| Americas 1st Choice Health Plans of South Carolina, Inc. |
20553 |
|
|
|
| Americas TPA |
41178 |
|
|
|
| Sage Technologies |
37105 |
|
|
|
| 1199 National Benefit Fund |
13162 |
|
|
Please include Network ID when submitting claims. Call Renaud Dufresne at 646-473-6960 for a list of Network Ids. |
| 21st Century Insurance and Financial Services |
51028 |
|
Y |
Claims and ERA's for Minnesota ONLY. |
| 3HAB MCO |
3HABM |
|
|
|
| A & I Benefit Plan Administrators |
93004 |
|
|
|
| AAG - American Administrative Group |
75185 |
|
|
|
| AARP |
36273 |
|
Y |
|
| ABC Health Plan of New York |
48185 |
|
|
|
| Absolute Total Care |
68055 |
|
|
|
| ACCLAIM |
64071 |
|
|
|
| Acclaim Repricing (Tupelo, MI) |
21356 |
|
|
Include group # when submitting claims |
| Accordia National |
87815 |
|
Y |
|
| ACM (See UHC at bottom of the list) |
|
|
|
|
| ACS Benefit Services |
72467 |
|
|
|
| Activa Benefit Svcs |
38254 |
|
|
Formerly Amway Corp |
| Admar Corporation |
95285 |
|
|
|
| Administrative Concepts, Inc |
22384 |
|
|
|
| AdminOne |
37278 |
|
|
|
| Advanced Data Solutions, Inc. |
58202 |
|
|
|
| Advantage by Bridgeway/Buckeye/Managed Health/Superior Healt |
68056 |
|
|
|
| Advantage Health Solutions |
35209 |
|
|
|
| Advantage Preferred Plus |
77070 |
|
|
|
| Advantek Benefit Administrators |
83077 |
|
|
|
| Advantra Freedom |
25133 |
|
Y |
|
| Advocate Health Centers ( IL ) |
36320 |
|
|
|
| Advocate Health Partners |
65093 |
|
|
Requires Payer Sub ID |
| Aetna Better Health Connecticut Medicaid |
23225 |
|
|
|
| Aetna Encounters |
60055 |
|
|
|
| Aetna Health Plans |
60054 |
|
Y |
|
| Aetna TX Medicaid and CHIP |
38692 |
|
|
|
| Affiliated Physicians group |
APG01 |
|
|
|
| Affordable Benefit Admin |
95426 |
|
|
|
| AFTRA Health Fund |
13346 |
|
|
|
| AGA |
37280 |
|
|
|
| Alabama Blue Shield |
BS000 |
Y |
Y |
|
| Alabama Medicaid |
ALMCD |
|
Y |
|
| Alabama Medicare |
ALMCR |
Y |
Y |
|
| Alaska Children's Services Inc. Grp#P68 |
91136 |
|
|
Please include Group # |
| Alaska Electrical Health & Welfare Fund |
92600 |
|
|
|
| Alaska Laborers Construction Industry Trust Grp#F23 |
91136 |
|
|
Please include Group # |
| Alaska Medicare |
AKMCR |
Y |
|
|
| Alaska Pipe Trades Local 375 Grp#F24 |
91136 |
|
|
Please include Group # |
| Alaska United Food & Commercial Workers Health and Welfare T |
91136 |
|
|
Please include Group # |
| ALICARE (also known as Amalgamated Life) |
13550 |
|
|
|
| Alliance Partners |
23172 |
|
|
|
| Alliance PPO - OneNet PPO, LLC |
52149 |
|
|
Professional Services 800-342-6141 or 301-294-5083 |
| Alliant Health Plans of Georgia |
58234 |
|
|
|
| Allied Administrators (San Francisco, CA) |
94177 |
|
|
|
| Allied Benefit Systems |
37308 |
|
|
Now accepted for the following addresses: 208 LaSalle St, Suite 1300, Chicago IL 60604; PO Box 909786, Chicago IL 60690; PO Box 909799, Chicago IL 60690 |
| Alta Bates Medical Group |
IP084 |
|
|
Network ID required on all claims. Call Mary Aguas at 510-627-4763 to obtain Network ID prior to first submission |
| Alternative Health (Louisville, KY) |
AHDSK |
|
|
|
| Alternative Technology resources |
37231 |
|
|
|
| Altius (Utah) |
25133 |
|
|
|
| AMA Insurance Agency |
AMAIA |
|
|
|
| Amalgamated Life (aka ALICARE) |
13550 |
|
|
|
| AmeriBen Solutions Inc |
75137 |
|
|
|
| Americaid Community Care (Maryland) |
27517 |
|
|
|
| Americaid Community Care (New Jersey) |
27516 |
|
|
Formerly Americaid Inc. |
| American Administrative Group |
75240 |
|
|
|
| American Behavioral |
63106 |
|
|
|
| American Benefit Plan Administrators |
95170 |
|
|
|
| American Benefits Management (North Canton, OH) |
34187 |
|
|
Payer ID valid only for claims with a billing submission address of P.O. Box 35008, N. Canton, OH 44735 |
| American Capitol Insurance Co |
AMC11 |
|
|
|
| American Chiropractic Network |
ACN01 |
|
|
|
| American Chiropractic Network |
41161 |
|
|
|
| American Chiropractic Network IPA of NY (ACNIPA) |
41160 |
|
|
|
| American Commercial Barge Lines |
87726 |
|
Y |
|
| American Community Mutual Insurance |
60305 |
|
Y |
|
| American Family Insurance |
AMF11 |
|
Y |
|
| American General (Nashville, TN) |
62030 |
|
Y |
|
| American Healthcare Alliance |
01066 |
|
|
|
| American Imaging Management Inc. |
36369 |
|
|
Assigned group Policy Plan ID is required. To obtain, Please call American Imaging Management at (800) 252-2021. |
| American Insurance Company of Texas |
81949 |
|
|
|
| American International Group (Wilmington, DE ) |
87726 |
|
Y |
|
| American Lifecare (Louisiana) |
72099 |
|
|
Please enter the Group Number from ID card when submitting claims. Payer ID valid only for claims with a billing submission address of 1100 Poydras Street, Suite 2600, New Orleans, LA 70163-2602 |
| American Medical Security, Inc. (AMS) |
81400 |
|
|
|
| American National Insurance (ANICO) - (Galveston, TX) |
74048 |
|
|
|
| American Pioneer South Florida |
APSFL |
|
|
|
| American Postal Workers Union Health Pla |
44444 |
|
|
Claims for the state of Maine ONLY must be sent on paper to MedNet, P. O. Box
15440, Portland, ME 04112 |
| American Progressive/Pyramid/Today's Option |
48055 |
|
|
|
| American Republic Insurance Co, ( Des Moines, IA) |
42011 |
|
Y |
|
| American Specialty Health (ASHLink) |
ASHP1 |
Y |
|
|
| American Worker Health Plus |
37322 |
|
|
|
| Americhoice of New Jersey Medicaid |
86047 |
|
|
|
| Americhoice of New York Medicaid |
86048 |
|
|
|
| Americhoice of Pennsylvania Medicaid |
86049 |
|
Y |
|
| Americhoice-New Jersey Medicare |
86001 |
|
|
All claims submitted require your AmeriChoice assigned Provider ID Number.
Please contact AmeriChoice at (888) 362-3368 for your Provider ID Number.
|
| Americhoice-New York Medicare |
86002 |
|
|
|
| Americhoice-Pennesylvania Medicare |
86003 |
|
|
|
| Amerigroup (Nevada, Austin, New Mexico) |
26375 |
|
|
|
| Amerigroup (Ohio, Illinois) |
27518 |
|
|
|
| AmeriGroup (TN) |
27514 |
|
|
|
| Amerigroup Corp (Ft. Worth/Dallas) |
27514 |
|
|
Formally Americaid Community Care (Dallas/Ft. Worth).
|
| Amerigroup Corp (Houston) |
27515 |
|
|
Formally Americaid Community Care (Houston).
|
| Amerigroup Florida |
27519 |
|
|
|
| Amerigroup Houston |
26374 |
|
|
|
| Amerigroup Illinois |
26378 |
|
|
|
| Amerigroup of Georgia |
27514 |
|
|
|
| AmeriHealth Administrators |
54763 |
|
|
|
| AmeriHealth HMO New Jersey and Delaware |
23037 |
|
|
|
| AmeriHealth Mercy Health Plan |
22248 |
|
|
Call 877-234-4272 |
| Amida Care |
24818 |
|
|
|
| Amway Corporation (N) |
38254 |
|
|
|
| Anchor Benefits Consulting (Maitland, FL) |
53085 |
|
|
|
| Ancillary Benefit Systems/Arizona Foundation for Medical Car |
86062 |
|
|
Include group # when submitting claims |
| Antares Management Solutions |
34192 |
|
Y |
|
| Anthem Healthy Indiana Plan (HIP) |
BS130 |
|
Y |
|
| Anthem Indiana |
BS130 |
|
Y |
|
| Anthem Kentucky |
BS160 |
|
Y |
|
| Anthem Ohio |
BS332 |
|
Y |
Enrollment required for Remittance Advice |
| APA Partners |
16140 |
|
|
|
| Apex Benefit Services |
34196 |
|
|
|
| Araz |
16120 |
|
|
|
| Arcadian Management Services |
77045 |
|
|
|
| Arizona Blue Shield |
53589 |
|
Y |
|
| Arizona Health Care Cost (AZ Medicaid) |
SKAZ0 |
Y |
Y |
|
| Arizona Medicare |
AZMCR |
Y |
Y |
|
| Arkansas Best |
75278 |
|
|
|
| Arkansas Blue Cross and Blue Shield |
SB520 |
|
|
|
| Arkansas Medicaid |
ARMCD |
Y |
Y |
|
| Arnett Health Plans (Lafayette, IN) |
95440 |
|
|
Requires Unique Provider ID |
| ASR/Physicians Care |
38265 |
|
|
|
| Associated Third Party Administration |
ATPA1 |
|
|
|
| Associates of Healthcare |
36326 |
|
|
|
| Association Benefit Plan |
25133 |
|
|
|
| Assurant Health |
39065 |
|
Y |
|
| Assurant Health (Fort Mill, SC only) |
37313 |
|
|
Must verify all claims should go to payer in Ft. Mill, SC.
|
| Assured Benefits Administrators (El Paso, TX) |
74240 |
|
|
|
| Athens Area Health Plan Select |
95691 |
|
|
|
| Atlantic Medical Insurance |
22285 |
|
|
|
| Atlanticare (Horizon Healthcare Admin/HHA) |
22304 |
|
|
|
| Atlantis Health Plan ( New York, NY) |
13853 |
|
|
|
| Atlas Administrators (USA MC) |
TH004 |
|
|
|
| Aultcare ( Ohio ) |
AULTC |
Y |
Y |
Contact ECP (800) 327-1213 |
| Aultcare HMO |
AULTC |
Y |
|
|
| Aultra Administrative Group |
37242 |
|
|
Payer ID valid only for claims with a billing submission address of P.O. Box 35276 Canton,OH 44735-5276
|
| Automated Benefit Services |
38259 |
|
|
|
| Automated Group Administration |
37280 |
|
|
|
| Automotive Machinists Local 289 Health and Welfare Trust Grp |
91136 |
|
|
Include Group # when submitting |
| Avera Health Plans |
46045 |
|
|
|
| Avesis Third Party Administrators |
87098 |
|
|
|
| AvMed, Inc |
59274 |
|
|
|
| Azeros Health Plans, Inc |
16114 |
|
|
|
| Azeros Health Plans, Inc. |
16644 |
|
|
|
| Banner Health Co |
SX145 |
Y |
|
|
| Bass Administrators, Inc |
37248 |
|
|
|
| BCI Administrators, Inc (Farmington Hills, MI) |
49153 |
|
|
|
| Beech Street Corp (Irvine, CA) |
95377 |
|
|
Must contain payer name |
| Behavioral Health Providers |
19993 |
|
|
Prior Authorization Required |
| Behavioral Health Systems |
63100 |
|
|
|
| Benefit Administrative Systems |
36149 |
|
|
|
| Benefit Coordinators Corporation (Pittsburg, PA) |
25145 |
|
|
|
| Benefit Management Admin (BMA) |
BMATP |
|
|
|
| Benefit Management Group |
20018 |
|
|
|
| Benefit Management Services Inc. |
00999 |
|
|
|
| Benefit Management Systems, Inc |
37212 |
|
|
|
| Benefit Plan Administrators (ND) |
37286 |
|
|
|
| Benefit Plan Administrators (Roanoke, VA) |
37118 |
|
|
|
| Benefit Plan Administrators (WI) |
39081 |
|
|
Payer ID valid only for claims with a billing submission address of P.O. Box 1128, Eau Claire, WI 54702-1128.
