| |
MEDICAL COMMERCIAL (Participating) |
|
|
|
|
| |
Payer |
Payer ID |
Enroll |
R-Enroll |
Additional Info |
| |
1199 National Benefit Fund |
13162 |
No |
No |
Please include Network ID when submitting claims.Call Renaud
Dufresne at (646) 473-6960 for a list of Network ID's. |
| |
8th District Electrical |
CMPUU |
No |
No |
|
| |
ABAS Inc. |
37225 |
No |
No |
Please call Julie Blazek at (630) 416-1111, ext 156, to verify
if you should be sending claims to ABAS Inc. Their address is 1733 Park St.
Naperville, IL 60563 |
| |
ABC Health Plan |
48185 |
No |
No |
For your ABC Provider Number, please call (631)360-3102 |
| |
ABMA(Alta Bates Medical Assoc) Medical Corp(Hinet Sr. and Secure
Horizon |
E3510 |
P |
T |
Only claims from providers in Northern California. Please
contact the EDI Dept for North American Medical Management(NAMM)-Northern
California Lead/Supervisor at 1-800-956-8000 prior to initial submission
of claims |
| |
Access Behavioral Care |
COACC |
No |
No |
|
| |
Acclaim |
64071 |
No |
No |
|
| |
Acclaim Repricing |
21356 |
No |
No |
|
| |
Acordia National |
87815 |
No |
No |
|
| |
ACS Benefit Services, Inc. |
72467 |
No |
No |
Do Not send ACS/Health Net or ACS, Inc. Medicaid claims to this
payer ID. This payer ID is for ACS Benefit Services Inc. only. |
| |
Activa Benefit Services, LLC |
38254 |
No |
No |
Formerly Amway Corporation |
| |
Admar Corporation |
95285 |
No |
No |
|
| |
AdminOne |
37278 |
No |
No |
|
| * |
Administrative Service Consultants |
37257 |
No |
No |
To obtain the payer ID, please call (440)262-1160 |
| |
Advanstaff, Inc. |
CMPUU |
No |
No |
|
| |
Advantage Care |
61123 |
No |
No |
|
| |
Advantra/Health America, Inc./Health Assurance |
25126 |
No |
No |
|
| |
ADVICA-New York Hospital Community Health Plan |
13373 |
No |
No |
|
| |
Advocate Health Centers |
36320 |
No |
No |
Required data elements needed for submission. Please contact Advocate Health
Partners Operations Debbie Motz at (847) 699-4377 or Tony Hani (847)
699-4368 for more info. |
| |
Advocate Health Partners |
65093 |
No |
No |
Required data elements needed for submission. Please contact Advocate Health
Partners Operations Debbie Motz at (847) 699-4377 or Tony Hani (847)
699-4368 for more info. |
| |
Aetna |
60054 |
No |
No |
|
| |
Affinity Medical Group |
AMGCA |
No |
No |
|
| |
AFL-CIO Food & Beverage Dealer's Trust Fund (Toledo, OH) |
34444 |
No |
No |
Payer ID valid only for claims with a billing submission address
of PO Box 457, Toledo, OH 43697-0457. |
| |
Aftra Health Fund |
13346 |
No |
No |
|
| |
AGA |
37280 |
No |
No |
|
| |
Affordable Benefit Administrators |
95426 |
No |
No |
|
| |
Agency Services Inc |
64158 |
No |
No |
|
| |
A.G.I.A. Inc |
95241 |
No |
No |
Claims are printed and mailed to the payer |
| |
Alaska Children's Services, Inc. |
91136 |
No |
No |
Please enter Group Number (P68) when submitting claims. |
| |
Alaska Electrical Health & Welfare Fund |
Pilot |
No |
No |
|
| |
Alaska Laborers Construction Industry Trust |
91136 |
No |
No |
Please enter Group Number (F23) when submitting claims. |
| |
Alaska Pipe Trades Local 375 |
91136 |
No |
No |
Please enter Group Number (F24) when submitting claims. |
| |
Alaska United Food & Commercial Workers Health & Welfare
Trust |
91136 |
No |
No |
Please enter Group Number (F45) when submitting claims. |
| |
Alexian Brothers |
37117 |
No |
No |
|
| |
ALICARE |
13550 |
No |
No |
|
| |
ALIGNIS |
58213 |
No |
No |
Only
claims with the following submission address can besent electronically
using Payer ID 58213: Alignis
45 Eisenhower Drive, Paramus NJ 07652-1416 |
| |
All Savers Insurance |
37602 |
No |
No |
|
| |
Alliance(The WI providers only) |
Call |
No |
No |
Payer ID, rendering provider and location number required to
submit claims. Please call
Dave Sell at (608) 210-6656 to obtain |
| |
Alliance Health Plan (Pennsylvania)(AHP) |
23251 |
No |
No |
|
| |
Alliance PPO, Inc. (Maryland) |
52149 |
No |
No |
|
| |
Alliant Health Plans of Georgia |
58234 |
No |
No |
|
| |
Allied Administrators (San Francisco, CA) |
94177 |
No |
No |
Claims with the following submission address can be sent
electronically using Payer ID 94177:
Allied Administrators PO Box 2500, San Francisco, CA
94126-2500 |
| |
Allied Benefit Systems |
37308 |
No |
No |
|
| |
Alta Bates Medical Group |
Call |
P |
T |
Network ID required on all claims. Call Sutter Connect EDI
Department at (800) 611-5191 to obtain Network ID prior to first
submission. |
| |
Alta Health Strategies |
87043 |
No |
No |
|
| |
Alta Senior Care (Hnet Sr and Secure Horizons only) |
E3510 |
No |
No |
Only
claims from providers in Northern California. Please contact the EDI Dept for
North American Medical Management (NAMM) -Northern California
Lead/Supervisor a 1-800-956-8000 prior to initial submission of
claims. |
| |
Amalgamated Life |
13550 |
No |
No |
|
| |
AmCare Medical Health Plan |
37252 |
No |
No |
|
| |
AmeriBen Solutions, Inc. |
75137 |
No |
No |
|
| |
Americaid Community Care (Maryland) |
27517 |
No |
No |
|
| |
Americaid Community Care (New Jersey) |
27516 |
No |
No |
|
| |
American Administrative Group |
75240 |
No |
No |
|
| |
American Benefit Administrative Services,Inc. |
37225 |
No |
No |
Please call Julie Blazek at (630) 416-1111, ext 156, to verify
if you should be sending claims to ABAS Inc. Their address is 1733 Park St.
