Sub-Clearinghouse Gateway  ·  Works Through Your Existing Clearinghouse  ·  Payer ID: FUNDS

My Patient Fund™  ·  Provider & Billing Office Guide

Everything your revenue
cycle team needs to
bill and get paid.

My Patient Fund™ works through your existing clearinghouse — no new technology, no credentialing, no card network. This guide covers the complete claim-to-payment workflow for your billing team and practice administrator.

Your Payer ID
FUNDS
Submit 837P · 837I
via your existing clearinghouse

Connected Clearinghouses — Submit to Payer ID: FUNDS Through Any of the Following

Office Ally · Gateway EDI · Change Healthcare · Optum · Availity · Trizetto · Waystar · and all major clearinghouses

My Patient Fund™ operates as a sub-clearinghouse gateway. Add Payer ID: FUNDS to your existing clearinghouse enrollment — no new system, no new contract, no new credentialing required. Your billing workflow stays exactly the same.

End-to-End Workflow

From patient check-in
to EFT in your account.

The My Patient Fund™ payment cycle follows the same EDI workflow your billing team already uses — with one difference: payment comes from a sponsor-funded FBO account rather than an insurance carrier's risk pool.

1
Front Desk
Member presents MPF™ Patient ID
The patient presents their My Patient Fund™ member ID — either the digital credential on their phone or a printed reference. Your front desk confirms the member name matches the patient chart and notes Payer ID: FUNDS for the billing team. The MPF™ ID is a healthcare identification credential only — not a payment card. Do not swipe or process it as a card transaction.
Front Desk Note: If a patient does not have their MPF™ ID handy, they can show the "Show Provider" view on their phone which displays a QR code and their member name. Contact Provider Relations to verify membership status: providers@mypatientfund.com
2
Billing Team
Submit 837P or 837I to Payer ID: FUNDS
Submit your claim through your existing clearinghouse exactly as you would for any other payer. Use standard HIPAA 837P (professional services) or 837I (institutional / facility) format. Payer ID is FUNDS. No new clearinghouse enrollment. No new EDI mapping. No proprietary format. Standard diagnosis codes, procedure codes, and modifiers apply.
Billing Note: My Patient Fund™ does not require pre-authorization for most services. If your practice has questions about specific service types, contact providers@mypatientfund.com before submission.
3
MPGI Claim Rules Validator
Claim validated against sponsor Rules and patient member limit
My Patient Fund™ receives the claim through the clearinghouse and validates it against the member's FBO account balance and eligible benefit parameters. MPGI then issues a payment instruction to our FDIC-insured banking partner. The banking partner executes EFT/ACH directly to your practice bank account. MPGI does not hold or custody funds — your payment comes directly from the banking partner.
4
Remittance
835 ERA returned via clearinghouse
The 835 Electronic Remittance Advice is returned to your practice through your clearinghouse upon payment processing — completing the standard HIPAA EDI transaction set. Post the ERA in your practice management system as you would any other payer remittance. Payment timing follows standard EFT/ACH settlement — typically 1–3 business days after Claim Rules Validator processing.
5
Balance Billing (If Applicable)
Member responsible for any unpaid remainder
My Patient Fund™ pays claims up to the available balance in the member's FBO sub-account. If the account balance is insufficient to cover the full approved claim amount, MPGI pays the available portion and issues a partial 835 ERA. Your practice may then bill the member directly for any unpaid remainder under your standard patient financial responsibility and collections policies. There is no network contract prohibiting balance billing — MPF™ is not an insurance network arrangement.
Best Practice: Communicate patient financial responsibility clearly at check-in. If you are unsure of the member's account balance, you may treat the MPF™ portion as a secondary payer and collect a patient estimate at time of service for any potential shortfall.
EDI Transaction Set

Standard HIPAA EDI —
nothing proprietary.

My Patient Fund™ uses the standard HIPAA 837/835 EDI transaction set. Your billing team's existing workflow, clearinghouse relationship, and practice management system require no modification.

Inbound Claim
837P — Professional
For physician office visits, specialist consultations, outpatient procedures, lab, radiology, therapy, and all professional billing. Submit via your clearinghouse to Payer ID: FUNDS using standard CMS-1500 / 837P format.
Payer ID: FUNDS  ·  Format: 837P  ·  Loop 2010BB NM109
Inbound Claim
837I — Institutional
For hospital inpatient, hospital outpatient, skilled nursing, surgery centers, and all facility billing. Submit via your clearinghouse to Payer ID: FUNDS using standard UB-04 / 837I format.
Payer ID: FUNDS  ·  Format: 837I  ·  Loop 2010BB NM109
Outbound Remittance
835 — ERA
The 835 Electronic Remittance Advice is returned to your clearinghouse upon payment. Post in your practice management system as you would any other payer ERA. Includes standard claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs).
Format: HIPAA 835  ·  Returned via clearinghouse  ·  Standard CARCs / RARCs
Payment Method
EFT / ACH
Payment is made via standard EFT/ACH bank-to-bank transfer directly to your practice bank account. No card network. No interchange fee. No third-party payment processor. Your practice receives 100% of the approved claim amount — net zero deduction.
Method: EFT/ACH  ·  Provider receives: 100% approved amount  ·  Timeline: 1–3 business days
Payment Scenarios

Three outcomes your
billing team should know.

Payment outcome depends on the member's FBO account balance at time of Claim Rules Validator processing. Your billing team should be prepared to handle all three scenarios.