|
| Benefit Systems & Services, Inc. (BSSI) |
36342 |
|
|
|
| Benesight |
87265 |
|
|
(Formarly known as the TPA)
|
| Benesys |
37248 |
|
|
|
| Berkshire Health Partners (Wyomissing, PA) |
Call |
|
|
Please call Lori Calpino at (610) 372-8044 ext3019 for Payer Code |
| Best Life & Health Insurance Co. |
95604 |
|
|
|
| Better Health Plans of South California |
32006 |
|
|
|
| Blue Cross Blue Shield New York Central Excellus |
SB805 |
|
|
|
| Blue Cross Blue Shield of Arizona |
SB530 |
Y |
Y |
|
| Blue Cross Blue Shield of Arizona |
SB530 |
Y |
Y |
|
| Bluegrass Family Health |
61124 |
|
Y |
|
| BMC (Boston Medical Center) HealthNet Plan |
13337 |
|
|
|
| Boilermakers National Health & Welfare Fund |
36609 |
|
|
|
| Boon-Chapman Administrators |
74238 |
|
|
|
| Boulder Administration Services |
20381 |
|
|
|
| BPS, Inc. |
13310 |
|
|
|
| Bravo Health Inc. |
52192 |
|
Y |
this payer was formerly known as Elder Health |
| Bridge Benefits (Maumee, OH) |
38365 |
|
|
|
| Bridgeway Arizona |
68054 |
|
Y |
Prior to submitting claims, please call Provider Relations Dept at 1-866-475-3129 to verify your provider info is on file in the claim system |
| BritCay |
22286 |
|
|
|
| Brockerage Concepts, Inc |
51037 |
|
|
|
| Brodart Company |
35182 |
|
|
|
| Broward Health |
37314 |
|
|
|
| Brown & Toland Medical Group |
94316 |
|
|
|
| Brown and Toland Medical Group |
BTSS1 |
|
|
|
| BS WV Medicare - Freedom Blue Cross Blue Shield |
BS768 |
Y |
|
|
| Buckeye Community Health Plan |
32004 |
|
Y |
|
| Butler Benefits |
42150 |
|
|
|
| C&O Employees Hospital Association (VA ) |
23708 |
|
|
|
| California Blue Cross |
47198 |
|
Y |
California License Number Required |
| California Blue Shield |
94036 |
|
Y |
Group number is required. Please contact Blue Shield of CA EDI Customer Service at (800) 480-1221 to verify correct provider information prior to sending claims. |
| California Medicaid |
CAMCD |
Y |
Y |
|
| California Medicare - Northern CA |
CAMCR |
Y |
Y |
|
| California Medicare - Southern CA |
CSMCR |
Y |
Y |
|
| Cannon Cochran Management Services, Inc. |
71057 |
|
|
|
| Cape Health Plan |
38245 |
|
|
|
| Capital Blue Cross Blue Shield PA |
23045 |
|
|
|
| Capital District Physicians Health Plan |
SX065 |
|
Y |
|
| Capital Health Plan |
95112 |
|
|
|
| Capital International Management Services |
65067 |
|
|
|
| Capitol Administrators |
68011 |
|
|
|
| Capitol Community Health Plans |
87726 |
|
|
|
| Capitol District Physicians Health Plan (CDPHP) |
CDPHP |
|
|
|
| Capstone Health Plan Inc |
86044 |
|
|
|
| Cardinal Administrative Services |
AULTC |
Y |
|
|
| Care Choices |
38269 |
|
|
|
| Care Improvement Plus |
77082 |
|
|
|
| Care Wisconsin Health Plan (Trizetto) |
27004 |
|
|
|
| CareCentrix |
11345 |
|
|
Enrollment required prior to claim submission. Please contact Rebecca Sweetman by email Rebecca.Sweetman@CareCentrix.com
|
| CareCore National |
14182 |
|
|
|
| CareCore National (Aetna Radiology Claims) |
14179 |
|
|
|
| CareCore National (Oxford Radiology Claims) |
14180 |
|
|
|
| CareCore National, LLC - Health Net New Jersey |
14185 |
|
|
|
| Carefirst Blue Choice |
SB580 |
|
|
|
| Carefirst BluePreferred |
SB580 |
|
|
|
| Carefirst Federal Employees Program (FEP) |
SB580 |
|
|
|
| Carefirst NCA Indemnity |
SB580 |
|
|
|
| Carelink Health Plan |
25133 |
|
|
|
| Carelink Medicaid |
25140 |
|
|
|
| Carenet of Virginia |
25142 |
|
Y |
|
| CareOregon, Inc |
93975 |
|
|
|
| CarePlus Health Plan |
95092 |
|
|
|
| CarePlus Health Plans, Inc |
65031 |
|
|
Formerly Physicians Healthcare Plans |
| CareSource (Ohio) |
DAYHP |
|
Y |
|
| Careworks MCO |
OHMCO |
|
|
|
| Carilion Clinic Medicare Health Plan |
77015 |
|
|
|
| Caritan Healthcare ( Knoxville, TN ) |
62073 |
|
|
|
| Caritan Senior Health ( Knoxville, TN) |
62072 |
|
|
|
| Carolina Care Plan |
29076 |
|
|
|
| Carolina Summit Healthcare, Inc. |
56195 |
|
|
|
| Carpenter's Health and Welfare Trust of St. Louis (St. Louis |
25125 |
|
|
|
| CBCA Administrators |
55438 |
|
|
|
| CBSA |
41124 |
|
|
|
| Cedars-Sinai Medical Network ( Beverly Hills, CA ) |
95166 |
|
|
|
| Celtic Insurance |
CELTC |
|
|
|
| CeltiCare |
68060 |
|
|
|
| Cement Masons & Plasterers Health & Welfare Trust Grp#F16 |
91136 |
|
|
|
| Cenpatico Massachusettes |
68061 |
|
|
|
| Cenpatico-OH |
68051 |
|
|
|
| Center Care (for Meritain) |
MER04 |
|
|
|
| Centra |
75243 |
|
|
|
| Centra (formerly Health Economics Corp) |
75196 |
|
|
|
| Central Benefits Life |
31118 |
|
|
|
| Central Benefits Mutual |
31118 |
|
|
|
| Central Benefits National |
31118 |
|
|
|
| Central Reserve Life |
34097 |
|
Y |
|
| Central States Health & Welfare Funds |
36215 |
|
|
|
| Century Health Solutions |
48120 |
|
|
|
| CHA - Commonwealth Health Alliance |
23171 |
|
Y |
|
| CHAMPVA - HAC |
84146 |
|
Y |
CHAMPVA – HAC is not associated with and does not process claims for TRICARE (formerly CHAMPUS)
|
| Chatwins Healthcare Administrators |
CHAT1 |
|
|
|
| Chautauqua County Health Care Plan ( Maryville, NY) |
16600 |
|
|
|
| CHEC - A Subsidiary of Sprint |
CHECS |
|
|
|
| Chesapeake Life Insurance |
59223 |
|
Y |
Valid for mailing address of PO Box 982017, North Richland Hills, TX 76182 |
| Chesterfield Resources, Inc. |
34154 |
|
|
|
| Choice One/UTMB CHIP Health Plan |
UHSCH |
|
|
Prior to submitting, call Provider Relations at (281) 652-8700 |
| ChoiceCare, Cincinnati, Ohio |
CHOIC |
|
|
|
| Christian Brothers Services |
61271 |
|
|
|
| Christus Spohn Health Network |
74261 |
|
|
|
| CIGNA |
62308 |
|
Y |
|
| Cigna Behavioral Health |
SX071 |
|
|
|
| CIGNA Health Plan-HMO |
62308 |
|
|
|
| CIGNA Healthcare for Seniors- Arizona Medicare |
86033 |
|
|
|
| Cigna Medicare Advantage |
86033 |
|
|
|
| CIGNA-PPO |
62308 |
|
|
|
| Cincinnati Financial Corp/Healthsmart |
46871 |
|
|
|
| Cincinnati Health Plan |
DAYHP |
|
|
|
| City of Amarillo Group Healthplan |
COA01 |
|
|
|
| City of Odessa (Odessa, TX) |
75600 |
|
|
|
| Claims Management Services |
39141 |
|
Y |
|
| Claimsware, Inc. ( Greenville, SC ) |
57080 |
|
|
|
| Clarendon's Healthy Kids / Cadent Underwriters / Bencomp Nat |
33192 |
|
|
|
| Clearchoice Health Plan/COIHS (Bend, OR) |
77201 |
|
|
|
| CNA Health Partners Repricing |
48153 |
|
|
|
| CNA Health Partners (PCP only) |
CALL |
|
|
Call Jonda Brown 800-972-3025 for Payor ID |
| CNA Health Partners, Little Rock |
71063 |
|
|
|
| Coastal Administrative Services |
77052 |
|
|
|
| Cofinity |
38335 |
|
|
|
| Colonial Healthcare (Lanham, MD) |
37123 |
|
|
|
| Colonial Medical |
22284 |
|
|
|
| Colorado Access |
84129 |
|
|
|
| Colorado Access (HMO) |
COACC |
|
|
|
| Colorado BCBS |
BS550 |
|
Y |
|
| Colorado Medicaid |
COMCD |
|
Y |
|
| Colorado Medicare |
COMCR |
Y |
Y |
|
| Columbia Cornell Care |
25351 |
|
|
|
| Columbia United Providers ( Vancouver, WA ) |
91162 |
|
Y |
|
| Columbus Health Plan |
DAYHP |
|
|
|
| Commerce Benefits Group |
34181 |
|
|
|
| Community Care Behavioral Health Organization |
23282 |
|
|
|
| Community Care Managed HC Plans (Oklahoma) |
73143 |
|
|
|
| Community Care Organization (Milwaukee, WI) |
39126 |
|
|
|
| Community Care Plus |
71079 |
|
|
Please note the payer name changed
effective 4/1/10. For questions, please contact Molina Healthcare of Missouri.
Please refer to the Member ID cards for payer contact information |
| Community Choice of Michigan |
38325 |
|
|
|
| Community First (Texas) |
COMMF |
|
|
|
| Community Health Alliance |
35193 |
|
|
|
| Community Health Choice ( Houston, TX ) |
48145 |
|
|
|
| Community Health Electronic Claims ( CHEC ) - Texas |
75261 |
|
Y |
|
| Community Health Network of Connecticut (Mediden, CT) |
62149 |
|
|
|
| Community Health Plan ( St. Joseph's, MO ) |
90010 |
|
Y |
Located in St. Joseph, MO. Service area
includes NW Missouri, NE Kansas, SW
Iowa, and SE Nebraska.
|
| Community Premier Pus for Neigh. ( NY, NY ) |
32481 |
|
|
|
| Comp - Ohio |
34177 |
|
|
|
| CompBenefits Corporation |
37297 |
|
|
|
| Comprehensive Benefits Admin ( South Burlington, VT ) |
03036 |
|
|
|
| Confederation Admin Services |
80705 |
|
|
|
| Confederation Life Insurance |
80705 |
|
|
|
| ConnectiCare, Inc |
06105 |
|
|
|
| Connecticare- Medicare |
78375 |
|
|
|
| Connecticut BCBS |
BS060 |
|
Y |
|
| Connecticut General (CIGNA) |
62308 |
|
|
|
| Connecticut Medicaid (EDS) |
SKCT0 |
Y |
Y |
|
| Connecticut Medicare |
CTMCR |
|
Y |
|
| Consociate Group ( Decatur, IL ) |
37135 |
|
|
|
| Consolidated Group/HPS |
04274 |
|
|
|
| Consolidated Health Plans |
87843 |
|
|
|
| Consumers Life Insurance Company |
29076 |
|
|
|
| Continental General Insurance Company |
71404 |
|
Y |
|
| Continental Key Family |
35315 |
|
|
|
| Contractors Laborers Teamsters & Engineers |
47046 |
|
|
|
| Cook Children's Health Plan |
CCHP1 |
|
|
|
| Cook Childrens Star Plan |
CCHP9 |
|
|
|
| Cook Group Health |
35149 |
|
|
|
| Cooperative Benefit Administrators-CBA |
52132 |
|
|
P.O. Box 6249 Lincoln, NE 68506-0249 |
| Cooperative Managed Services |
35199 |
|
|
|
| Coordinated Medical Specialists |
58204 |
|
|
|
| Core Administrative Services |
58231 |
|
|
|
| CoreSource Little Rock |
75136 |
|
Y |
Only for claims where the "submit claims to address" on the medical ID
card is a CoreSource address in Little Rock, Arkansas. For assistance call
800-689-0106. |
| CoreSource MD PA IL |
35182 |
|
Y |
|
| Coresource of North Carolina (Charlotte, NC) |
35180 |
|
Y |
Only for claims where the submit claims to address on the medical ID card is a CoreSource address in the states of North Carolina or Indiana. For assistance call 800-689-0106. |
| CoreSource OH |
35183 |
|
Y |
Only for claims where the "submit claims to address" on the medical ID card is a CoreSource address in the state of Ohio. For assistance call
800-689-0106.
|
| Cornerstone Benefit Admin |
35202 |
|
|
|
| Corporate Benefit Services of America ( CBSA ) (MN) |
41124 |
|
|
|
| Corporate Benefits Services ( Charlotte, NC ) |
56116 |
|
|
|
| Corporate Systems Administration ( Johnson City, TN ) |
37246 |
|
|
|
| Correctional Medical Services |
43160 |
|
|
|
| Country Life Ins. Co. |
62553 |
|
|
|
| Covenant Administrators (Atlanta, GA) |
58102 |
|
|
|
| Covenant Management SYS Employ Bene |
CMSEB |
|
|
|
| Coventry Health Care |
25133 |
|
|
|
| CoventryCares |
00510 |
|
|
|
| Creative Medical Systems |
64068 |
|
|
|
| Creative Plan Administrators |
37320 |
|
|
|
| Croy-Hall Mgmt, Inc |
37266 |
|
|
Please enter the unique policy number
or ID card when submitting claims.