Naperville, IL 60563 |
| * |
American Benefits Management |
34187 |
No |
No |
|
| |
American Chiropractic Network (ACN) |
41161 |
No |
No |
|
| |
American Chiropractic Network IPA of NY (ACNIPA) |
41160 |
No |
No |
|
| |
American Chiropractic Network, Inc. |
ACN01 |
No |
No |
|
| |
American Commercial Barge Lines |
37128 |
No |
No |
|
| |
American Community Mutual Insurance |
60305 |
No |
No |
|
| |
American Complimentary Care Network, Inc. |
ACN01 |
No |
No |
|
| |
American General |
62030 |
No |
No |
|
| |
American Healthcare Alliance |
01066 |
No |
No |
|
| |
American Imaging Management, Inc. |
36369 |
No |
No |
Assigned Group Policy Plan ID is required. To obtain, please
call American Imaging Management, Inc. at (800) 252-2021. |
| |
American International Group, Inc. (AIG) |
87726 |
No |
No |
Plan of United Healthcare |
| |
American LIFECARE |
72099 |
No |
No |
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 St. Suite
2600 New Orleans, LA 70163-2602 |
| |
American Medical Security, Inc. |
81400 |
No |
No |
|
| * |
American National Insurance Company (ANICO) |
74048 |
No |
No |
|
| |
American Postal Workers Union Health Plan |
44444 |
No |
No |
Claims for the state of Maine ONLY must be sent on paper to
MedNet, P. O. Box 15440, Portland, ME 04112 |
| |
American PPO |
14190 |
No |
No |
|
| |
American Republic Insurance |
42011 |
No |
No |
|
| |
AmeriChoice of New Jersey Personal Care Plus(Medicare) |
86001 |
No |
No |
All claims submitted require your AmeriChoice assigned Provider
ID Number. Please contact AmeriChoice at (888) 362-3368 for your Provider
ID Number. |
| |
AmeriChoice of New Jersey, Inc. (Medicaid NJ) |
86047 |
No |
No |
|
| |
AmeriChoice of New York Personal Care Plus(Medicare) |
86002 |
No |
No |
All claims submitted require your AmeriChoice assigned Provider
ID Number. Please contact AmeriChoice at (888) 362-3368 for your Provider
ID Number. |
| |
AmeriChoice of New York, Inc. (Medicaid NY) |
86048 |
No |
No |
|
| |
AmeriChoice of Pennsylvania Personal Care Plus (Medicare) |
86003 |
No |
No |
All claims submitted require your AmeriChoice assigned Provider
ID Number. Please contact AmeriChoice at (800) 345-3627 for your Provider
ID Number. |
| |
AmeriChoice of Pennsylvania, Inc. (Medicaid PA) |
86049 |
No |
No |
|
| |
Amerigroup
Corporation (Ft Worth) |
27514 |
No |
No |
Formally Americaid Community Care (Dallas/Ft Worth) |
| |
Amerigroup Corporation
(Houston) |
27515 |
No |
No |
Formally Americaid Community Care (Houston) |
| |
Amerigroup Florida |
27519 |
No |
No |
|
| |
Amerigroup Illinois |
27518 |
No |
No |
|
| |
AmeriHealth Administrators |
23252 |
No |
No |
Claims are printed and mailed to the payer. |
| |
AmeriHealth HMO New Jersey and Delaware |
23037 |
No |
No |
|
| |
AmeriHealth Mercy Health Plan |
22248 |
No |
No |
Medicaid managed care. For EDI support, please email
edi.amhp@kmhp.com |
| |
Amerikids-Dallas/Ft. Worth |
26375 |
No |
No |
|
| |
Amerikids-Houston |
26374 |
No |
No |
|
| * |
Anchor Benefits Consulting, Inc |
53085 |
No |
No |
|
| * |
Ancillary Benefit Systems/Arizona Foundation for Medical Care |
86062 |
No |
No |
|
| |
APA Partners, Inc. |
16140 |
No |
No |
|
| |
Apex Benefit Services |
34196 |
No |
No |
|
| |
ARAZ |
16120 |
No |
No |
|
| |
Arcadian Management Services |
77045 |
No |
No |
|
| |
Arkansas Best Corporation |
75278 |
No |
No |
|
| |
Arnett Health Plans |
95440 |
No |
No |
Payer requires unique Provider ID for billing, rendering and/or
referring provider fields.