Scenario A — Full Payment
Sufficient Account Balance
Member's FBO account balance covers the full approved claim amount. MPGI instructs the banking partner to EFT 100% of the approved amount to your practice. 835 ERA issued. Claim closes. Member owes nothing further for this claim.
✓ Full EFT payment issued. 835 ERA returned. Post and close.
Scenario B — Partial Payment
Insufficient Account Balance
Member's FBO account balance covers part of the approved claim. MPGI pays the available balance via EFT. Partial 835 ERA issued showing amount paid and balance remaining. Your practice may bill the member directly for the unpaid remainder under your standard patient financial responsibility policy.
⚠ Partial EFT issued. Balance-bill member for remainder.
Scenario C — No Payment
Zero Account Balance / Unfunded
Member's FBO account has been depleted or the account has not been funded. MPGI cannot process payment. Claim is returned with zero payment. Your practice is responsible for collecting the full amount directly from the member under your standard billing and collections procedures.
✗ No payment issued. Bill member directly for full amount.
Payer Reference

Complete payer
reference data.

Field Value / Description
Payer IDFUNDS
Payer NameMy Patient Fund™ / My Patient Global INC.
Claim Types Accepted837P (Professional)  ·  837I (Institutional)
Submission MethodElectronic — via your existing clearinghouse. No direct submission portal required.
Clearinghouse EnrollmentNot required. Use your existing clearinghouse relationship. Add Payer ID: FUNDS as a new payer in your clearinghouse configuration.
Network Contract RequiredNo. Any licensed healthcare provider may receive My Patient Fund™ payments without a network agreement or credentialing process.
Pre-AuthorizationGenerally not required. Contact Provider Relations for questions about specific high-cost service types.
Remittance Format835 ERA — returned via your clearinghouse. Standard HIPAA EDI format.
Payment MethodEFT / ACH — direct bank-to-bank transfer to your practice bank account on file.
Payment TimingTypically 1–3 business days after Claim Rules Validator processing and 835 ERA issuance.
Provider Receives100% of the approved claim amount. No interchange fee. No card network deduction.
Balance BillingPermitted. No network contract prohibiting balance billing. Members are responsible for any unpaid balance not covered by their FBO account.
Member IdentificationMPF™ Patient ID — digital credential showing member name, active status, and Payer ID: FUNDS. Not a payment card. Do not swipe.
Insurance TypeNot health insurance. Not ACA Minimum Essential Coverage. Sponsor-funded, closed-loop healthcare payment platform.
HIPAA ComplianceMPF™ operates as a HIPAA-compliant platform. Standard 837/835 EDI. PHI handled per HIPAA minimum necessary standard.
Claim Submission TimingContact Provider Relations for current claim submission timing: providers@mypatientfund.com
Appeals / DisputesContact Provider Relations within 90 days of Claim Rules Validator processing for payment disputes or ERA discrepancies.
Provider Supportproviders@mypatientfund.com  ·  Response within 1 business day
Websitemypatientfund.com
Billing FAQ

Questions your revenue cycle
team will ask.

Do we need to enroll with a new clearinghouse?
No. Use your existing clearinghouse relationship. Simply add My Patient Fund™ as a new payer in your clearinghouse configuration using Payer ID: FUNDS. The EDI format, connectivity, and workflow are identical to your existing payer setup.
Do we need to sign a participation or network agreement?
No. My Patient Fund™ does not require network agreements or credentialing. Any licensed provider that submits electronic claims via standard clearinghouse is eligible to receive payment. There is no exclusive arrangement and no contracted rate.
Is pre-authorization required?
Generally no. My Patient Fund™ operates as a direct-pay platform — pre-authorization is typically not required. For questions about specific high-cost procedures, contact Provider Relations before submission to confirm.
Can we balance-bill the patient for the full amount if MPF™ pays less?
Yes. My Patient Fund™ is not an insurance network arrangement, and there is no balance-billing prohibition. If the member's FBO account is insufficient to cover the full approved amount, you may bill the patient directly for the remainder under your standard financial responsibility policy.
What happens if we submit a claim and get no response?
Contact Provider Relations at providers@mypatientfund.com with the claim reference number and submission date. We respond within one business day. Common causes include incorrect Payer ID entry or clearinghouse routing issues — both are quickly resolved.
How do we handle the 835 ERA in our practice management system?
Post the 835 ERA exactly as you would any other payer remittance. MPF™ uses standard HIPAA CARCs and RARCs. If your PM system requires a new payer setup for ERA auto-posting, add Payer ID: FUNDS and map the ERA accordingly. Contact your clearinghouse for payer enrollment assistance.
Is this Medicare, Medicaid, or a managed care plan?
None of the above. My Patient Fund™ is a sponsor-funded, closed-loop healthcare payment platform administered by My Patient Global INC. It is not health insurance, not a government program, and does not constitute ACA Minimum Essential Coverage. It operates independently of all insurance networks.
What are the claim submission timing requirements?
Contact Provider Relations for current claim submission timing. As a best practice, submit MPF™ claims within the same timeframe as your standard commercial payer filing window — typically within 90–180 days of service date.
Can the patient pay by card instead of using MPF™?
Yes. The patient may choose to pay out-of-pocket by any method your practice accepts. MPF™ is their payment platform — not a requirement. If the patient wishes to use their MPF™ account, they'll ask you to submit to Payer ID: FUNDS. If they choose to pay directly, process normally.
We received payment but the amount is less than billed. Why?
Two possible reasons: (1) The member's FBO account balance was less than the billed amount — you received the available balance and may bill the member for the remainder. (2) Claim Claim Rules Validator processing applied standard payment rules. Review the 835 ERA adjustment codes for detail, then contact Provider Relations if you have questions.

Questions?
We're here for you.

Our Provider Relations team responds within one business day. First claim questions, ERA setup, clearinghouse issues — we'll walk through it with you.

Payer ID
FUNDS
Provider Support
providers@mypatientfund.com
Website
mypatientfund.com