Payer ID valid only for claims with a
billing submission address of PO Box
982005 Ft. Worth, TX 76182. |
| Custom Benefit Administrators (Lacrosse, WI) |
39170 |
|
|
|
| Custom Design Benefits |
82056 |
|
|
|
| Dart Management Corporation / Dart Container |
06172 |
|
|
|
| Dean Health Plan (Pewaukee, WI) |
39113 |
|
|
|
| Definity Health (Amherst, NY) |
64159 |
|
|
|
| Delaware Medicaid |
DEMCD |
Y |
Y |
|
| Delaware Medicare |
DEMCR |
Y |
Y |
|
| Delaware Physicians Care Inc/ DPCI |
27009 |
|
|
Rendering Provider ID Required |
| Delta Health Systems |
DHS01 |
|
|
|
| Denver Health Medicaid Choice (Denver, Co) |
84133 |
|
|
|
| Denver Health Medical Plan (Denver, CO) |
84135 |
|
|
|
| Denver Health-Indigent (Denver, CO) |
84134 |
|
|
|
| Deseret Mutual |
SX105 |
|
Y |
|
| Destiny Health |
36436 |
|
|
|
| Detroit Medical Center |
56240 |
|
|
|
| Diamond Plan |
25131 |
|
Y |
|
| DiaTri, LLC |
36439 |
|
|
|
| Directors Guild of America-Producer Health Plan |
23706 |
|
|
|
| District of Columbia Medicare |
DCMCR |
Y |
Y |
|
| Diversified Administration (Marlborough, CT) |
06102 |
|
|
Please verify the Payer ID on the
Member ID card in addition to the Payer
City and State before submitting claims
to Diversified Admin (Payer ID 06102)
|
| Driscoll Children’s Health Plan |
74284 |
|
|
|
| DSCC (Division of special care children) |
37600 |
|
|
|
| E-V Benefits Management (Columbus, OH) |
34159 |
|
|
|
| East Bay Medical Network |
94318 |
|
|
Network ID requird on all claims. Call Mercy Aguas at 510 627-4763 to obtain Network ID prior to first submission. |
| Eastland Medical Group |
66122 |
|
|
|
| EBMS |
SX182 |
|
|
|
| EBMS (Employee Benefit Management Services, Inc.) |
81039 |
|
|
|
| EHI (Employers Health Insurance) |
73288 |
|
|
As of December 1, 2002, please send all
medical and hospital claims to payer ID
61101. Please submit all Humana
encounters and informational claims to
payer ID 61102.
|
| El Paso First Group Health |
EPF08 |
|
|
|
| El Paso First Health Network |
EPF03 |
|
|
Call ECP for forms.
|
| Elder Health ( Baltimore, MD ) |
52192 |
|
|
|
| Elderplan (Brooklyn, NY) |
31625 |
|
Y |
Elderplan no longer requires enrollment & individual provider testing; However,
Elderplan Provider ID is necessary on all
claim submissions. If you do not know
your provider Id, contact (718) 921-7979. |
| Elmco |
37253 |
|
|
|
| Emerald Health Network (All PPO Business) |
34167 |
|
|
|
| EMPHESYS |
73288 |
|
|
As of December 1, 2002, please send all
medical and hospital claims to payer ID
61101. Please submit all Humana
encounters and informational claims to
payer ID 61102.
|
| Empire Blue Cross Blue Shield (New York Only) |
BS803 |
|
Y |
|
| Empire Medicare (New York Only) |
NXMCR |
Y |
Y |
|
| Employee Benefit Admin and Mgmt |
95288 |
|
|
|
| Employee Benefit Concepts, Inc. ( Farmington Hills, MI ) |
38241 |
|
|
|
| Employee Benefit Corporation |
37215 |
|
|
|
| Employee Benefit Management Corp (EBMC) |
31074 |
|
|
|
| Employee Benefit Management Svcs. (MT or Salt Lake City, UT) |
81039 |
|
|
|
| Employee Benefit Services ( Charlotte, NC ) |
37216 |
|
|
|
| Employee Benefit Services Charlotte NC. |
37126 |
|
|
|
| Employee Benefit Services of Louisiana, Inc |
41198 |
|
|
|
| Employee Benefits Plan Administration, Inc (EBPA) |
03036 |
|
|
|
| EMPLOYEE CLAIM ADJUDICATION SVCS |
75184 |
|
|
|
| Employee Plans, LLC |
35112 |
|
|
|
| Employer's Direct Health |
75232 |
|
|
|
| Employer's Direct Health-Employee Plan |
75236 |
|
|
|
| Employer's Direct Health-FI |
75235 |
|
|
|
| Employer's Direct Health-SF |
75233 |
|
|
|
| Employer's Health Alliance |
20048 |
|
|
|
| Employers Health |
73288 |
|
|
As of December 1, 2002, please send all
medical and hospital claims to payer ID
61101. Please submit all Humana
encounters and informational claims to
payer ID 61102.
|
| Employers Life Ins Corp |
37249 |
|
|
|
| Employers Mutual (Jacksonville, FL) |
59298 |
|
|
|
| Employers Mutual (Stuart, FL) |
59331 |
|
|
|
| Encircle PPO |
35206 |
|
|
|
| Encore Health Network ( Ft. Wayne, IN ) |
35206 |
|
|
|
| Encore Health Network ( Hillview, KY ) |
35206 |
|
|
|
| ENH Medical Group IPA |
36364 |
|
|
|
| Enstar Natural Gas - Grp. #P61 |
91136 |
|
|
Please include group number when submitting claims. |
| Entrust |
36878 |
|
|
|
| Envoy Health Network ( Ft.Wayne, IN ) |
35206 |
|
|
|
| Envoy Health Network ( Hillview, KY ) |
35206 |
|
|
|
| Epoch Group |
28777 |
|
|
|
| EQUICOR |
62308 |
|
|
|
| EQUICOR-PPO |
62308 |
|
|
|
| Equitable (CIGNA) |
62308 |
|
|
|
| Equitable Plan Services (Oklahoma City, OK) |
73126 |
|
|
|
| Erin Group Administrators (Lancaster, PA) |
23250 |
|
|
|
| Essence Healthcare |
20818 |
|
|
|
| EVERCARE (All States) |
87726 |
|
|
|
| Evergreen Health Plan |
58233 |
|
|
|
| Evolutions Healthcare Systems |
59313 |
|
|
|
| Excellus - Blue Cross / Blue Shield Central New York |
SB804 |
|
|
|
| ExclusiCare |
71412 |
|
|
|
| F.A. Richard & Assoc |
37289 |
|
|
|
| Facey Medical Foundation |
95432 |
|
|
|
| FACS/Federated HR Services/Federated Benefits (Mason, OH) |
37300 |
|
|
|
| Fallon Community Health |
22254 |
|
|
|
| Family Care |
60995 |
|
|
|
| Family Care Medicaid |
FCD01 |
|
|
|
| Family Care Medicaid Mental Health |
FCM01 |
|
|
|
| Family Care Medicare |
FCR01 |
|
|
|
| Family Health Partners ( Kansas City, MO ) |
43173 |
|
Y |
|
| Family Health Partners - |
31472 |
|
Y |
|
| Family Health Plan |
96865 |
|
|
|
| FARA Benefit Services |
37289 |
|
|
|
| Farm Family (Albany, NY) |
14140 |
|
|
|
| FCE Benefit Administrators, Inc (Burlingame, CA) |
33033 |
|
|
|
| Federated Mutual Insurance |
41041 |
|
Y |
|
| Fidelis Care New York |
11315 |
|
|
|
| Fidelis Secure Care |
77054 |
|
|
|
| First (1st) Medical Network - Atlanta, GA |
29076 |
|
|
|
| First Administrators, Inc. |
FAMR1 |
|
|
|
| First Care Southwest (Texas) |
FCARE |
|
|
|
| First Carolina Care |
56196 |
|
|
|
| First Choice (CT) |
14162 |
|
|
Render Provider Network ID required. |
| First Choice Health Network |
91131 |
|
|
|
| First Health Network (f.k.a. CCN & PPO Oklahoma) |
73159 |
|
|
|
| First Option Health Plan |
06108 |
|
|
Call 203-381-7618 for provider ID |
| First State Health Plan |
63080 |
|
|
|
| Firstcare - Medicaid |
94998 |
|
Y |
|
| FirstGuard Health Plan |
90060 |
|
|
Call Karen Joslin at 816-922-7225 to verify provider ID. |
| FirstGuard Missouri (Kansas City, MO) |
90061 |
|
|
Provider ID Required |
| Fitzharris & Company (Farmingdale, NY) |
11244 |
|
|
|
| Florida Blue Cross BlueShield |
BS590 |
|
Y |
|
| Florida First |
59276 |
|
|
|
| Florida Health Network--PPO |
87815 |
|
|
|
| Florida Hospital Healthcare Systems |
59321 |
|
|
|
| Florida Hospital Waterman |
48116 |
|
|
|
| Florida Humana |
61101 |
|
|
|
| Florida Medicaid |
FLMCD |
Y |
Y |
|
| Florida Medicare |
FLMCR |
Y |
Y |
|
| Florida PHP |
PLRAM |
|
|
|
| FloridianCare |
APBPN |
|
|
|
| FloridianCare (SFL) American Pioneer Health Plan |
20165 |
|
Y |
|
| FMH Benefits Services |
48117 |
|
Y |
|
| Foreign Service Benefit Plan |
25133 |
|
|
|
| Formax, Inc |
87066 |
|
|
|
| Fortis Benefits, Inc. |
70408 |
|
Y |
|
| Fortis Ins. Co. |
39065 |
|
Y |
PHCS Network Claims only |
| Fortis Self-funded Admin Svcs. |
41124 |
|
|
|
| Foundation Benefits Administration |
BOONG |
|
|
|
| Foundation Health Plan ( Sunrise, FL) |
59257 |
|
|
|
| Fox Valley Medicine Site 199 |
FVMCH |
|
|
|
| Fox Valley Medicine Site 451 |
FVMC1 |
|
|
|
| Fox-Everett - Ingalls Ship Building |
64067 |
|
|
|
| Fox-Everett, Inc. |
64069 |
|
|
|
| Freedom Life Insurance of America |
62324 |
|
|
|
| Fresenius Medical Care Health Plan |
FMCHP |
|
|
|
| Fringe Benefits Coordinators |
59204 |
|
|
|
| FrontPath Health Coalition |
34171 |
|
|
|
| G.E. Group Administrators Texas |
75238 |
|
|
Formerly Phoenix Group Services - Texas |
| Gallagher Benefit Administrators/GBA |
37283 |
|
|
Lisle, IL, San Antonio, TX, Jackson, MS, San Francisco, CA |
| Galveston County Indigent Health Care |
30005 |
|
|
|
| Gateway Health Plan |
25169 |
|
Y |
|
| Geisinger Health Plan (Danville, PA) |
75273 |
|
Y |
|
| Genelco (St. Louis only) |
63665 |
|
|
|
| General American Life Insurance Co. |
63665 |
|
|
ALIASES: GENELCO, Sanus HMO--St.Louis, Sanus PPO--St. Louis |
| Georgia Blue Cross |
BS601 |
|
Y |
Enrollment required for 835 only. |
| Georgia Medicaid |
GAMCD |
Y |
Y |
|
| Georgia Medicare |
GAMCR |
Y |
Y |
|
| Gettysburg Health |
23212 |
|
|
|
| GH Basic Health Plan |
91051 |
|
|
Western WA call (206) 901-6347 |
| GH Individual and Family Plan |
91051 |
|
|
Western WA call (206) 901-6347 |
| GHC Medicare + Choice |
91051 |
|
|
Western WA call (206) 901-6347 |
| GHC-Commercial |
91051 |
|
|
Western WA call (206) 901-6347 |
| GHI HMO Select |
25531 |
|
|
|
| GHI--NY (Group Health, Inc.) |
13551 |
|
Y |
|
| GHP (Group Health Plan) |
25133 |
|
|
|
| GI Innovative Management |
58204 |
|
|
|
| GIC Indemnity Plan |
80314 |
|
Y |
|
| Gilsbar, Inc |
07205 |
|
Y |
|
| Global Care Inc. |
07689 |
|
|
|
| Global Health |
GLOBL |
|
|
|
| Golden Rule Insurance Co. |
37602 |
|
|
Please include group number when submitting. |
| Golden Triangle Physician Alliance |
GTPA1 |
|
|
|
| Government Employees Hospital Assn. (GEHA) |
44054 |
|
Y |
|
| Grant Physicians Practice Assoc (Chicago, IL) |
37234 |
|
|
|
| Great Lakes Health Plan (Southfield, MI) |
95467 |
|
|
|
| Great-West |
80705 |
|
Y |
|
| Group & Pension Administrators |
48143 |
|
|
|
| Group Administrators Ltd. |
36338 |
|
|
|
| Group Administrators Self Funded AL |
GASA1 |
|
|
|
| Group and Pension Administrators ( Richardson, TX ) |
48143 |
|
|
|
| Group Health Cooperative ( Madison, WI ) |
39167 |
|
|
|
| Group Health Cooperative ( Madison, WI )- |
39168 |
|
|
|
| Group Health Cooperative of Puget |
91051 |
|
|
Western Washington state. Please call (206) 901-6347 prior to first submission of production claims. |
| Group Health Insurance--DE |
61101 |
|
|
|
| Group Health Managers (Redford, MI) |
38194 |
|
|
9-digit numeric insured ID required |
| Group Health Northwest |
91121 |
|
|
Eastern Washington State and Northern Idaho. Signed provider agreement required - please call (509) 241-7317 prior to submitting claims. |
| Group Insurance Service Center (Pembroke, MA) |
37276 |
|
|
|
| Group Practice Affiliates |
68046 |
|
|
|
| Guardian Life Ins. Co. of America |
64246 |
|
Y |
|
| Gundersen Lutheran Health Plan |
39180 |
|
|