Contact Arnett Health Plan's EDI Coordinator at (765) 448-7483 for
additional information prior to first claims submission. |
| |
ASC of Oho |
37257 |
No |
No |
To obtain the payer ID, please call (440)262-1160 |
| |
Associates for Health Care, Inc. (AHC) |
36326 |
No |
No |
|
| * |
Assured Benefits Administrators |
74240 |
No |
No |
|
| |
Athens Area Health Plan Select |
95691 |
No |
No |
|
| |
Atlanticare [also known as Horizon HealthCare Admin (HHA)] |
22304 |
No |
No |
|
| |
Atlantis Health Plan |
13853 |
No |
No |
|
| |
Automated Group Administrators(AGA) |
37280 |
No |
No |
|
| |
Automotive Machinists Local 289 Health & Welfare Trust |
91136 |
No |
No |
Please enter Group Number (F32) when submitting Claims. |
| |
Avera Health Plans |
46045 |
No |
No |
|
| |
AvMed |
59274 |
No |
No |
The insured ID and Patient ID from this payer must be the 11
digit Member ID |
| |
AVMED-Parity Healthcare (OB/Gyn only) |
58204 |
No |
No |
|
| |
AZ Luthern PHO /
Banner Health Systems |
AZULT |
No |
No |
|
| |
AZ Foundation for Medical Care |
SX147 |
W |
No |
|
| |
Bankers United Life- Student Division |
74227 |
No |
No |
|
| |
Banner Health AZ |
SX145 |
W |
No |
|
| |
Bass Administrators, Inc. |
37248 |
No |
No |
|
| |
Batavia City Schools' Tri-County Medical Plan |
16112 |
No |
No |
|
| |
Beech Street Corporation |
95377 |
No |
No |
|
| |
BeneFirst |
37125 |
No |
No |
|
| |
Benefit Coordinators Corporation (Pittsburgh, PA) |
25145 |
No |
No |
Payer ID valid only for claims with a billing submission address
of 111 Ryan Court, Suite 300 Pittsburgh, PA 15205 |
| |
Benefit Management Systems, Inc |
37212 |
No |
No |
|
| |
Benefit Plan Administrators Co. (Eau Claire, WI) |
39081 |
No |
No |
Payer ID valid only for claims with a billing submission address
of P.O. Box 1128, Eau Claire, WI 54702-01128 |
| |
Benefit Plan Administrators, Inc. (Roanoke, VA) |
37118 |
No |
No |
Please call Mary Bender at (940) 345-2721 to verify if you
should be sending to the Benefit Plan Administrators, Inc., in Roanoke,
VA. |
| |
Benefit Plan Management, Inc. |
37222 |
No |
No |
|
| |
Benefit Planners, Inc. |
74223 |
No |
No |
|
| |
Benefit Resources |
02053 |
No |
No |
|
| |
Benefit Services, Inc. (Akron, OH) |
34178 |
No |
No |
|
| |
Benefit Systems & Services, Inc. (BSSI) |
36342 |
No |
No |
|
| * |
Benefits, Inc |
42148 |
No |
No |
|
| * |
Benefits Source, Inc. |
38257 |
No |
No |
|
| |
Benesight |
87265 |
No |
No |
|
| |
Benesys |
37248 |
No |
No |
|
| |
Benesys, Inc. |
37248 |
No |
No |
|
| |
Best Life & Health Insurance Company |
95604 |
No |
No |
|
| |
Better Health Plans, Inc. |
62183 |
No |
No |
|
| |
Bexar Medical IPA |
Pilot |
No |
No |
|
| |
Blue Cross Blue Shield of Colorado |
SB550 |
Yes |
Yes |
For Enrollment infomration, call (888) 397-3434 |
| |
Blue Cross and Blue Shield of Louisiana |
23738 |
F |
No |
For enrollment information, call (225) 295-2427. |
| |
Blue Cross Blue Shield Mississippi |
SB730 |
Yes |
Yes |
For enrollment Information call (888)-397-3434 |
| |
Blue Cross and Blue Shield of Missouri |
SB741 |
W |
No |
A Provider Id is required to submit claims. Please contact
Wellpoint Health Networks at (800) 392-8772, ext. 101. WebMD requires a
provider set up form to be completed before initial claims
submission. |
| |
Blue Cross Blue Shield of Missouri (Blue Choice) |
SB742 |
No |
No |
Participating Payer - see last page for definition. A Provider ID is required to
submit claims. Please contact
Wellpoint Health Networks at (800) 392-8772, ext. 101. WebMD Envoy requires a provider
set up form to be completed
before initial claims submission |
| |
Blue Cross of California |
47198 |
Yes |
Yes |
California License number required. |
| |
Blue Shield of California |
94036 |
Yes |
Yes |
Group number is required. |
| |
BMC HealthNet Plan |
13337 |
No |
No |
Submissions to BMCHP must include the correct 12 digit BMCHP
Provider ID #, including all leading zeros |
| |
Bluegrass Family Health |
61124 |
No |
No |
|
| |
Boilermakers National Health & Welfare Fund |
36609 |
No |
No |
|
| |
Boon-Chapman Benefit Administrators, Inc. |
74238 |
No |
No |
|
| |
BPA/Benefit Plan Administrators (North Dakota) |
37286 |
No |
No |
|
| |
Boston Medical Center Health Plan Inc. |
13337 |
No |
No |
Submissions to BMCHP must include the correct 12 digit BMCHP
Provider ID #, including all leading zeros |
| |
Botsford Health Plan (Farmington Hills, MI) |
38324 |
No |
No |
|
| |
BoydCare/Boyd Bros. |
37273 |
No |
No |
|
| |
BPS, Inc. |
48964 |
No |
No |
|
| |
Bridgestone Claims Services |
37285 |
No |
No |
|
| |
Brokerage Concepts, Inc. |
51037 |
No |
No |
|
| * |
Brokerage Service Inc |
37257 |
No |
No |
To obtain the payer ID, please call (440)262-1160 |
| |
Brown & Brown Benefits |
59069 |
No |
No |
|
| |
Brown & Toland Medical Group |
94316 |
No |
No |
|
| * |
BSI |
37257 |
No |
No |
To obtain the payer ID, please call (440)262-1160 |
| |
Buckeye Community Health Plan |
32004 |
No |
No |
|
| |
Buenaventura Medical Group, Inc. |
50240 |
No |
No |
Claims are printed and mailed to the payer. |
| |
C&O Employees Hospital Association |
23708 |
No |
No |
|
| * |
C&R Consulting, Inc |
13390 |
No |
No |
|
| |
Cambridge ISG |
59334 |
No |
No |
|
| |
Cannon Cochran Management Services, Inc. |
37105 |
No |
No |
|
| |
Cape Health Plan |
38245 |
No |
No |
|
| |
Capital Blue Cross/CAIC |
23045 |
No |
No |
Participating Payer
see last page for definition |
| |
Capital Community Health Plan |
87726 |
No |
No |
|
| |
Capitol Administrators |
68011 |
No |
No |
|
| |
Care Management Group Of Greater NY, Inc. |
11311 |
No |
No |
|
| |
Care Plus Health |
Pilot |
No |
No |
|
| |
Carechoices Michigan - Mercy Healthplans |
Pilot |
P |
T |
Enrollment required; please contact Noreen at
(248)489-5281. |
| |
CareCore National |
14182 |
No |
No |
|
| |
CareCore National,LLC (Aetna Radiology Claims) |
14179 |
No |
No |
|
| |
CareCore National, LLC (Oxford Radiology Claims) |
14180 |
No |
No |
|
| |
CareFirst Blue Cross Blue Shield of DC / NCA |
SB580 |
Yes |
No |
Includes coverage for DC and Northern Virginia. Please call 888-397-3434 for
Enrollment Forms |
| |
CareFirst Blue Cross Blue Shield of MD |
SB690 |
Yes |
No |
Please call 888-397-3434 for Enrollment Forms |
| |
Carelink Advantra |
25139 |
No |
No |
West Virginia HealthAssurance and Carelink commercial claims
only. For Carelink Medicaid, send on paper to P.O. Box 7373, London, KY
40742. |
| |
Carelink Health Plan |
25139 |
No |
No |
West Virginia HealthAssurance and Carelink commercial claims
only. For Carelink Medicaid, send on paper to P.O. Box 7373, London, KY
40742. |
| * |
Carelink Medicaid |
25140 |
No |
No |
Participating payer see last page for definition |
| |
Carenet |
25142 |
No |
No |
|
| |
CarePlus Health Plans, Inc |
65031 |
No |
No |
(Formerly Physicians Healthcare Plans Inc) |
| |
CareSource |
31114 |
No |
No |
|
| |
Cariten Healthcare |
62073 |
No |
No |
|
| |
Cariten Senior Health |
62072 |
No |
No |
|
| |
Carolina Benefit Administrators Inc. |
37245 |
No |
No |
|
| |
Carolina Care Plan |
57105 |
No |
No |
|
| |
Carolina Summit Healthcare, Inc. |
56195 |
No |
No |
|
| |
Carpenters' Health and Welfare Trust Fund of St. Louis |
25125 |
No |
No |
Utlizes the CMR Network.
