current successors).

Supported clearinghouses

Curative lists TriZetto as its allowable clearinghouse for EDI submissions, but because most clearinghouses exchange data with one another, you don’t necessarily need a direct TriZetto account. If your practice already uses a different clearinghouse, such as Claim.MD or Availity Essentials, you can typically route claims to Curative through your existing setup using payer ID CURTV.

Setting up Electronic Remittance Advice (ERA)

To receive electronic remittance advice, you’ll need to coordinate with your clearinghouse to establish ERA specifically with Curative, since this isn’t automatic just because you’re submitting electronic claims. Curative’s Provider Relations team can help if your clearinghouse needs additional setup steps on their end.

Electronic Funds Transfer (EFT)

Curative also offers EFT for claims payments, which it markets as faster and more predictable than paper cheques. Funds are typically delivered within 1 to 3 business days once EFT is set up, compared with the delays common with mailed payments. You’ll need to complete an Electronic Funds Transfer Form, available through curative.com/electronic-claims-processing, to get started.

Submitting Paper Claims

If electronic submission isn’t an option, Curative accepts paper claims by mail at:

Curative Health Plan P.O. Box 1786 Austin, Texas 78767

Note that Curative’s own materials have referenced more than one P.O. Box address across different provider documents, so it’s worth confirming the current address on curative.com or your latest provider manual before mailing anything, since these details can change between manual revisions.

Appeals submissions

Claim appeals go through a separate fax line: 877-734-6537. Keep a confirmation of your fax transmission, as with any appeal, in case you need to follow up on processing timeframes later.

What Counts as a Clean Claim

Curative follows Texas Department of Insurance (TDI) prompt payment rules, which means a claim is only considered processed on time if it’s paid, pended for review, or denied within the statutory timeframe. To count as a “clean claim” and avoid processing delays, Curative requires:

• Valid member identification and provider NPI
• Accurate diagnosis and procedure codes
• Correct dates of service and billed amounts
• Servicing location details
• Complete, legible information across all required fields

Claims needing prior authorization, coordination of benefits, or supporting medical records must include all of that documentation up front. Missing any of it is one of the most common reasons a submitted claim gets kicked back for additional information rather than processed straight through.

Gold Card Exemption: A Texas-Specific Rule to Know

One detail that trips up billing staff unfamiliar with Curative specifically: under Texas’s Gold Card legislation, Curative cannot deny or reduce payment for a service covered by the exemption. But the exemption only applies when the ordering, rendering, or referring provider is correctly identified on the claim.

On a professional claim, that means the ordering or rendering provider. On an institutional claim, it’s the referring or rendering provider. If that field is left blank or filled in incorrectly, Curative will treat the claim as not clean, even if the underlying Gold Card exemption should otherwise apply, and it’ll go through standard prior authorization review instead.

Eligibility and Benefits Checks

Before submitting a claim, most billing offices run an eligibility and benefits check first. Curative’s payer ID CURTV supports this through the same clearinghouses used for claims submission, so you shouldn’t need a separate setup for eligibility verification versus claims.

Given the Baseline Visit rule mentioned earlier, it’s worth checking specifically whether a patient has completed theirs. A patient who hasn’t may be subject to standard copays and deductibles rather than the $0 cost-sharing Curative markets, which affects what you’ll ultimately collect from the patient versus the plan.

Common Payer ID Mix-Ups to Avoid

A few things worth double-checking before you assume a claim is going to the right place:

• CURTV is specific to Curative Health Plan. Don’t confuse it with payer IDs for Curative’s pharmacy services or any unrelated “Curative” named entity in a different state, since payer ID directories sometimes group similarly named payers together.
• Mediview Curative appears as a related but separate listing in some clearinghouse payer directories, tied to a level-funded account structure. If your claim involves a level-funded Curative plan rather than standard Curative Health Plan coverage, confirm you’re using the correct listing with your clearinghouse support team, since the two aren’t always interchangeable.
• Address changes happen. Curative has updated its provider manual multiple times in the past year (the most recent being version 7, dated November 2025), and mailing addresses have shifted between versions. Always check the current provider manual rather than relying on an old printout.

FAQs

What is the payer ID for Curative Health Insurance?

The payer ID is CURTV. It’s used for Professional/1500 claims, Institutional/UB claims, secondary claims, and eligibility and benefits checks submitted through most major clearinghouses.

Where do I mail paper claims to Curative?

Paper claims currently go to Curative Health Plan, P.O. Box 1786, Austin, Texas 78767. Since this address has changed across provider manual versions, confirm it against the latest manual on curative.com before mailing.

Does Curative accept electronic claims?

Yes, and Curative actively prefers it, citing faster processing and fewer errors compared to paper submissions. Claims must use the HIPAA-compliant 837 format, and Curative names TriZetto as its allowable clearinghouse, though most other clearinghouses can route claims through to Curative as well.

What clearinghouse does Curative use?

Curative’s provider manual names TriZetto specifically, but the payer ID CURTV is also listed and supported by other clearinghouses including Claim.MD and Availity Essentials. Check with your own clearinghouse to confirm CURTV is set up on their system before submitting.

How do I appeal a denied Curative claim?

ppeals go by fax to 877-734-6537. Keep your fax confirmation and reference your original claim number when following up, since Curative doesn’t publish a separate online appeals portal in its current provider materials.

What is the Baseline Visit requirement?

Curative members need to complete a Baseline Visit within 120 days of their plan start date to keep $0 copays and deductibles for in-network services. Missing that window means standard cost-sharing applies instead, so it’s worth verifying Baseline Visit status before assuming a patient qualifies for reduced cost-sharing.

What is the Gold Card exemption and how does it affect Curative claims?

It’s a Texas rule preventing Curative from denying or reducing payment for certain exempted services, but only when the ordering, rendering, or referring provider is correctly listed on the claim. Leaving that field blank or incorrect means the claim won’t qualify as clean and will go through standard prior authorization review instead.

Does Curative use First Health Network?

Yes, Curative’s core network runs through First Health Network, with secondary access through First Choice of the Midwest and Cofinity depending on the state and plan. This gives members provider access outside Texas, including parts of Florida and Alabama.

How long does Curative take to process claims?

Curative follows Texas Department of Insurance prompt payment rules, meaning a claim must be paid, pended for review, or denied within the statutory timeframe to count as processed on time. Exact day counts depend on TDI’s current regulations, so check the latest TDI guidance if you need a specific figure for a disputed claim.