Call Shari Oelke (608) 775-8026 before submit. |
| H.E.R.E.I U. Welfare Pension Funds |
37114 |
|
|
|
| HAA Preferred Partners |
65101 |
|
|
|
| Harmony Health Plan (Illinois) |
36406 |
|
|
|
| Harmony Health Plan (Indiana) |
36405 |
|
|
Indiana Hoosier Healthwise members only. |
| Harrington Benefit Services |
75196 |
|
|
|
| Harrington Benefit Services (Oklahoma) |
22521 |
|
|
|
| Harrington Health-Kansas formerly known as Fiserv Health-KS |
62061 |
|
|
Formerly Willis Admin Services Corp/ Harrington |
| Harvard Pilgrim Health Care |
04271 |
|
|
|
| Hawaii Management Alliance Association (HMAA) |
48330 |
|
|
|
| Hawaii Medicare |
HIMCR |
Y |
Y |
|
| HCH Administration (Illinois) |
37111 |
|
|
|
| HCH Administration, Inc |
37215 |
|
|
Formerly John P. Pearl Assoc. |
| HCHA Albq-Self Funded |
37329 |
|
|
|
| HCS-Health Claims Service (Boise, ID) |
82018 |
|
|
|
| HDM Benefit Solutions |
TH070 |
|
|
|
| Health 1,2,3, Inc. |
23173 |
|
|
|
| Health Alliance Exclusive Plus Aliance Partners |
23172 |
|
|
|
| Health Alliance Medical Plans |
77950 |
|
Y |
|
| Health Alliance Plan of Michigan |
38224 |
|
|
|
| Health America Inc |
25133 |
|
|
|
| Health Care Network of Wisconsin (HCN) |
42102 |
|
|
|
| Health Choice Arizona |
62179 |
|
Y |
|
| Health Choice Generations |
62180 |
|
Y |
|
| Health Cost Solutions |
62111 |
|
|
|
| Health Design Plus ( Findlay, OH ) |
34158 |
|
|
|
| Health EZ |
16120 |
|
|
|
| Health First Health Plans |
95019 |
|
|
|
| Health First--Tyler, TX |
75234 |
|
|
|
| Health Future, LLC |
30946 |
|
|
|
| Health Market Care Assured |
62295 |
|
|
|
| Health Net - California |
95570 |
|
|
(Professional Encounters ONLY) |
| Health Net Pearl |
SX185 |
Y |
|
|
| Health Net Pearl |
SX185 |
|
|
|
| Health Net--California & Oregon |
95567 |
|
Y |
|
| Health Net-Arizona |
38309 |
|
|
Payer requires unique provider ID; please call the Provider Call Unit at 800-289-2818 |
| Health Net-Northeast, Inc |
06108 |
|
Y |
|
| Health Network America (Eatontown, NJ) |
20199 |
|
|
|
| Health New England |
04286 |
|
|
|
| HEALTH OPTIONS OF ILLINOIS, INC |
NAHOI |
|
|
|
| Health Partners (Jackson, TN) |
62157 |
|
|
|
| Health Partners, AL aka HealthSpring |
63092 |
|
|
|
| Health Partners, PA |
80142 |
|
|
|
| Health Partners, Southeast |
63092 |
|
|
|
| Health Plan Management ( Lake Bluff, IL ) |
37221 |
|
|
|
| Health Plan of Michigan |
83253 |
|
Y |
|
| Health Plan of Upper Ohio Valley |
HPUOV |
|
Y |
|
| Health Plans Inc. |
44273 |
|
|
|
| Health Pledge HMO |
95435 |
|
|
Requires Rendering Provider Number. |
| Health Plus PHSP, Inc (Brooklyn, NY) |
11324 |
|
Y |
|
| Health Risk Management |
55438 |
|
|
|
| Health Risk Management, Inc |
41170 |
|
|
|
| Health Services Consulting Group Inc. |
20896 |
|
|
|
| Health Services For Children-Special Needs |
37290 |
|
|
|
| Health Services Management |
41150 |
|
|
|
| Health Services Preferred (HSP) by Emerald Health |
34167 |
|
|
|
| Health Systems International |
27008 |
|
|
|
| Health Value Management--DE (Humana) |
61101 |
|
|
|
| Healthcare Options |
EPF37 |
|
|
Call ECP for forms |
| Healthcare Partners, IPA |
11328 |
|
|
|
| Healthcare Resources Group, HRG |
82468 |
|
|
Formerly Heritage NY Medical Group |
| Healthcare Solutions Group (Muskogee, OK) |
73147 |
|
|
|
| HealthCare USA |
HCUSA |
|
Y |
|
| Healthease |
59608 |
|
|
|
| Healthfirst Inc |
80141 |
|
Y |
|
| Healthfirst of Austin |
75289 |
|
|
|
| Healthfirst TPA (Tyler, TX) |
75234 |
|
|
|
| HealthGuard of Lancaster |
23226 |
|
|
|
| HealthHelp Network, Inc (HHNI) |
59087 |
|
|
|
| Healthlink HMO |
96475 |
|
|
|
| Healthlink PPO |
90001 |
|
|
|
| Healthnet - California |
95570 |
|
|
|
| HealthPartners MN |
HPART |
|
Y |
|
| HealthPlan Services (Tampa only) |
59140 |
|
|
|
| HealthPlus of Lousiana |
95009 |
|
|
|
| HealthPlus of Michigan |
38216 |
|
|
|
| HealthSCOPE Benefits, Inc |
71063 |
|
Y |
|
| HealthSCOPE Benefits, Inc (Repricing AR) |
48153 |
|
|
|
| Healthsmart Accel |
75237 |
|
|
|
| Healthsmart Preferred ( Lubbock, TX ) |
75250 |
|
|
|
| Healthsource CMHC |
02041 |
|
|
|
| Healthsource Massachusetts Inc |
02041 |
|
|
|
| Healthsource Provident Adminstrators |
68195 |
|
|
|
| Healthsource, AR |
71074 |
|
|
|
| Healthsource, AR (Medicare HMO) |
71075 |
|
|
Payor requires provider ID; call 800-831-6654 |
| Healthsource, GA |
58210 |
|
|
|
| Healthsource, IN |
35167 |
|
|
|
| Healthsource, KY |
61127 |
|
|
|
| Healthsource, ME |
01041 |
|
|
|
| Healthsource, NC |
56147 |
|
|
Requires unique provider ID. Contact 800-909-2227 x 5760 |
| Healthsource, NH |
02038 |
|
|
|
| Healthsource, North Texas |
75255 |
|
|
|
| Healthsource, OH |
31141 |
|
|
|
| Healthsource, SC |
06119 |
|
|
|
| Healthsource, TN |
62129 |
|
|
|
| Healthsource/Hudson Health Plan |
13335 |
|
|
|
| HealthSpring of Alabama |
63092 |
|
|
|
| HealthStar, Inc |
36332 |
|
|
Formerly The Oath-A Health Plan for Alabama |
| HEALTHWAYS WHOLEHEALTH NETWORKS |
58213 |
|
|
|
| HEALTHWAYS WHOLEHEALTH NETWORKS |
58213 |
|
|
|
| Healthy Options (DSHS) |
91051 |
|
|
|
| Heritage Consultants |
59230 |
|
|
Western WA |
| Heritage Consultants ( Auburndale, FL ) |
59230 |
|
|
|
| Heritage New York Medical Group |
11328 |
|
|
|
| Heritage Physician Network |
HPN11 |
|
|
|
| Heritage Physician Network-Encounters onl |
ENCTR |
|
|
|
| HFN, Inc. |
36335 |
|
|
|
| HHIC Freedom Blue |
BS768 |
|
Y |
|
| High Desert Primary Care (Victorville, CA) |
33069 |
|
|
|
| Hillcrest Benefit Administrators (Maitland, FL) |
59347 |
|
|
|
| HIP - Health Insurance Plan of Greater New York |
55247 |
|
Y |
|
| HMA Administrators, LLC |
39044 |
|
|
|
| HMO Blue Star Plus ( Texas ) |
HMOBS |
|
|
|
| HMO Colorado. |
COHMO |
|
|
|
| HMPK, Inc. |
61101 |
|
|
|
| Holy Cross Health Partners |
36412 |
|
|
|
| Holy Cross Health Partners |
36412 |
|
|
|
| Hometown Health Network ( Massillon, OH ) |
34150 |
|
|
|
| Hometown Health Providers |
88537 |
|
|
|
| Horizon Blue Cross Blue Shield of New Jersey |
22099 |
|
Y |
|
| Horizon Healthcare Admin (HHA) |
22304 |
|
|
|
| Horizon Mercy (NJ) |
22326 |
|
Y |
|
| Hotel Employees & Restaurant Employees Health Trust Grp# F19 |
91136 |
|
|
Call 877-234-4273 |
| Hplan, Inc |
61101 |
|
|
|
| HPS Paradigm, Inc |
58227 |
|
|
|
| HRM |
41170 |
|
|
|
| HRM Claim Management |
41170 |
|
|
|
| Humana Care Plan |
61101 |
|
|
|
| Humana Encounters |
61102 |
|
|
|
| Humana Group Health Plan |
61101 |
|
|
|
| Humana Health Chicago |
61101 |
|
|
|
| Humana Health Chicago Insurance Company |
61101 |
|
|
|
| Humana Health Plan |
61101 |
|
Y |
|
| Humana Insurance Agency |
61101 |
|
|
|
| Humana Insurance Company |
61101 |
|
|
|
| Humana Medical Plan--CA |
61101 |
|
|
|
| Humana Medical Plan--KY |
61101 |
|
|
|
| Humana Veterans Healthcare/VA Hero |
61160 |
|
|
|
| Hunt Insurance Group |
37260 |
|
|
|
| I.E. Shaffer (West Trenton, NJ) |
22175 |
|
|
|
| IAA |
37279 |
|
|
|
| IBA Self Funded Group ( Kalamazoo, MI ) |
38234 |
|
|
|
| IBI |
41124 |
|
|
|
| ICM |
37296 |
|
|
|
| IHG Direct |
75274 |
|
|
|
| Illinois BlueCross/Blue Shield |
BS121 |
Y |
Y |
|
| Illinois Central Hospital Assoc (Tinley Park, IL) |
36600 |
Y |
|
|
| Illinois Medicaid |
ILMCD |
|
|
|
| Illinois Medicare |
ILMCR |
Y |
Y |
|
| Imcare |
41600 |
|
|
|
| IMS Management Services |
IMSMS |
|
|
|
| INDECS Corp (Lyndhurst, NJ) |
40585 |
|
|
|
| Independent Health |
IHLTH |
|
|
|
| Indian Health Services |
SX171 |
|
|
Providers should contact BCBSNM Customer Service Department at 1-800-225-0241 before sending claims.
|
| Indiana BlueCross/Blue Shield |
BS130 |
|
Y |
|
| Indiana Comprehensive Health Insurance Association (ICHIA) |
BS130 |
|
Y |
|
| Indiana Health Network |
35204 |
|
Y |
Enrollment required for Remittance Advice |
| Indiana Medicaid |
INMCD |
|
Y |
|
| Indiana Medicare |
INMCR |
Y |
Y |
|
| Indiana ProHealth Network |
35161 |
Y |
|
|
| Indiana Teamsters Health Benefits Fund (Indianapolis, IN) |
35107 |
|
|
|
| Individual Health Insurance Companies |
31053 |
|
|
Formerly Local 135 Health Benefits Fund |
| Informed LLC/Self Funding Admin |
52196 |
|
|
|
| Ingalls Provider Group |
36348 |
|
|
|
| Innovative Healthware Solutions |
23266 |
|
|
|
| INS Health Services |
VAICE |
|
|
|
| Insurance Administrators of America, Inc |
37279 |
|
|
|
| Insurance Claims Services ( Birmingham, AL ) |
63082 |
|
|
|
| Insurance Design Administrators |
13315 |
|
|
|
| Insurance Service of Lubbock |
ISL11 |
|
|
|
| Insurers Administrative Corp |
IAC01 |
|
|
|
| Integra Administrative Group (Seaford, DE) |
51020 |
|
|
|
| Integra Group |
31127 |
|
|
|
| Integra Group ( Cincinnati, OH ) |
31127 |
|
|
|
| Integra Group CHA |
31129 |
|
|
|
| Integranet |
INET1 |
|
|
|
| Integrated Care Network (ICN) |
34167 |
|
|
|
| Integrity Benefit Network ( Marietta, GA ) |
58200 |
|
|
|
| Intercare Health Plans, Inc. (Greenwood Village, CO ) |
37227 |
|
|
|
| Interface EAP (Houston, TX) |
60280 |
|
|
|
| Intergroup Services PPO |
23287 |
|
|
|
| International Brotherhood of Boilermakers |
36609 |
|
Y |
|
| International Funding, LTD |
39182 |
|
|
|
| International Medical Group, Inc. |
IMGIN |
|
|
|
| International Union of Operating Engineers, Local 15, 15A, 1 |
37269 |
|
|
|
| Iowa Benefits - Meritain Health Minneapolis |
41124 |
|
|
|
| Iowa Blue Cross/Blue Shield |
BS140 |
|
Y |
|
| Iowa Medicaid |
IAMCD |
Y |
Y |
|
| Iowa Medicare |
IAMCR |
Y |
Y |
|
| IU Medical Group Primary Care |
SX172 |
|
|
|
| J. F. Molloy and Associates, Inc. |
61271 |
|
|
|
| John Alden Life Insurance Co. |
41099 |
|
Y |
|
| John Muir/Mt Diablo Health Network (Walnut Creek, CA) |
68036 |
|
|
Certification required; please contact payer. |
| John P. Pearl and Associates |
37215 |
|
|
|
| Joplin Claims |
43178 |
|
|
|
| JP Farley Corporation |
34136 |
|
|
formerly BMI |
| JSL Administrators |
37272 |
|
Y |
|
| Kaiser (Colorado except Colorado Springs) |
COKSR |
|
|
|
| Kaiser Foundation Health Plan ( Mid-Atlantic States ) |
52095 |
|
Y |
|
| Kaiser Foundation Health Plan of Georgia |
21313 |
|
Y |
|
| Kaiser Foundation Health Plan of MD |
52095 |
|
|
Tara Kremer 404-949-5043 |
| Kaiser Foundation Health Plan of Ohio |
34092 |
|
|
remits only require enrollment |
| Kaiser Foundation Health Plan of Southern CA region |
94134 |
|
|
|
| Kaiser Foundation Health Plan of the Northwest |
93079 |
|
|
This payer id only to be used to submit claims for Oregon and Washington Kaiser Permanente members.