Claims are printed and mailed to the payer |
| |
Cascade East Health Plans |
93040 |
No |
No |
|
| |
CBA, Inc. |
52132 |
No |
No |
|
| |
CBCA Administrators |
55438 |
No |
No |
|
| |
CBSA |
41124 |
No |
No |
|
| |
CCN Managed Care, Inc. |
33005 |
No |
No |
Please include Group Name and Insured's Employer Name on
claims. |
| |
CCS (Comprehensive Care Systems) |
MNBLS |
No |
No |
|
| |
Cedars-Sinai Medical Network ( Encounters) |
95167 |
No |
No |
|
| |
Cedars-Sinai Medical Network Services |
95166 |
No |
No |
|
| |
Cemara Administrators Inc. |
37250 |
No |
No |
|
| |
Cement Masons & Plasterers Health & Welfare Trust |
91136 |
No |
No |
Please enter Group Number (F16) when submitting claims. |
| |
Centra Benefits Services |
75243 |
No |
No |
|
| |
Central Benefits Life |
31118 |
No |
No |
|
| |
Central Benefits Mutual |
31118 |
No |
No |
|
| |
Central Benefits National |
31118 |
No |
No |
|
| |
Central Reserve Life |
34097 |
No |
No |
|
| |
Central States Health & Welfare Funds |
36215 |
No |
No |
|
| |
Central States Joint Board Health and Welfare Fund |
37214 |
No |
No |
|
| |
Central Valley Medical Group |
E3510 |
P |
T |
Only claims providers in Northern California. Please contact the EDI Dept for
North American Medical Management (NAMM) - Northern California
Lead/Supervisor at 1-800-956-8000 prior to initial submission of
claims |
| * |
Century Health Solutions |
48120 |
No |
No |
|
| |
CHA - Commonwealth Health Alliance |
23171 |
No |
No |
|
| |
CHAMPVA - HAC |
84146 |
No |
No |
CHAMPVA - HAC is not associated with and does not process claims
for TRICARE (formerly CHAMPUS) |
| |
Chatauqua County Healthcare Plan ( Mayville, NY) |
16600 |
No |
No |
|
| * |
Chesapeake Life Insurance Company - Insurance Center |
59223 |
No |
No |
Participating payer see last page for definition |
| |
Children of Women Vietnam Veterans - VA HAC |
84146 |
No |
No |
|
| |
ChiroCare |
ACN01 |
No |
No |
|
| |
Choice One/UTMB CHIP Health Plan |
76049 |
P |
T |
Prior to submitting please call Provider Relations at (281)
652-8700. |
| |
CHP/RPU (FABOH) |
Call |
No |
No |
Payer ID, rendering provider and location number required to
submit claims. Please call
Dave Sell at (608) 210-6656 to obtain |
| |
Christian Brothers Services |
61271 |
No |
No |
|
| |
CHS Claims |
37288 |
No |
No |
|
| |
CIGNA |
62308 |
No |
No |
|
| |
CIGNA - PPA |
62308 |
No |
No |
|
| |
CIGNA - PPO |
62308 |
No |
No |
|
| |
CIGNA Health Plan - HMO |
62308 |
No |
No |
|
| |
Claim Management Services |
39141 |
No |
No |
|
| |
ClaimsWare, Inc. DBA ManageMed |
57080 |
No |
No |
Claims are printed and mailed to the payer. |
| |
Coalition for Care/Medtrex Payer HS |
Call |
No |
No |
Please
call provider Relations at (201) 634-8700 for the payer ID |
| |
Coalition for Care/Medtrex Payer WL |
Call |
No |
No |
Please
call provider Relations at (201) 634-8700 for the payer ID |
| |
Coalition for Care/Medtrex Payer TC |
Call |
No |
No |
Please
call provider Relations at (201) 634-8700 for the payer ID |
| |
Coalition for Care/Medtrex Payer IX |
Call |
No |
No |
Please
call provider Relations at (201) 634-8700 for the payer ID |
| |
Coalition for Care/Medtrx GH |
Call |
No |
No |
Please contact Provider Relations at 201-634-8700 for Payer
ID |
| |
Coalition for Care/Medtrx L8 |
Call |
No |
No |
Please contact Provider Relations at 201-634-8700 for Payer
ID |
| |
Coalition for Care/Medtrx EM |
Call |
No |
No |
Please contact Provider Relations at 201-634-8700 for Payer
ID |
| |
Coalition for Care/Medtrx FI |
Call |
No |
No |
Please contact Provider Relations at 201-634-8700 for Payer
ID |
| |
Coalition for Care/MedtrxHP |
Call |
No |
No |
Please contact Provider Relations at 201-634-8700 for Payer
ID |
| |
Colonial Healthcare |
37123 |
No |
No |
|
| |
Columbia Cornell Care |
25351 |
No |
No |
|
| |
Columbia United Providers |
91162 |
No |
No |
|
| |
Combined Benefits, Inc. |
37271 |
No |
No |
|
| |
Commerce Benefits Group |
34181 |
No |
No |
|
| |
CommonWealth Administrative Group |
37237 |
No |
No |
|
| |
Community Care Behavioral Health Organization |
25179 |
No |
No |
|
| |
Community Care Managed Health Care Plans of Oklahoma |
73143 |
No |
No |
|
| |
Community Care Organization |
39126 |
No |
No |
|
| |
Community Care Plus |
Pilot |
No |
No |
|
| * |
Community Choice of Michigan |
Pilot |
No |
No |
|
| |
Community Health Alliance |
35193 |
No |
No |
|
| |
Community Health Choice |
48145 |
No |
No |
|
| |
Community Health Electronic Claims/CHEC/webTPA |
75261 |
No |
No |
|
| |
Community Health Network of CT |
62149 |
No |
No |
Cannot accept electronic claims for Anesthesia. If you have
questions on how to submit these claims contact LeAnn Olson, at
(203)-237-4000 ext. 3136. |
| |
Community Health Plan |
90010 |
No |
No |
Located in St. Joseph, MO Service are includes NW Missouri, NE
Kansas, SW Iowa, and SE Nebraska. |
| |
Community Premier Plus |
Pilot |
No |
No |
|
| |
Community Premier Plus for Neighborhood Health Providers |
32481 |
No |
No |
|
| |
Comp-Ohio (Austintown, OH) |
34177 |
No |
No |
|
| |
CompBenefits Corporation |
37297 |
No |
No |
|
| |
Comprehensive Benefits Administrator, Inc. |
03036 |
No |
No |
|
| |
Confederation Admin Services |
80705 |
No |
No |
|
| |
Confederation Life Insurance |
80705 |
No |
No |
|
| |
ConnectiCare, Inc |
06105 |
No |
No |
|
| |
Connecticut General (CIGNA) |
62308 |
No |
No |
|
| |
Consociate Group |
37135 |
No |
No |
|
| |
Consolidated Associates Railroad |
75284 |
No |
No |
|
| |
Consumer Health Solutions |
37295 |
No |
No |
|
| |
Continental General Insurance Company |
71404 |
No |
No |
|
| |
Cooperative Benefit Administrators (CBA) |
52132 |
No |
No |
|
| |
Coordinated Medical Specialists |
58204 |
No |
No |
|
| |
Core Administrative Services |
58231 |
No |
No |
|
| |
Core Source AZ MN |
41045 |
No |
No |
Only
for claims where the "submit claims to address" on the medical ID card is
a CoreSource address in the states of Arizona or Minnesota. For assistance
call 800-689-0106 |
| |
CoreSource Little Rock |
75136 |
No |
No |
Onlyfor 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 of NC, IN |
35180 |
No |
No |
Onlyfor 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, PA, MD, IL |
35182 |
No |
No |
Onlyfor claims where the "submit claims to address" on the
medical ID card is a CoreSource address in the states of Maryland,
Pennsylvania or Illlinois. For assistance call
800-689-0106 |
| |
CoreSource OH |
35183 |
No |
No |
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 |
| |
Corporate Benefit Services of America |
41124 |
No |
No |
Payer ID valid only for claims with a billing submission address
of PO Box 27267, Minneapolis, MN 55427-0267 |
| |
Corporate Benefits Service, Inc. (NC) |
56116 |
No |
No |
Claims are printed and mailed to the payer.Payer ID Valid only
for claims with a claims submission. |
| |
Corporate Systems Administration |
37246 |
No |
No |
|
| |
Correctional Medical Services |
43160 |
No |
No |
|
| |
CorSolutions |
48146 |
No |
No |
|
| |
Cottage Health System |
37288 |
No |
No |
|
| |
Cottage Hospital |
37288 |
No |
No |
|
| |
Country Life Insurance Company |
62553 |
No |
No |
|
| |
Covenant Administrators, Inc. (Atlanta GA.) |
58102 |
No |
No |
|
| |
Coventry - Kansas City Medicare (Advantra) |
25144 |
No |
No |
As of June 17, 2003, claims for payer id 25144 are being
converted to payer id 25133(Coventry Health Care of Kansas, Inc. -Kansas
City) |
| |
Coventry Health Care of Delaware, Inc. |
25130 |
No |
No |
|
| |
Coventry Health Care of Georgia, Inc. |
25127 |
No |
No |
|
| |
Coventry Health Care of Iowa, Inc. |
25132 |
No |
No |
|
| |
Coventry Health Care of Kansas, Inc. - Kansas City |
25133 |
No |
No |
|
| |
Coventry Health Care of Kansas, Inc. - Wichita |
25134 |
No |
No |
|
| |
Coventry Health Care of Louisiana, Inc. |
25135 |
No |
No |
|
| |
Coventry Health Care of Nebraska, Inc. |
25136 |
No |
No |
|
| |
Creative Medical Systems |
64068 |
No |
No |
|
| |
Croy-Hall Mgmt. Inc |
37266 |
No |
No |
|
| |
Dean Health Plan |
39113 |
No |
No |
|
| |
Definity Health |
64159 |
No |
No |
|
| |
Denver Health Medical Plan |
84135 |
No |
No |
|
| |
Diamond Plan |
25131 |
No |
No |
|
| |
Directors Guild of America-Producer Health Plans |
23706 |
No |
No |
|
| |
Diversified Administration Corporation |
06102 |
No |
No |
|
| |
E3 Health, Inc. |
75232 |
No |
No |
|
| |
E-V Benefits Management |
34159 |
No |
No |
Payer ID valid only for claims with billing submission address
of P.O. Box 94928, Cleveland, OH 44101-4928 or P.O. Box 89476, Cleveland,
OH 44101-5476 |
| |
eAppeal Solutions |
65009 |
No |
No |
Claims are printed and mailed to the payer. |
| * |
EBC Mid-America |
37257 |
No |
No |
To obtain the payer ID, please call (440)262-1160 |
| * |
EBC, Inc |
37257 |
No |
No |
|
| |
East Bay Medical Network |
Call |
P |
T |
Network ID required on all claims. Call Sutter Connect EDI
Department at (800) 611-5191 to obtain Network ID prior to first
submission. |
| |
EBMS (Employee Benefit Management Services, Inc.) |
81039 |
No |
No |
Please submit rendering provider Tax ID in record type E6 Field
07 to ensure proper adjudication.