|
| Kaiser Permanente (Colorado Springs) |
KSRCS |
|
|
|
| Kanawha Insurance Co. |
57038 |
|
Y |
|
| Kansas Blue Shield |
BS650 |
|
Y |
|
| Kansas City Blue Cross Blue Shield |
BS740 |
Y |
Y |
Enrollment is required |
| Kansas City Life Insurance (Kansas City, MO) |
N/A |
Y |
|
|
| Kansas Medicaid |
KSMCD |
|
Y |
|
| Kansas Medicare |
KSMCR |
|
Y |
|
| Kelsey Seybold |
KELSE |
|
|
|
| Kempton Company |
73100 |
|
|
|
| Kempton Group Administrators |
73100 |
|
|
|
| Kentucky Blue Shield (Anthem) |
BS160 |
|
Y |
|
| Kentucky Medicaid |
KYMCD |
|
Y |
Enrollement Required for Remittance Advice |
| Kentucky Medicare |
KYMCR |
Y |
Y |
|
| Kern Health Systems |
77039 |
|
Y |
|
| Key Benefit Administrators ( Indianapolis, IN ) |
37217 |
Y |
|
|
| Key Benefits Administrators-TransChoice (SC) |
37284 |
|
|
|
| Key Select |
37321 |
|
|
|
| Keystone Health Plan Central |
23045 |
|
|
|
| Keystone Health Plan East |
KEYHE |
|
|
|
| Keystone Mercy Health Plan |
23284 |
|
Y |
|
| Keystone Mercy Health Plan East |
KEYHE |
|
|
|
| Keystone Mercy Health Plan East |
KEYHE |
|
|
|
| Keystone Mercy Health Plan West |
KEYHP |
|
|
|
| Klais & Company |
34145 |
|
|
|
| Korean American Medical Group |
66123 |
|
|
|
| Lake County Physicians Association |
37116 |
|
|
|
| Lakeside Comprehensive Healthcare |
66127 |
|
|
|
| Lakeside Health Services |
95415 |
|
|
|
| Lakeside IPA |
95416 |
|
|
|
| Lakeside Medical Group |
66125 |
|
|
|
| Landmark Healthcare |
LNDMK |
|
|
|
| LBA Health Plans |
52193 |
|
|
|
| LHP Claims Unit |
37248 |
|
|
|
| Liberty Mutual/Wausau Insurance |
11123 |
|
|
|
| Liberty Union/Life Assurance Company |
37281 |
|
|
|
| Life Investors Inc Co of America |
LIICA |
|
|
Specialized claims only. Call
866-745-3545 with claim routing questions.
|
| Life Trac (Golden Valley, MN) |
41136 |
|
|
|
| Lifewise Health Plan of Arizona |
91155 |
|
|
|
| Lifewise Health Plan of Arizona |
91155 |
|
|
|
| Lifewise of Oregion |
93093 |
|
|
Include group # when submitting claims |
| Lifewise, A Premera Healthplan ( Bend, OR ) |
93093 |
|
|
|
| Lifwise of Oregon |
93093 |
|
|
Include group # when submitting claims |
| Lincoln National (Green Bay and Madison, WI) |
73288 |
|
|
As of December 1, 2002, please send all
medical and hospital claims to payer ID
61101. Please submit all Humana
encounters and informational claims to
payer ID 61102.
|
| Lincoln National--Phoenix, AZ (Humana) |
61101 |
|
|
|
| Linn County (Dallas, TX) |
75283 |
|
|
|
| LIPA/Agate Resources |
LIPA1 |
|
|
|
| Local 135 Health Benefits |
35107 |
|
|
|
| Loma Linda University |
37267 |
|
|
|
| Louisiana Blue Shield |
BS738 |
|
Y |
|
| Louisiana Medicaid |
LAMCD |
Y |
Y |
Call ECP |
| Louisiana Medicare |
LAMCR |
Y |
Y |
|
| Louisiana State Group Benefits |
72087 |
Y |
|
|
| Lovelace Sandia Health Plan (New Mexico) |
90328 |
|
|
|
| Machinist District 9 Welfare |
37292 |
|
|
|
| Magellan Behaviorial |
MAGLN |
|
|
|
| MagnaCare |
11303 |
|
|
Call ECP (800) 327-1213 |
| Mail Handlers Benefit Plan |
25133 |
|
|
|
| Maine Blue Cross Blue Shield |
BS680 |
|
Y |
|
| Maine Medicaid |
MEMCD |
|
Y |
|
| Maine Medicare |
MEMCR |
Y |
Y |
|
| MAMSI Life and Health Insurance Co. (MLH) |
52148 |
|
|
|
| Managed Care Services ( Ft. Wayne, IN ) |
35162 |
|
|
|
| Managed Health Network (MHN) |
22771 |
|
|
|
| Managed Health Services Indiana/Maxicare (Medicaid HMO) |
39186 |
|
Y |
Prior to submitting claims, please call
Provider Relations Dept at
1-866-296-8731 to verify your provider
info is on file in the claim system.
|
| Managed Health Services Wisconsin |
39187 |
|
Y |
|
| Managed Physical Network |
41159 |
|
|
|
| Manatee Service Center (Bradenton, FL) |
41555 |
|
|
|
| Maryland Blue Cross Blue Shield |
SB690 |
|
Y |
|
| Maryland Medicaid |
MDMCD |
|
Y |
|
| Maryland Medicare |
MDMCR |
|
Y |
|
| Maryland Physicians Care |
22348 |
|
|
|
| Mashantucket Pequot Tribal Nation |
37121 |
|
|
Requires Rendering Provider ID |
| Massachusetts Blue Cross Blue Shield |
BS200 |
|
Y |
|
| Massachusetts Medicaid |
MAMCD |
|
Y |
mamcd |
| Massachusetts Medicare |
MAMCR |
Y |
Y |
|
| Masters, Mates and Pilots Plan |
MMPHB |
|
|
|
| Mayo Management Services Inc. (MMSI) |
41154 |
|
Y |
|
| MBA Benefit Administrators / CDO Technologies |
87065 |
|
|
|
| McKinley Life Insurance Co |
AULTC |
|
|
|
| McLaren Health Plan (Flint, MI) |
38338 |
|
|
|
| MD--Individual Practice Association, Inc (M.D.IPA) |
52148 |
|
|
|
| Mdwis-HIP |
MDWIS |
|
|
|
| MDWise Hoosier Alliance |
20475 |
|
Y |
|
| MedAdmin Solutions |
58202 |
|
|
|
| MedAdmin Solutions |
58204 |
|
|
|
| MedCom |
59231 |
|
|
|
| MedCost Benefit Services (Winston-Salem, NC) |
56205 |
|
|
|
| MedCost, Inc. |
56162 |
|
|
|
| Medfocus |
95321 |
|
|
|
| Medica |
94265 |
|
|
|
| Medical Benefits Administrators |
74323 |
|
|
|
| Medical Benefits Mutual |
74323 |
|
Y |
Located in Newark, Ohio |
| Medical Claims Service Inc. |
04258 |
|
|
Located in Newark, Ohio |
| Medical Development international (MDI) |
52181 |
|
|
|
| Medical Mutual of Ohio |
29076 |
|
Y |
|
| Medical Network of Colorado Springs |
CSMED |
|
|
|
| Medical Pathways |
33029 |
|
|
|
| Medical Plan of Kansas City-MO |
61101 |
|
|
|
| Medical Resource Network--Atlanta, GA |
58203 |
|
|
|
| Medical Value Plan--Ohio (MVP) |
38224 |
|
|
|
| Medicare Plus Blue - BCBS of Michigan |
MB710 |
Y |
|
Online emrollment required |
| Medicare--DMERC Region A |
DMERA |
|
Y |
|
| Medicare--DMERC Region B |
DMERB |
|
Y |
|
| Medicare--DMERC Region C |
DMERC |
|
Y |
|
| Medicare--DMERC Region D |
DMERD |
|
Y |
|
| MediGold / Mt Carmel Health Plan |
95655 |
|
|
|
| Mediplan |
AULTC |
Y |
|
|
| MEDSOLUTIONS, INC (NASHVILLE, TENNESSEE) |
62160 |
|
|
|
| MedStar Family Choice |
39190 |
|
|
|
| Medstar Physician Partners |
00243 |
|
|
|
| MEGA Life & Health (Student Division) |
74227 |
|
|
Payer ID only valid if the P.O. Box on
the Health ID Card matches one of the
following P.O. Boxes: P.O. Box 890025,
809067, 809079, 809066, 809036,
809081, Dallas, Tx 75380-9025
|
| MEGA Life and Health Insurance (North Richland Hills, TX) |
59221 |
|
Y |
|
| MEGA Life and Health Insurance (Oklahoma City, OK) |
59227 |
|
|
|
| Memorial Clinical Assiciates |
MCA11 |
|
|
|
| Memorial Hermann Health Network |
MHHNP |
|
|
|
| Mennonite Mutual Aid Association and Affiliates (MMA) |
35605 |
|
|
|
| Mercy Care Plan (Phoenix, AZ) |
86052 |
|
|
|
| Mercy Health Plans |
MER11 |
|
|
Requires Rendering Provider ID |
| Mercy Health Plans |
43166 |
|
|
|
| Meridian Health Plan |
13189 |
|
|
|
| Meritain Health / Agency Services |
64158 |
|
|
|
| Meritain Health / North American Admin |
64157 |
|
|
|
| Mesa Mental Health |
85035 |
|
|
|
| Metcare Health Plans Inc. |
65113 |
|
|
|
| MetraHealth Railroad Medicare |
TRRGA |
|
Y |
|
| Metro Plus Health Plan |
13265 |
|
|
|
| Metropolitan Health Plan |
10850 |
|
Y |
|
| METROWEST HEALTH PLAN-PREFERRED CARE |
MWP01 |
|
|
|
| MHN (Managed Health Network) |
22771 |
|
|
|
| MHNet Behavioral Health |
74289 |
|
|
|
| Michael Reese Physicians Group ( Hindsdale, IL ) |
37127 |
|
|
|
| Michigan BC/BS |
BS710 |
Y |
Y |
|
| Michigan Blue Care |
77910 |
|
|
|
| Michigan Blue Cross/Blue Shield |
BS710 |
Y |
Y |
|
| Michigan Medicaid |
MIMCD |
Y |
Y |
|
| Michigan Medicare |
MIMCR |
|
Y |
|
| Michigan Medicare Advantage |
MA710 |
|
|
Online enrollment required |
| Mid Atlantic Psychiatric Services, Inc. |
52149 |
Y |
|
|
| Mid Rogue Oregon Health Plan. |
MRIPA |
|
|
|
| Mid-America Assoc/Liberty Union (Madison Hts, MI) |
37281 |
|
|
|
| Mid-Atlantic Health System |
63079 |
|
|
|
| Mid-West National Life Ins ( Tennessee) |
59224 |
|
Y |
|
| Mid-West United Life (Student Division) |
74227 |
|
|
Requires Unique Insured ID #.