When possible include rendering provider last in record type E6
field 09, first name in field 11 address in field 15 city in field 16
state in field 17 and zip code in field 18 |
| |
EHI (Employers Health Insurance) |
73288 |
No |
No |
As of December 1, 2002, please send all medical and hospital
claims to payer ID 61101.
Please submit all Humana encounters and information claims to payer
ID 61102 |
| * |
Elder Health HMO of Pennsylvania |
52192 |
No |
No |
Elder Health service providers in the Maryland and Pennsylvania
area only. Not to be confused
with ElderPlan in NY |
| |
Elder Health Maryland HMO Inc. |
52192 |
No |
No |
Elder Health service providers in the Maryland and Pennsylvania
area only. Not to be confused
with ElderPlan in NY |
| * |
ElderPlan Inc |
31625 |
No |
No |
Phone enroll ( 718) 491-7280 Enrollment via email:
epedi@mjhs.org - send name, provider#, contact info |
| |
ELMCO |
37253 |
No |
No |
|
| |
Emerald Health Network, Inc. (All PPO Business) |
34167 |
No |
No |
|
| |
EmoryCare |
68241 |
No |
No |
|
| |
EMPHESYS |
73288 |
No |
No |
As of December 1, 2001, please begin using Payer ID 61101 |
| * |
Employee Benefit
Claims - Mid America |
37257 |
No |
No |
To obtain the payer ID, please call (440)262-1160 |
| * |
Employee Benefit Claims of WI |
37257 |
No |
No |
To obtain the payer ID, please call (440)262-1160 |
| * |
Employee Benefit Claims of Wisconsin |
37257 |
No |
No |
To obtain the payer ID, please call (440)262-1160 |
| |
Employee Benefit Concepts (Farmington Hills, MI) |
38241 |
No |
No |
|
| |
Employee Benefit Consultants, Inc |
37257 |
No |
No |
To obtain the payer ID, please call (440)262-1160 |
| |
Employee Benefit Corporation |
37215 |
No |
No |
|
| |
Employee Benefit Services |
37216 |
No |
No |
|
| |
Employee Benefits Plan Adminstration, Inc. (E.B.P.A.) |
03036 |
No |
No |
|
| |
Employee Plans, LLC |
35112 |
No |
No |
|
| |
Employers Direct Health |
75232 |
No |
No |
|
| |
Employers Health |
73288 |
No |
No |
As of December 1, 2002, please send all medical and hospital
claims to payer ID 61101.
Please submit all Humana encounters and information claims to payer
ID 61102 |
| |
Employers Health Insurance |
73288 |
No |
No |
As of December 1, 2002, please send all medical and hospital
claims to payer ID 61101.
Please submit all Humana encounters and information claims to payer
ID 61103 |
| |
Employers Insurance of Wausau - aka Wausau |
39026 |
No |
No |
|
| |
Employers Life Insurance Corp. |
37249 |
No |
No |
|
| |
Employers Mutual, Inc (Jacksonville,FL) |
59298 |
No |
No |
|
| |
Employers Mutual, Inc (Stuart,FL) |
59331 |
No |
No |
|
| |
Encircle PPO |
35206 |
No |
No |
|
| |
Encompass |
37110 |
No |
No |
|
| |
Encore Health Network |
35206 |
No |
No |
|
| |
ENH Medical Group IPA |
36364 |
No |
No |
|
| |
Enstar Natural Gas |
91136 |
No |
No |
Please enter Group Number P61 when submitting claims. |
| |
EQUICOR |
62308 |
No |
No |
|
| |
EQUICOR - PPO |
62308 |
No |
No |
|
| |
Equitable Plan Services (Oklahoma City, OK) |
73126 |
No |
No |
Payer ID valid only for claims with a billing submission address
of P.O. Box 720460, Oklahoma City, OK 73172 |
| |
Erin Group Administrators |
23250 |
No |
No |
|
| |
ERISA Administrative Services |
74234 |
No |
No |
|
| |
Evercare |
87726 |
No |
No |
|
| |
Evergreen Health Plan |
58233 |
No |
No |
|
| |
ExclusiCare |
71412 |
No |
No |
|
| |
F.A. Richard & Associates, Inc |
37289 |
No |
No |
|
| |
FACS Group(Federated HR Services/Federated Benefits) |
37300 |
No |
No |
|
| |
FABOH (CHP/RPU) |
Call |
No |
No |
Payer ID, rendering provider and location number required to
submit claims. Please call
Dave Sell at (608) 210-6656 to obtain |
| |
Fallon Community Health |
SX072 |
Yes |
No |
|
| |
Family Health Partners/MC+ Missouri |
43173 |
No |
No |
|
| |
FARA |
37289 |
No |
No |
|
| |
FARA Benefit Services, Inc. |
37289 |
No |
No |
|
| |
FCE Benefit Administrators |
Pilot |
No |
No |
|
| |
Federated Benefits |
37300 |
No |
No |
|
| |
Federated HR Services |
37300 |
No |
No |
|
| |
Federated Mutual Insurance |
41041 |
No |
No |
|
| |
Fidelis Care NY |
11315 |
No |
No |
|
| |
First Carolina Care |
56196 |
No |
No |
|
| |
First Choice (CT) |
14162 |
No |
No |
Please note that all claims submitted require a 5-8 character
Render Provider Network ID. |
| * |
First Choice Health Administrators |
Call |
No |
No |
To obtain the payer ID, please call (206)268-2348 |
| |
First Choice Health Network |
91131 |
No |
No |
|
| |
First Choice of Midwest (PPO) |
75138 |
No |
No |
|
| |
First Health |
87043 |
No |
No |
|
| |
First Priority |
23241 |
No |
No |
|
| |
First State Health Plan |
63080 |
No |
No |
|
| |
FirstGuard Health Plan |
90060 |
No |
No |
|
| |
Fisery Health - Kansas/ Tennessee |
62061 |
No |
No |
(Formerly Willis Administrative Services Corporation) |
| |
Fitzharris & Company, Inc |
11244 |
No |
No |
|
| |
Florida 1st |
59276 |
No |
No |
|
| |
Florida Hospital Healthcare Systems |
59321 |
No |
No |
In-network FHHS providers must submit either their UPIN number
or FHHS Provider ID, as the rendering provider number. Out of network providers must
contact FHHS at 407-741-4893 for additional requirements. The FHHS member ID must be 11
digits in length. |
| |
Florida Hospital Waterman |
48116 |
No |
No |
|
| |
Formax |
87066 |
No |
No |
For assistance send email to HIPPA@f-m-h.com |
| |
FMH Benefit Services, Inc. |
48117 |
No |
No |
For assistance send email to HIPPA@f-m-h.com |
| |
Fortis Benefits Insurance Company |
70408 |
No |
No |
|
| |
Fortis Insurance Company |
39065 |
No |
No |
|
| |
Foundation Health Plan (Sunrise, FL) |
59257 |
No |
No |
|
| |
FoxEverett - Ingalls Ship Building |
64067 |
No |
No |
|
| |
Fox-Everett, Inc. |
64069 |
No |
No |
|
| |
Fringe Benefits Coordinators |
59204 |
No |
No |
|
| |
G.E. Group Life Assurance Company |
67815 |
No |
No |
|
| |
Gallagher
Benefit Administrators Inc,/GBA |
37283 |
No |
No |
Claims are printed and mailed to the payer |
| |
Galveston County Indigent Health Care |
30005 |
No |
No |
|
| |
Gateway Health Plan |
25169 |
No |
No |
|
| |
GBA |
37283 |
No |
No |
Claims are printed and mailed to the payer |
| |
GE Group Administrators, Texas |
75238 |
No |
No |
(Formerly Phoenix Group Services - Texas) |
| |
GE Group Administrators, South Carolilna |
06143 |
No |
No |
(Formerly Phoenix Group Services, Inc) |
| |
Geisinger Health Plan |
75273 |
P |
No |
Payer requires enrollment prior to first electronic submission.
Please contact the payer at (570) 271-7836 for an enrollment form. |
| |
Genelco (St. Louis) |
63665 |
No |
No |
|
| |
General American Life Insurance Company |
63665 |
No |
No |
|
| |
Genesee County Medical Plan |
16112 |
No |
No |
|
| |
GH Basic Health Plan |
91051 |
P |
No |
Western Washington State. Please call (206) 901-6347 prior to
first submission of production claims. |
| |
GH Individual and Family Plan |
91051 |
P |
No |
Western Washington State. Please call (206) 901-6347 prior to
first submission of production claims. |
| |
GHC Medicare + Choice |
91051 |
Yes |
No |
Western Washington State. Please call (206) 901-6347 prior to
first submission of production claims. |
| |
GHC-Commercial |
91051 |
P |
No |
Western Washington State. Please call (206) 901-6347 prior to
first submission of production claims. |
| |
GHI - New York (Group Health Inc.) |
13551 |
No |
No |
|
| |
GHI HMO |
25531 |
No |
No |
|
| |
GI Innovative Management |
58204 |
No |
No |
|
| |
GIC Indemnity Plan |
80314 |
No |
No |
|
| |
Gilsbar, Inc. |
07205 |
No |
No |
|
| |
Glassworkers Health & Welfare Fund |
91136 |
No |
No |
|
| |
Golden Rule Insurance Company |
37602 |
No |
No |
Allow the Insured ID (Record Type D0, field 07) and the Group
Number (Record Type D0, field 9) to contain the same data. |
| |
Government Employees Hospital Association (GEHA) |
44054 |
No |
No |
|
| |
Grant Physicians Practice Association |
37234 |
No |
No |
|
| |
Great Lakes Health Plan |
95467 |
No |
No |
|
| |
Great-West Healthcare |
80705 |
No |
No |
|
| |
Group Administrators Ltd. |
36338 |
No |
No |
|
| |
Group and Pension Administrators |
48143 |
No |
No |
|
| |
Group Benefit Administrators (Hendersonville, TN) |
72153 |
No |
No |
|
| |
Group Health Cooperative - East |
91121 |
P |
P |
Eastern Washington State.
Please call (206)901-6347 prior to first submission of productin
claims |
| |
Group Health Cooperative - West |
91051 |
P |
P |
Western Washington State. Please call (206) 901-6347 prior to
first submission of production claims. |
| |
Group Health Cooperative of South Central Wisconsin |
39167 |
No |
No |
|
| * |
Group Health Cooperative of South Central Wisconsin |
39168 |
No |
No |
|
| |
Group Health Managers |
38194 |
No |
No |
|
| |
Group Health Options/ Aliant Plus,Aliant Select,Options, Options
Prime and Options Select |
91051 |
P |
T |
Western Washington State. Please call (206) 901-6347 prior to
first submission of production claims. |
| |
Group Health Plan (GHP) |
25141 |
No |
No |
|
| * |
Group Insurance Service Center, Inc |
37276 |
No |
No |
Claims are printed and mailed to the payer |
| |
Guardian Life Insurance Company of America |
64246 |
No |
No |
|
| |
Gundersen Lutheran Health Plan, Inc |
39180 |
No |
No |
Before submitting
electronically to Gundersen Lutheran Health Plan, Inc., all providers must
call Shari Oelke at (608)775-8026 |
| |
H.E.R.E.I.U Welfare Pension Funds |
37114 |
No |
No |
|
| |
Harmony Health Plan of Illinois |
36406 |
No |
No |
Claims will be printed and mailed until further notice |
| |
Harmony Health Plan of Indiana |
36405 |
No |
No |
|
| |
Harrington Benefit Services, Inc. |
06131 |
No |
No |
(Formerly TPCM) |
| |
Harrington Benefit Services, Inc. |
75196 |
No |
No |
(Formerly Centra) |
| |
Harrington Benefit Services, Inc. |
95266 |
No |
No |
|
| |
Harrington Benefit Services, Inc. (Oklahoma) |
59142 |
No |
No |
|
| |
Harvard Pilgrim Health Care |
04271 |
No |
No |
|
| |
HCH Administration (Illinois) |
37111 |
No |
No |
|
| * |
HCH Administration, Inc |
37215 |
No |
No |
Formerly John P. Pearl Associates |
| |
HCHA Albq-Self Funded |
37329 |
No |
No |
|
| |
HCS-Health Claims Service (Boise, ID) |
82018 |
No |
No |
|
| * |
Health 1,2,3, Inc |
23173 |
No |
No |
|
| |
Health Administration Service, Inc. |
34185 |
No |
No |
|
| |
Health Alliance Exclusive & Plus |
23172 |
No |
No |
Participating payer see last page for definition |
| |
Health Alliance Medical Plans |
77950 |
No |
No |
|
| |
Health Alliance Plan of Michigan |
38224 |
No |
No |
|
| |
Health Assurance/Health America, Inc./Advantra |
25126 |
No |
No |
|
| * |
Health Care Network of Wisconsin (HCN) |
42102 |
No |
No |
|
| |
Health Care Savings |
56142 |
No |
No |
|
| |
Health Choice Inc |
22345 |
No |
No |
|
| |
Health Connecticut |
37263 |
No |
No |
|
| |
Health Cost Solutions |
62111 |
No |