Payer ID only valid if the P.O. Box on
the Health ID Card matches one of the
following P.O. Boxes: P.O. Box 890025,
809067, 809079, 809066, 809036,
809081, Dallas, Tx 75380-9025
|
| Midlands Choice (Nebraska/Iowa) |
47080 |
|
|
Please include group policy # when submitting claims. |
| Midlands Health Partners (Nebraska/Iowa) |
47080 |
|
|
|
| Midwest Health Plans |
MHP77 |
|
|
|
| Midwest Security |
79480 |
|
Y |
|
| Minnesota Blue Cross Blue Shield |
BS720 |
|
Y |
|
| Minnesota Medicaid |
MNMCD |
Y |
Y |
|
| Minnesota Medicare |
MNMCR |
Y |
Y |
|
| Mississippi Blue Cross/Blue Shield (incl State & Teachers) |
BS230 |
|
Y |
|
| Mississippi Medicaid |
MSMCD |
|
Y |
|
| Mississippi Medicare |
MSMCR |
Y |
Y |
|
| Mississippi Physicians Care Network |
64084 |
|
|
|
| Mississippi Public Entity Employee Benefit Trust |
37233 |
|
|
|
| Mississippi Select Healthcare |
64088 |
|
|
|
| Missoula County Medical Benefits Plan |
37275 |
|
|
Also DBA Select Administrative Services (SAS) |
| Missouri Blue Cross/Blue Shield |
BS999 |
|
Y |
|
| Missouri Care/ MC (Columbia, MO) |
43179 |
|
|
|
| Missouri Medicaid |
MOMCD |
Y |
Y |
|
| Missouri Medicare |
MOMCR |
|
Y |
Rendering Provider ID Required |
| MMA |
35316 |
|
|
|
| MMSI |
41154 |
|
Y |
|
| Molina Healthcare of California |
38333 |
|
|
|
| Molina Healthcare of Missouri |
71079 |
|
|
|
| Molina Healthcare of New Mexico Salud |
09824 |
|
|
|
| Molina Healthcare of New Mexico SCI . |
04423 |
|
|
|
| Molina Healthcare of Ohio |
20149 |
|
|
|
| Molina Healthcare of Texas |
20554 |
|
|
|
| Molina Healthcare of Washington |
38336 |
|
|
|
| Montana Medicaid |
MTMCD |
|
Y |
|
| Montefiore CMO ( Yonkers, NY ) |
13174 |
|
|
The provider is responsible for contacting the payer directly for enrollment information. If asked, provider will be sending through the EMDEON clearinghouse
|
| Motion Pictures Industry |
99282 |
|
|
|
| Motorola ( Scottsdale, AZ ) |
36111 |
|
|
|
| Mountain States Administrative Services (Tucson, AZ) |
86040 |
|
|
|
| MPA-Custom Provider Network |
80900 |
|
|
|
| MPE Services Inc/MPEEBT, Inc |
37233 |
|
|
|
| Mplan, Inc/HealthCare Group, LLC |
95444 |
|
|
|
| Multi Plan For American Family |
39634 |
|
|
Payer ID 39634 only accepts claims for the states of AZ, IL, IN and OH. |
| Multiplan Wisconsin Preferred Provider Network |
34080 |
|
|
|
| Mutual Assurance Administrators |
37256 |
|
|
|
| Mutual Group, The (US) |
59140 |
|
|
|
| Mutual of Omaha Insurance Co. |
71412 |
|
Y |
|
| Mutually Preferred |
71412 |
|
|
|
| MVP Health Plan of NY |
14165 |
|
|
|
| N.W. Ironworkers Health & Security Trust Fund Grp#F15 |
91136 |
|
|
|
| N.W. Roofers & Employers Health & Security Trust Fund Grp#F2 |
91136 |
|
|
|
| N.W. Textile Processors Grp#F14 |
91136 |
|
|
Please include group# |
| NAA/North American Administrators (Nashville, TN) |
65085 |
|
|
Please include group# |
| NABN (Cleveland, OH) |
34159 |
|
|
|
| NALC (National Association of Letter Carriers) |
53011 |
|
|
|
| National Assoc. of Letter Carriers/NALC |
53011 |
|
|
|
| National Benefit Administrators ( Charlotte, NC) |
56176 |
|
|
|
| National Benefit Administrators ( Parsippany, NJ) |
56175 |
|
|
|
| National Capital Preferred Provider Organization |
90001 |
|
|
|
| National Claim Administration (Garden City, NY) |
37126 |
|
|
|
| National Health Insurance Company |
75275 |
|
|
|
| National Rural Electronic Coop (NRECA) |
52132 |
|
|
|
| National Rural Letter Carrier Assoc.(Policy#GMG1846) |
71412 |
|
|
|
| National Teachers Association |
NTA11 |
|
|
|
| Nationwide Group |
31417 |
|
|
|
| Nationwide Health Plan |
31417 |
|
Y |
|
| Nationwide Insurance |
31417 |
|
|
|
| NCAS - Charlotte, NC |
75191 |
|
|
|
| NCAS - Fairfax, VA |
75190 |
|
|
|
| Nebraska Blue Shield |
BS260 |
|
Y |
|
| Nebraska Medicaid |
NEMCD |
Y |
Y |
|
| Nebraska Medicare |
NEMCR |
Y |
Y |
|
| Neighborhood Health Partners |
11325 |
Y |
|
|
| Neighborhood Health Partnership of Florida |
96107 |
|
|
|
| Neighborhood Health Plan (Boston, MA) |
04293 |
|
|
|
| Neighborhood Health Providers |
11325 |
|
|
|
| Nesika Health Group |
37255 |
|
|
|
| Netcare Life and Health Insurance (Hagatna, Guam) |
66055 |
|
|
|
| Network Health |
04332 |
|
|
Before initiating submissions, please contact Provider Relations at (617) 806-8104 or edi@network-health.org |
| Network Health Insurance Corp-Medicare |
77076 |
|
|
|
| Network Health Plan Of Wisconsin |
39144 |
|
|
Use for Network Health Plan HMO and
POS claims only. Payer Id valid only if
the send claims to address on the back
of the member's card is PO Box 568
Menasha, WI 54952. DO NOT USE this
payer id for Network Platinum Plus,
Network Premier Plus or Managed |
| Network TPA, LLC |
58204 |
|
|
|
| Nevada Medicaid |
NVMCD |
Y |
Y |
|
| Nevada Medicare |
NVMCR |
|
Y |
|
| New Era Life Insurance Co |
75281 |
|
|
|
| New Hampshire Blue Cross Blue Shield |
BS770 |
|
Y |
|
| New Hampshire Medicaid |
NHMCD |
Y |
Y |
|
| New Hampshire Medicare |
NHMCR |
Y |
Y |
|
| New Jersey Horizon Blue Shield |
22099 |
|
Y |
|
| New Jersey Medicaid |
NJMCD |
Y |
Y |
|
| New Jersey Medicare |
NJMCR |
|
Y |
ALIAS: The New England |
| New Market Dimensions (Bowling Green, KY) |
65056 |
Y |
|
|
| New Mexico Blue Cross Blue Shield |
BS790 |
|
Y |
|
| New Mexico Medicaid |
NMMCD |
|
Y |
|
| New Mexico MedicaidValue Options - |
VALNM |
Y |
|
|
| New Mexico Medicare |
NMMCR |
Y |
Y |
|
| New York Blue Cross Blue Shield |
BS803 |
|
Y |
|
| New York Blue Cross Blue Shield Southwest and Northeast Regi |
BS800 |
|
Y |
|
| New York Medicaid |
SKNY0 |
Y |
Y |
|
| New York Medicare (EMPIRE) |
NXMCR |
Y |
Y |
|
| New York Medicare (UPSTATE) |
NYMCR |
|
Y |
|
| New York Network Management, LLC |
11334 |
Y |
|
|
| New York Presbyterian Community |
48186 |
|
|
Please include group policy # when submitting claims. |
| New York Presbyterian System Select Health |
24819 |
|
|
|
| NewMarket Dimensions (Bowling Green, KY) |
65056 |
|
|
|
| NGS American |
38225 |
|
Y |
|
| NHC Health Benefit Plan (Murfreesboro, TN) |
62124 |
|
|
|
| NHP/SHP (Neighborhood Health Providers and Suffolk Health Pl |
11325 |
|
|
|
| Nippon Life Insurance Co. |
81264 |
|
Y |
Unique Provider ID required |
| NJ Carpenters Health Fund |
22603 |
|
|
|
| North American Administrators, Inc. |
64157 |
|
|
|
| North American Benefits Network (Cleveland, OH) |
34159 |
|
|
|
| North American Health Plan |
64157 |
|
|
|
| North Carolina Blue Shield |
BS310 |
|
Y |
|
| North Carolina Medicaid |
NCMCD |
Y |
Y |
|
| North Carolina Medicare |
NCMCR |
Y |
Y |
|
| Northeastern New York |
BS800 |
Y |
|
|
| Northern Claifornia Sheet Metal Worker |
38238 |
|
|
|
| Northern Illinois Health Plan |
36347 |
|
|
|
| Northern Nevada Trust Fund |
88027 |
|
|
|
| Northwest Life |
PH018 |
|
|
|
| Northwest Suburban IPA (Illinois) |
36346 |
|
|
|
| Novasys Health Network ( Little Rock, AR ) |
71080 |
|
|
|
| NTCA - National Tele. Contract Association |
52103 |
|
|
|
| NTCA - National Telecommunications Coop Association |
52103 |
|
|
|
| Nyhart |
37299 |
|
|
|
| Ocean State PHP, Inc. PVD (Rhode Island) |
PLFRM |
|
|
|
| Ochsner Health Plan |
72127 |
|
|
|
| ODS Health Plan |
13350 |
|
|
|
| Office of Group Benefits-Louisianna |
72087 |
|
|
|
| Ohio Blue Shield: Anthem |
BS332 |
|
Y |
|
| Ohio Health Choice PPO |
34189 |
|
|
Payer ID valid only for claims with a billing submission address of PO Box 3619, Akron, OH 44309-3619 or PO Box 93538 |
| Ohio Medicaid |
OHMCD |
|
Y |
enrollment required with exceptions for provider linked to hospitals or facilities not using ECP as their clearinghouse Payer requires group number |
| Ohio Medicare |
OHMCR |
Y |
Y |
|
| Ohio Worker's Comp |
OHMCO |
|
|
|
| Oklahoma Blue Cross Blue Shield |
BS840 |
|
Y |
|
| Oklahoma Medicaid |
OKMCD |
|
Y |
|
| Oklahoma Medicare |
OKMCR |
|
Y |
|
| OMNI/Medicore HP |
68037 |
|
|
|
| Omnicare, A Coventry Health Plan |
25150 |
|
Y |
|
| One Health Plan of California, Inc |
95379 |
|
|
|
| One Health Plan of Georgia, Inc |
95569 |
|
|
|
| Operating Engineers Locals 302 &612 Grp#F12 |
91136 |
|
|
|
| OptiCare |
56190 |
|
|
|
| Optima Health Insurance Co. (Virginia Beach, VA ) |
54154 |
|
|
|
| Optima Health Plan ( Virginia Beach, VA ) |
54154 |
|
|
|
| Optimum Choice of the Carolina's |
52152 |
|
|
|
| Optimum Choice, Inc (OCI) |
52148 |
|
|
|
| Optimum Healthcare, Inc. |
20133 |
|
|
|
| OptumHealth - CMC |
41194 |
|
|
|
| Oregon BCBS Regence |
00851 |
|
Y |
|
| Oregon Medicaid |
SKOR0 |
|
Y |
|
| Oregon Medicare |
ORMCR |
|
Y |
|
| OrthoNet - Aetna |
13383 |
|
|
|
| OrthoNet - Uniformed Svcs Family Health Plan (White Plains, |
13382 |
|
|
Claims are printed and mailed to the
payer. For Payable USFHP (NY & NJ)
outpatient therapy claims only. Contact
Theresa Malgioglio at (914) 681-8800
|
| Orthonet Corp. ( White Plains, NY ) |
13381 |
|
|
|
| OSF Health Plan |
OSFIL |
|
|
|
| OSF Health Plan Care Advantage |
OSFMC |
|
|
|
| OSMA (Oklahoma State Medical Association) |
73071 |
|
|
|
| Oxford Health Plan |
06111 |
|
Y |
|
| P5 Health Plan Solutions of Utah |
87068 |
|
|
|
| Pacificare Behavioral Health ( Laguna Hills, CA ) |
33053 |
|
|
|
| Pacificare Behaviorial Health ( Laguna Hills, CA ) |
33053 |
|
|
|
| Pacificare Health Systems ( Cypress, CA ) |
95999 |
|
|
|
| PacifiCare of Arizona (Claims only) |
95964 |
|
|
|
| PacifiCare of California |
95959 |
|
Y |
Diane Steele-Smith @ 800-344-3782 x5508 |
| PacifiCare of Colorado |
95962 |
|
|
Please call Tim Peterson at (714) 226-2442. |
| PacifiCare of Oklahoma |
95959 |
|
|
|
| PacifiCare of Oregon |
95959 |
|
Y |
Call Carolyn Jordan at 714-226-2421 |
| PacificSource Health Plans |
93029 |
|
|
Call Lynne Jacoby 206 230-7313 |
| PAI |
37287 |
|
|
Call Margaret Murphy at 206-230-7475 |
| Paramount ( Ohio ) |
PRMNT |
|
Y |
|
| Parity Healthcare (Hollywood, CA) |
58204 |
|
|
Call ECP (800) 327-1213 |
| Parkland Community Health |
66917 |
|
|
|
| Partners National Health Plans of North Carolina, Inc |
56152 |
|
|
|
| Passport Advantage |
76569 |
|
|
for DOS 1/1/2010 and after
|
| Passport Advantage |
SX154 |
|
|
for DOS prior to 1/1/2010 |
| Passport Health Plan |
61129 |
|
Y |
|
| Payer |
Code |
Y |
|
AddInfo 12345 |
| PEHP (Utah Public Employee Health Plan) |
12X36 |
|
Y |
|
| Pennsylvania Blue Shield |
BS362 |
|
Y |
|
| Pennsylvania Medicaid |
PAMCD |
|
Y |
|
| Pennsylvania Medicare |
PAMCR |
|
Y |
|
| Peoples Benefit Life Insurance Company |
PBLIC |
|
|
|
| Peoples Health Network |
72126 |
|
Y |
|
| Personal Choice- PA |
PAIBC |
|
|
The provider must be enrolled with BC/BS of Pennsylvania (BS362) to submit claims electronically for Personal Choice claims |
| Personal Insurance Administrators, Inc. (Agoura Hills, CA) |
95397 |
|
|
|
| Personal Physician Care |
34173 |
|
|
|
| PersonalCare |
25133 |
|
|
|
| PHCS |
70408 |
|
|
|
| PHCS (Private Healthcare Systems) |
13306 |
|
|
|
| PHP of North Carolina, Inc. (Wilmington) |
87726 |
|
|
|
| PHP of Greater St. Louis, Inc. |
87726 |
|
|
|
| PHP of Greater St. Louis, Inc. CARUS |
87726 |
|
|
|
| PHP of Mid Michigan, Inc |
87726 |
|
|
|
| PHP of North Carolina, Inc. (Fayetteville) |
87726 |
|
|
|
| PHP of North Carolina, Inc. (Greensboro) |
87726 |
|
|
|
| PHP of S. Michigan, Inc |
87726 |
|
|
|
| PHP of SW Michigan, Kalamazoo |
87726 |
|
|
|
| PHP of West Michigan, Inc. |
87726 |
|
|
|
| PHP Tenncare (Knoxville, TN) |
62155 |
|
|
|
| Phyicians Health Plan (PHP) |
37330 |
|
Y |
|
| Physician Associates of Louisiana |
58204 |
|
|
|
| Physician Care Network |
58204 |
|
|
|
| Physicians Alliance/Stones River Regional |
15749 |
|
|
|
| Physicians Care Network (Rockford, IL ONLY) |
36345 |
|
|
|
| Physicians Health Association of Illinois |
37136 |
|
|
Payer ID valid onlyfor claims with billing submission name, city, and state of Physicians Care Network, Rockford, IL |
| Physicians Health Plan of No. Indiana |
12399 |
|
Y |
|
| Physicians Health Plan PHP |
37330 |
|
Y |
|
| Physicians Mutual Insurance Company (Omaha, NE) |
47027 |
|
Y |
Please send all PPO and dental claims to the address on the back of the insured's ID Card.
|
| Physicians Plus Insurance Corporation |
39156 |
|
|
|
| Physicians United Plan |
10775 |
|
|
|
| Piedmont Administrators |
56151 |
|
|
|
| Pinnacle Claims Management Inc. |
24735 |
|
|
|
| Pipeline Industry Benefit Fund ( Tulsa, OK ) |
73074 |
|
|
|
| Pittman & Associates |
37224 |
|
Y |
|
| Planned Administrators, Inc |
37287 |
|
|
|
| Plumbers and Pipefitters |
72045 |
|
|
|
| Podi Care Managed Care |
58204 |
|
|
|
| Poly America Medical & Dental Benefits Plan |
32680 |
|
|
|
| POMCO |
16111 |
|
|
|
| PPOM |
38335 |
|
|
Requires Provider Group # |
| PPOPlus, LLC ( Lubbock, TX) |
72148 |
|
|
|
| PRACTICARE (Marietta, GA) |
04334 |
|
|
|
| Prairie States Enterprises, Inc (Chicago, IL/Sheboygan, WI) |
36373 |
|
|
|
| Preferred Administrators |
EPF10 |
|
|
Call ECP for forms.
|
| Preferred Benefit Administrators |
53476 |
|
|
|
| Preferred Benefits Administrator (Wichita, KS) |
61665 |
|
|
|
| Preferred Care |
SX089 |
|
|
|
| Preferred Care |
SX089 |
|
|
|
| Preferred Care |
SX089 |
|
|
|
| Preferred Care Inc. (Florida) |
59291 |
|
|
|
| Preferred Care Inc. (North Carolina) |
56178 |
|
|
|
| Preferred Care Partners (Florida) |
65088 |
|
|
Rendering Provider ID Required |
| Preferred Choices |
38269 |
|
|
|
| Preferred Community Choice/PCCSELECT/CompMed (Tulsa, OK) |
73145 |
|
|
|
| Preferred Health Network (PHN) |
35173 |
|
|
|
| Preferred Health Plan (Louisville, KY) |
61106 |
|
|
|
| Preferred Health Professionals |
31478 |
|
|
|
| Preferred Healthcare System |
23266 |
|
|
|
| Preferred Network Access (Darien, IL) |
36401 |
|
|
Requires Insured Group # |
| Preferred One (CT) a Division of First Choice |
14162 |
|
|
|
| Preferred Plus of Kansas ( Wichita, KA ) |
60110 |
|
|
|
| PreferredOne (MN) |
41147 |
|
|
|
| Premier Benefits |
43166 |
|
|
|
| Premier Health Plans |
43166 |
|
|
|
| Premier Health Systems |
29076 |
|
|
|
| Presbyterian Health Plan |
PREHP |
|
|
|
| Presbyterian Salud (NM) |
PRESA |
|
|
|
| Prevea Health Insurance Plan |
39185 |
|
|
Requires Provider # |
| Primary Health Plan |
PRIME |
|
|
|
| Primary Physician Care, Inc. |
56144 |
|
|
|
| Prime Benefits Systems, Inc.--MO |
61101 |
|
|
|
| Prime Care Health Plan |
UH015 |
|
|
|
| Prime Health of Kansas, Inc.--MO |
61101 |
|
|
|
| Prime Vision Health Plan |
56190 |
Y |
|
|
| Prime West Health Plan |
61604 |
|
Y |
|
| PrimeSource Health Network |
23266 |
|
|
|
| Primetime Health Plan |
AULTC |
Y |
|
|
| Primetime Medical Insurance Co |
AULTC |
|
|
|
| Princeton Premier IPA |
PRI01 |
|
|
|
| Principal Financial Group |
61271 |
|
Y |
|
| Principal Life Insurance Co. |
61271 |
|
|
|
| Principal Mutual Life Insurance Co. |
61271 |
|
|
|
| Prinicipal Health Care |
61271 |
|
|
|
| Priority Health |
38217 |
|
Y |
Payer requests providers to contact them directly for 835 enrollment. Providers may call (800) 942-0954 x 8686 or email edisetup@priority-health.com
|
| Prism - Univera |
37315 |
|
|
|
| Prism Network, Inc |
37268 |
|
|
|
| Pro Care Health Plan, Inc. (Detroit, MI) |
38329 |
|
|
Payer ID valid for claims with the
following submission addresses: PO Box
3160, Detroit MI 48203 AND PO Box
3590, Detroit MI 48203
|
| Professional Benefit Administrators (Oak Brook, IL) |
36331 |
|
|
Payer ID is valid only for claims with
billing submission name, city, and state
of Professional Benefit Administrators,
Inc., Oak Brook, IL.
|
| Professional Benefits Administrators |
59296 |
|
|
|
| Professional Risk Management |
34134 |
|
|
|
| Providence Good Health Plan |
PHP01 |
|
|
|
| PSYCHCARE, LLC |
51052 |
|
|
|
| Puget Sound Benefits Trust Grp#F25 |
91136 |
|
|
|
| Puget Sound Electrical Workers Trust Grp#33 |
91136 |
|
|
Please include Group# |
| Pyramid Life |
48055 |
|
|
|
| Quad Med (Pewaukee, WI) |
39197 |
|
|
|
| Qual Choice, Cleveland |
QUALC |
|
|
|
| QualCare, Inc. |
23342 |
|
|
|
| QualChoice, Arkansas |
35174 |
|
|
|
| Quincy Health Care Management ( Quincy, IL ) |
37129 |
|
|
|
| QVI Risk Solutions (Bend, OR) |
57117 |
|
|
|
| Railroad Medicare |
TRRGA |
Y |
Y |
|
| RBMS, LLC |
91176 |
Y |
|
|
| Regency Employee Ben (Port Huron, MI) |
38221 |
|
|
|
| Regional Care Inc (Scottsbluff, NE) |
47076 |
|
|
9-digit numeric insured ID required |
| Resurrection Health Care Preferred / FKA |
36396 |
|
|
Please call (773) 572-8311 or( 773) 572-8309 prior to first submission of claims
|
| River Quest Network ( Quincy, IL ) |
37129 |
|
|
|
| RMSCO |
16117 |
|
|
|
| Rocky Mountain Health Plan Grand Junction |
SX141 |
Y |
|
|
| Rooney Life Inc. |
37602 |
|
|
|
| Rural Carrier Benefit Plan |
25133 |
|
|
|
| RUSH Prudential - HMO Only |
36389 |
|
|
|
| S & S Healthcare Strategies |
31441 |
|
|
|
| Sagamore Health Network (IN) **Requires Group Policy Number |
35164 |
|
|
|
| Sanford Health Plan |
91184 |
|
Y |
|
| Sante Health System and Affiliates (NY, NY) |
77038 |
|
|
|
| Scott & White |
88030 |
|
|
|
| Secure Health Plans of Georgia (Macon) |
28530 |
|
|
|
| Secure Horizons |
87726 |
|
|
|
| SecureCare of Iowa |
42142 |
|
|
Requires Rendering Provider Number. |
| Security Health Plan |
39045 |
|
|
|
| Select Benefit Administrators (Des Moines, IA) |
42137 |
|
|
Benefit plan administrator of St. Louis, MO, Office of the Administrator, Wash. D.C. |
| Select Benefit Administrators of America (Ashland, WI) |
37282 |
|
|
|
| Select Health of South Carolina |
25176 |
|
|
|
| Select Health of South Carolina ( Charleston, SC ) |
23285 |
|
Y |
|
| SelectCare |
00014 |
|
|
|
| Selectcare of Oklahoma - Tribute |
SCOK1 |
|
|
|
| SelectCare of Texas (Kelsey-Seybold) |
61225 |
|
|
|
| SelectHealth |
SX107 |
|
Y |
|
| Self Insured Benefit Admin (Clearwater, FL) |
59111 |
|
|
|
| Self Insured Plans, Naples FL |
36404 |
|
|
|
| Self-Funded Plans (IL, PA, OH) |
34131 |
|
|
|
| Senior Care Partners |
36390 |
|
|
|
| Senior Whole Health |
83035 |
|
|
|
| Sentara Family Care |
54154 |
|
|
|
| Sentara Health Management |
54154 |
|
Y |
|
| Sentara Health Management ( Virginia Beach, VA ) |
54154 |
|
|
|
| Sentinel Management Svcs |
23249 |
|
|
|
| Sentry Life Insurance Company (Stephens Point, WI) |
39033 |
|
Y |
Include group # when submitting claims |
| Seton CHIP |
76056 |
|
|
Include group # when submitting claims |
| Seton Employee Plan |
SHEBP |
|
|
|
| Seton Employee Plan |
TH080 |
|
|
|
| Seton Health Plan - ILL/HMO |
UH005 |
|
|
|
| Seton Health Plan - ILL/PPO |
UH006 |
|
|
|
| Seton Health Plan Chip |
SHPCH |
|
|
|
| Seton Map Program (Mediveiw) |
SHMAP |
|
|
|
| Seven Corners |
25404 |
|
|
|
| Shasta Administrative Services |
75280 |
|
|
|
| Sheakley Unicomp |
OHMCO |
|
|
|
| Sheet Metal Workers Local 104 Health Care Plan |
38238 |
|
|
|
| Sierra Health Services (Las Vegas, NV) |
76343 |
|
|
|
| Sierra Health Services (Las Vegas, NV) |
76342 |
|
Y |
EFT is a requirement to receive ERA
transactions from Sierra Health Services
|
| Signature Health Alliance |
62159 |
|
|
|
| Significa Benefit Services Inc. |
23250 |
|
Y |
|
| Sinclair Health Plan (South Temple, UT) |
84076 |
|
|
|
| SISCO (Self Insured Services Company) |
00540 |
|
|
|
| Sloan's Lake Managed Care (N) |
84096 |
|
|
|
| Smith Administrators (Ft Worth, TX) |
02057 |
|
|
|
| SoonerCare |
SNMCD |
|
|
|
| Sound Health (Sisters of Providence) |
91131 |
|
|
Now known as First Choice Health Network |
| South Carolina Blue Cross/Blue Shield |
BS401 |
|
Y |
|
| South Carolina Blue Cross/Blue Shield Federal |
BS402 |
Y |
|
|
| South Carolina Companion HealthCare |
BS922 |
Y |
|
|
| South Carolina Medicaid |
SCMCD |
|
Y |
|
| South Carolina Medicare |
SCMCR |
Y |
Y |
|
| South Central Preferred |
23266 |
|
|
|
| SouthCare/Healthcare Preferred |
25147 |
Y |
|
|
| Southeast Texas Gov't EMPS Benefits |
STGEB |
|
|
|
| Southern Benefit Services LLC |
37318 |
|
|
|
| Southern Group Admin (Winston-Salem, NC) |
56131 |
|
|
|
| Southern Health Service |
25133 |
|
Y |
|
| Southwest Service Life |
37266 |
|
|
Please enter the unique policy number
or ID card when submitting claims.
Payer ID valid only for claims with a
billing submission address of PO Box
982005 Ft. Worth, TX 76182. |
| Special Risk International (Lutherville, MD) |
52190 |
|
|
|
| Spectrum Administrators |
23253 |
|
|
|
| Spina Bifida - VA HAC |
84146 |
|
Y |
CHAMPVA – HAC is not associated with and does not process claims for TRICARE (formerly CHAMPUS)
|
| SPOHN Health |
SPOHN |
|
|
|
| SRC Aetna Affordable Health Choices |
57604 |
|
|
|
| St. Anthony Memorial Healthcare Services - MDWISE |
35199 |
|
|
|
| St. Barnabas System Health Plan |
22240 |
|
|
|
| St. Catherine Hospital PHO - MDWISE |
35199 |
|
|
|
| St. Francis Health Network |
35199 |
|
|
|
| St. John's Claims Admin |
37264 |
|
|
|
| St. Margaret Mercy Health Centers-MDWISE |
35199 |
|
|
|
| Star HRG |
59225 |
|
|
|
| Starbridge |
59225 |
|
|
|
| Starmark |
61425 |
|
|
|
| State Auto Insurance Companies |
46450 |
|
|
|
| State Employees Group Benefits Program |
72087 |
|
|
Formerly ICH Corp. |
| State Farm Group Medical & Individual Health Insurance Compa |
31053 |
|
Y |
Not for auto accident claims |
| State Insurance Division |
74227 |
|
|
Payer ID only valid if the P.O. Box on
the Health ID Card matches one of the
following P.O. Boxes: P.O. Box 890025,
809067, 809079, 809066, 809036,
809081, Dallas, Tx 75380-9025
|
| States General Life Insurance |
75087 |
|
|
|
| Staywell Health Plan |
14163 |
|
|
|
| Sterling Option One (Bellingham, WA) |
91151 |
|
|
|
| Stirling and Stirling |
06089 |
|
|
Rendering Provider Network ID required |
| Stoner and Associates (Cincinnati, OH) |
31121 |
|
|
|
| Student Insurance Division |
74227 |
|
|
Payer ID only valid if the P.O. Box on
the Health ID Card matches one of the
following P.O. Boxes: P.O. Box 890025,
809067, 809079, 809066, 809036,
809081, Dallas, Tx 75380-9025
|
| Suburban Health Organization |
35199 |
|
|
|
| Suffolk Health Plan of New York |
88331 |
|
|
|
| SummaCare HMO |
95202 |
|
|
|
| Summit America Insurance Services (Leawood, KS) |
37301 |
|
|
Student Accident and Sickness, College Sports and NASCC claims only
|
| Superior Administrators, Inc (Santa Ana, CA) |
23218 |
|
|
|
| Superior Benefits |
23218 |
|
|
|
| Superior Health / Centene Corp |
SHP11 |
|
Y |
|
| Superior Health Plan of Texas |
39188 |
|
Y |
Prior to submitting claims, please call
Provider Relations Dept at
1-800-218-7453 to verify your provider
info is on file in the claim system. This
will prevent rejections and allow
payments to be made in a timely
manner.
|
| Tall Tree Administrators |
88067 |
|
|
|
| Tarrant Health Services ( Ft. Worth, TX ) |
37228 |
|
|
|
| TASB (TX Assn of School Boards) |
TTASB |
|
|
|
| TBG Administrative Services |
39157 |
|
|
|
| Teachers Health Trust |
88019 |
|
|
|
| Team Choice - Alpha Care Gold |
ADSL1 |
|
|
|
| Team Choice Gold |
75139 |
|
|
|
| Team Choice PPO |
75133 |
|
|
|
| Team Choice UMC |
75134 |
|
|
|
| Teamcare |
36215 |
|
|
|
| Teamsters Local Union #301 ( Waukegan, IL ) |
36612 |
|
|
|
| Tehtys Health ventures |
20212 |
|
|
|
| Tenncare Select |
BS390 |
|
|
|
| Tennessee Blue Care |
TN002 |
|
|
|
| Tennessee Blue Cross |
BS390 |
Y |
Y |
|
| Tennessee Medicare |
TNMCR |
Y |
Y |
|
| Texas Association of School Boards |
A0234 |
|
|
Payer id is for Workers Comp claims Only. You and/or your vendor must be contracted for this transaction service (Emdeon Office customers excluded).
Please visit www.transact.emdeon.com
for info.
|
| Texas Blue Shield |
BS400 |
|
Y |
|
| Texas Children's Health Plan (N) |
76048 |
Y |
|
|
| Texas Childrens Star Medicaid |
TXCSM |
|
|
|
| Texas First Health Plans - TIOPA |
76046 |
|
|
|
| Texas HealthSpring |
33104 |
|
|
|
| Texas Medicaid |
TXMCD |
|
Y |
|
| Texas Medicare |
TXMCR |
|
Y |
|
| Texas Premier Plan - Medicaid |
EPF02 |
|
|
Call ECP for forms |
| Texas True Choice |
TTCEC |
|
|
|
| The Chesapeake Life Insurance Co-Student Insurance (Dallas, |
74227 |
|
|
Payer ID only valid if the P.O. Box on
the Health ID Card matches one of the
following P.O. Boxes: P.O. Box 890025,
809067, 809079, 809066, 809036,
809081, Dallas, Tx 75380-9025
|
| The Ford Meter Box Company, Inc (Wabash, IN) |
37305 |
|
|
|
| The Healthcare Group |
35206 |
|
|
|
| The Loomis Company |
2322 |
|
|
Please call 610-374-4040 x 2438 prior to submit |
| The Loomis Company |
23223 |
|
|
Please call 610-374-4040 x 2438 prior to submit |
| The Mutual Group/HealthPlan Services |
59140 |
|
|
|
| The Perfect Health Insurance Co. |
13522 |
|
|
|
| The Union Labor Life Insurance Company |
13142 |
|
|
|
| Theramatrix |
38259 |
|
|
Please call 313-202-8579 |
| Theraphysics |
THERA |
|
|
|
| Theraphysics - Pacificare |
COTHE |
|
|
|
| Therapy Review Systems |
75305 |
|
|
|
| Time Insurance, a Fortis company |
39065 |
|
Y |
|
| Tongass Timber Trust |
92620 |
|
|
|
| Tooling & Manufacturing Assoc. |
61425 |
|
|
|
| Total Care (NY) |
TCARE |
|
|
|
| Total Community Care |
31182 |
|
|
|
| Total Healthcare |
38201 |
|
|
|
| Touchpoint Healthplan HMO |
97910 |
|
|
|
| Touchstone Health PSO (NY,NY) |
23856 |
|
Y |
|
| Touchstone Health/Health Net Smart Choice (NY, NY) |
13402 |
|
|
|
| Tower Life Insurance Co. |
69493 |
|
|
|
| TPA Health Care Administrators |
87265 |
|
|
|
| TR Paul Inc |
37230 |
|
|
|
| Transamerica Life Insurance |
59222 |
|
Y |
|
| TransChoice-Key Benefit Administrators (SC) |
37284 |
|
|
Requires Unique Insured ID #. |
| Transwestern Insurance Admin, Inc. |
TRAN1 |
|
|
|
| Travelers |
87726 |
|
|
|
| Travelers Railroad Medicare |
TRRGA |
|
|
|
| Travelers/CGT - PPO |
87726 |
Y |
|
|
| TriCare Region 1 |
TRI01 |
Y |
Y |
covered states: ME, VT, NH, MA, RI, CT, NJ, DE, MD, DC, PA |
| TriCare Region 10 |
TRI10 |
Y |
Y |
coivered states: NORTHERN CA |
| TriCare Region 11 |
TRI11 |
Y |
Y |
covered states: WA, OR |
| TriCare Region 12 |
TRI12 |
|
Y |
covered states: AK, HI |
| TriCare Region 2 |
TRI02 |
Y |
Y |
Ccovered states: VA, NC |
| TriCare Region 3 |
TRI03 |
Y |
Y |
covered states: SC, GA, FL |
| TriCare Region 4 |
TRI04 |
Y |
Y |
covered states: TN, AL, MS |
| TriCare Region 5 |
TRI05 |
Y |
Y |
covered states: OH, WV, KY, IN, IL, WI, MI |
| TriCare Region 6 |
TRI06 |
Y |
Y |
covered states: OK, AR, LA, TX(except SW lower corner) |
| TriCare Region 7 |
TRI07 |
Y |
Y |
covered states: MN, IA, MO, ND, SD, NE, KS, MT, WY, CO, TX(lower SW corner) |
| TriCare Region 8 |
TRI08 |
Y |
Y |
covered states: NM, AZ, UT, NV, ID |
| TriCare Region 9 |
TRI09 |
Y |
Y |
covered states: SOUTHERN CA |
| TriHealth Physician Solutions |
31144 |
|
|
|
| Trihealth Physician Solutions - Concern |
31143 |
|
|
|
| Trinity Health |
38269 |
|
|
|
| Trisurant |
34185 |
|
|
|
| TRLHN/EB AKA Trilogy Health Network |
62777 |
|
|
|
| True Choice USA |
TCUSA |
|
|
|
| True Choice USA - Christus Healthplan |
TCUCH |
|
|
|
| Trusteed Plans Service Corp |
91078 |
|
|
|
| Trustmark |
61425 |
|
Y |
|
| Tufts Health Plan |
04298 |
|
|
Submitter must call payer before sending 888-880-8699, ext 4042 |
| UBH RIOS |
16412 |
|
|
Must contact Susan Hoffmann at 888-880-8699 x4648 (Upon approval, Tufts will mail information, including payor id). |
| UBH United Behavioral Health (former MetraHealth-UNET) |
87726 |
|
|
|
| UCARE |
UCARE |
|
Y |
|
| UHC (Columbus) |
87726 |
|
|
|
| UHC (Dayton) |
87726 |
|
|
Use 9-digit SSN/member ID. Use 7-digit provider number. |
| UHC Iowa Choice & Senior Care |
87726 |
|
|
Use 9-digit SSN/member ID. Use 7-digit provider number. |
| UHC Utah, Inc. |
87726 |
|
|
|
| UICI/Benefit Planners |
74223 |
|
|
|
| UMR - Harrington (formerly known as Harrington Benefit Servi |
95266 |
|
|
|
| UMR - Lexington |
37237 |
|
|
formerly known as CommonWealth Administrative Group |
| UMR - Wausau/UHIS (formerly Fiserv Health - Wausau Benefits/ |
39026 |
|
Y |
|
| UMWA Health and Retirement Funds |
52180 |
|
|
|
| UniCARE |
80314 |
|
Y |
|
| Unified Group Svcs |
35198 |
|
|
Effective 6-1-98, payor ID 65935 will no longer be valid. Please send to ID 80314. |
| Unified Health Svcs. |
62170 |
|
|
|
| Uniform Medical Plan (also known as Centra) |
75243 |
|
|
|
| Uniformed Services Family Health ( Staten Island, NY ) |
13407 |
|
|
Serving parts of New York, NYC, all of
New Jersey, Southeastern Pennsylvania,
and Western Connecticut. For member
eligibility, call 1-800-241-4848
|
| Union Pacific RR Employees (Salt Lake City, UT) |
87042 |
|
|
|
| Unison / Better Health Plans ( Monroeville, PA) |
62183 |
|
Y |
|
| Unison/Three Rivers Health Plans |
25175 |
|
Y |
|
| United Behavioral Health (Formerly MetraHealth) |
87726 |
|
|
|
| United Benefits |
59069 |
|
|
|
| United Health & Life |
87726 |
|
|
|
| United Healthcare |
87726 |
|
Y |
|
| United Healthcare of River Valley |
95378 |
|
Y |
Prior to initial submission, provider must first contact John Deere at (309) 765-1593, toll free (866) 509-1593 to receive provider id.
|
| United HealthCare RailRoad Medicare |
TRRGA |
|
|
|
| United Healthcare--Metrahealth/Metropolitan |
87726 |
Y |
|
|
| United HealthCare--Travelers |
87726 |
|
|
|
| United Medical Alliance |
84132 |
|
|
|
| United Medical Resources |
31107 |
|
Y |
|
| United Mine Workers |
52180 |
|
|
|
| United of Omaha |
71412 |
|
|
|
| Univera Healthcare |
UNINW |
|
|
|
| Universal Care of California |
33001 |
|
|
|
| Universal Health Care |
50528 |
|
Y |
|
| University Health Plan of NJ |
22329 |
|
|
|
| University of Illinois at Chicago, Div of Specialized Care f |
37601 |
|
|
|
| University of Missouri |
25133 |
|
|
|
| UPMC Health Plan |
23281 |
|
Y |
|
| UPMC Health Plan ( Pittsburgh, PA ) |
23281 |
|
Y |
|
| Upper Peninsula Health Plan (Marquette, MI) |
38337 |
|
|
|
| US Benefits (Portland, OR) |
93092 |
|
|
|
| US Department of Labor |
LABOR |
|
|
|
| US Family Healthplan |
USFHP |
|
|
|
| USAA (United States Automobile Assoc.) |
74095 |
|
|
|
| USFHP - St. Vincent Catholic Medical Centers of NY |
13407 |
|
|
Serving parts of New York, NYC, all of
New Jersey, Southeastern Pennsylvania,
and Western Connecticut. For member
eligibility, call 1-800-241-4848
|
| Utah Blue Cross / Blue Shield |
SB910 |
Y |
Y |
|
| Utah Medicaid - UHN |
SKUT0 |
Y |
Y |
|
| Utah Medicare |
pending |
Y |
|
|
| Utah Medicare |
UTMCR |
Y |
Y |
|
| UTMB CHIP/Mediview ( Austin, TX ) |
76049 |
|
|
|
| UTMB HealthCare Systems |
76049 |
|
|
|
| VA Fee Basis Programs |
12115 |
|
Y |
Assigned Group Policy Plan ID is required. Call 800-252-2021. |
| Valley Preferred |
23253 |
|
|
|
| Value Options |
VALUE |
Y |
|
|
| Vanderbilt Health Plan |
23173 |
|
|
|
| Vantage Health Plan |
72128 |
|
|
|
| Verdugo Hills Medical Group |
66126 |
|
|
|
| Verity National Group |
75256 |
|
|
|
| VHP Community Care |
23173 |
|
|
|
| Virginia Blue Cross Blue Shield |
BS923 |
|
Y |
|
| Virginia Medicaid |
VAMCD |
|
Y |
|
| Virginia Medicare |
VAMCR |
Y |
Y |
|
| Virginia Premier Health |
54176 |
Y |
|
|
| Vision Care Inc |
37297 |
Y |
|
|
| Vista Health |
25133 |
|
|
|
| Vista/Foundation/Coventry ( Sunrise, FL) |
55248 |
|
|
|
| Viva Health Plan |
63114 |
|
|
VIVA Health requires a complete member ID number, including suffix, on all claim submissions. Pls use the following site to verify member information: https://estepp.cschcg.com/TRI_provider/doEntry.jsp
|
| Vytra Healthcare |
22264 |
|
|
Requires Rendering Provider Number. |
| Washington Employers Trust (Seattle, WA) |
37294 |
|
|
|
| Washington Medicaid |
WAMCD |
|
Y |
|
| Washington Medicare |
WAMCR |
Y |
Y |
|
| Washington State Department of Labor & Industries |
SX063 |
|
|
|
| Washington State Premera Blue Cross |
BS934 |
|
Y |
|
| Washington State Regence Blue Cross |
BS932 |
|
Y |
|
| Washington, D.C. Medicare |
DCMCR |
Y |
Y |
|
| Waterstone Benefit Administrators |
73155 |
|
|
|
| WEA Trust |
39151 |
|
|
|
| webTPA/Community Health Electronic Claims/CHEC |
75261 |
|
Y |
|
| Wellcare Health Plan, Inc (Encounters) |
59354 |
|
|
|
| Wellcare Health Plan, Inc (Encounters) |
59354 |
|
|
|
| Wellcare HMO Inc |
14163 |
|
|
|
| Wellcare of CT |
14164 |
|
|
|
| Wellcare of Florida |
59608 |
|
|
|
| Wellcare of Georgia |
14163 |
|
|
|
| Wellcare of Louisiana |
14163 |
|
|
|
| Wellcare of New York |
14164 |
|
|
New providers must contact 914-334-4173 |
| Wellcare of New York |
14163 |
|
|
|
| Wellcare of Ohio |
14163 |
|
|
|
| Wellcare Private Fee for Service Plans |
77072 |
|
|
|
| Wellmed Medical (Claims) |
WELM2 |
|
|
|
| Wellmed Medical Management |
WELMD |
|
|
|
| WellPath |
25133 |
|
|
|
| WELS Benefit Plan Office (Milwaukee, WI) |
22925 |
|
|
|
| Wenatchee Valley Medical Center |
91064 |
|
|
|
| West Covina Medical Group |
66124 |
|
|
|
| West Virginia Blue Shield |
BS443 |
|
Y |
|
| West Virginia Medicaid |
WVMCD |
|
Y |
Need to test for each new client |
| West Virginia Medicare |
WVMCR |
Y |
Y |
|
| Western Grower's Assurance Trust |
24735 |
|
|
|
| Western Grower's Insurance Company |
24735 |
|
|
|
| Western Health, Inc. |
37306 |
|
|
|
| Western Mutual Insurance |
37247 |
|
|
|
| Western Southern Financial Group (Cincinnati, OH) |
31048 |
|
|
|
| Westlake Financial Group Inc. |
90560 |
|
|
|
| Weyco, Inc. |
38232 |
|
|
|
| William J. Sutton & Co. (Toronto, Canada) |
98010 |
|
|
|
| Windsor Medicare Extra |
62153 |
|
|
|
| Winhealth Partners |
WNHLT |
|
|
|
| Wisconsin Auto and Truck Dealers |
39200 |
|
|
|
| Wisconsin Blue Cross Blue Shield |
BS950 |
|
Y |
|
| Wisconsin Department of Corrections |
74101 |
|
|
|
| Wisconsin Medicaid |
WIMCD |
|
Y |
|
| Wisconsin Medicare |
WIMCR |
|
Y |
|
| World Insurance Company ( Omaha, NE ) |
75276 |
|
Y |
|
| WPS Commercial |
WPS01 |
Y |
|
|
| Writers Guild Industry Health ( Burbank, CA ) |
23710 |
|
|
|
| Wyoming BCBS |
BS960 |
Y |
Y |
|
| Wyoming Medicaid |
WYMCD |
Y |
Y |
|
| Wyoming Medicare |
WYMCR |
Y |
Y |
|
| Young Life |
75285 |
|
|
|