No |
|
| |
Health Data Solutions |
46114 |
No |
No |
|
| |
Health Design Plus (Hudson, OH) |
34158 |
No |
No |
|
| |
Health Economics Group |
16112 |
No |
No |
|
| |
Health EZ |
16120 |
No |
No |
|
| |
Health Management Associates (HMA) |
86065 |
No |
No |
|
| |
Health Future, LLC |
30946 |
No |
No |
|
| * |
Health Net of Arizona |
38309 |
No |
No |
Payer requires unique provider ID: please call
(866) 334-4638 |
| |
Health Net of California and Oregon |
95567 |
No |
T |
|
| |
Health Net of the Northeast, Inc. |
06108 |
P |
T |
Payer requires unique provider ID: please call
(866) 334-4638 |
| |
Health Network America |
20199 |
No |
No |
|
| |
Health New England |
04286 |
No |
No |
|
| |
Health One Alliance |
58216 |
No |
No |
|
| |
Health Partners - Jackson, TN |
62157 |
No |
No |
|
| |
Health Partners of Alabama, Inc |
63092 |
P |
T |
|
| |
Health Partners, PA |
80142 |
No |
No |
All
claims submitted require a valid Health Partners, PA, provider ID in the
Rendering Provider Network ID field. |
| |
Health Partners Southeast |
63092 |
P |
T |
|
| |
Health Plan Management |
37221 |
No |
No |
|
| |
Health Plan SouthEast(Tallahassee, FL) |
59256 |
No |
No |
|
| |
Health Plans Inc. |
44273 |
No |
No |
Claims are printed and mailed to the payer. |
| |
Health Pledge HMO |
95435 |
No |
No |
|
| |
Health Risk Management |
55438 |
No |
No |
|
| |
Health Services Preferred (HSP) by Emerald Health |
34167 |
No |
No |
|
| |
Health Smart Preferred Care |
HSPC1 |
No |
No |
|
| |
HealthCare Partners, IPA |
11328 |
No |
No |
Formerly Heritage New York Medical Group |
| |
Healthcare USA |
25143 |
No |
No |
|
| |
HealthEase |
59608 |
No |
No |
Please note that all claims submitted require a 5-9 character
Rendering Provider Network ID. |
| |
Healthfirst - Tyler, TX |
75234 |
No |
No |
|
| |
Healthfirst, Inc. (NY) |
80141 |
No |
No |
All claims submitted require a valid Healthfirst, Inc. (NY)
provider ID in the Rendering Provider Network ID field. |
| |
HealthGuard of Lancaster |
23226 |
No |
No |
|
| |
HealthHelp Network, Inc. (HHNI) |
59087 |
No |
No |
|
| |
Healthlink HMO |
96475 |
No |
No |
Please call Provider Relations Dept at (800) 624-2356 for unique
provider number. |
| |
Healthlink PPO |
90001 |
No |
No |
Please call Provider Relations Dept at (800) 624-2356 for unique
provider number. |
| |
HealthPlan Services (Tampa only) |
59140 |
No |
No |
|
| |
HealthPower HMO |
31106 |
No |
No |
|
| |
HealthRight, Inc. |
06142 |
No |
No |
|
| |
HealthSCOPE Benefits, Inc. |
71063 |
No |
No |
|
| |
HealthSCOPE Benefits, Inc. (PCP Only) |
Call |
P |
T |
Call Jonda Brown (800) 972-3025 for Payer ID. |
| |
HealthSCOPE Benefits, Inc. (Repricing AR) |
48153 |
No |
No |
|
| |
Healthsource CMHC |
02041 |
No |
No |
|
| |
Healthsource Massachusetts, Inc. |
02041 |
No |
No |
|
| |
Healthsource Provident (CIGNA) |
68195 |
P |
T |
Claims are edited under CIGNA's payer specific edits, Payer ID
62308. |
| |
Healthsource, AR |
71074 |
P |
T |
Payer requires provider ID number; please call
(800)831-6654. |
| |
Healthsource, AR (Med) (CIGNA) |
71075 |
No |
No |
Claims are edited under CIGNA's payer specific edits, Payer ID
62308. |
| |
Healthsource, GA (CIGNA) |
58210 |
No |
No |
Claims are edited under CIGNA's payer specific edits, Payer ID
62308. |
| |
Healthsource, IN |
35167 |
No |
No |
|
| |
Healthsource, KY |
61127 |
No |
No |
|
| |
Healthsource, ME |
01041 |
P |
T |
Payer requires unique provider ID; please contact (800)
909-2227, ext. 5760. |
| |
Healthsource, N. TX (CIGNA) |
75255 |
No |
No |
Claims are edited under CIGNA's payer specific edits, Payer ID
62308. |
| |
Healthsource, NC (CIGNA) |
56147 |
No |
No |
Claims are edited under CIGNA's payer specific edits, Payer ID
62308. |
| |
Healthsource, NH |
02038 |
P |
No |
Payer requires unique provider ID for new providers; please
contact Donna Wilson at (603) 268-7439. |
| |
Healthsource, OH |
31141 |
No |
No |
|
| |
Healthsource, SC |
06119 |
No |
No |
Healthsource Network Providers Only |
| |
Healthsource, TN (CIGNA) |
62129 |
No |
No |
Claims are edited under CIGNA's payer specific edits, Payer ID
62308. |
| |
HealthSource/Hudson Health Plan |
Call |
P |
T |
Provider enrollment is required by the payer. Please contact Sam
Gutwillig at (914) 372-2291 to obtain Payer ID. |
| |
Healthsouth Medical Plan Administrators |
63086 |
No |
No |
|
| |
HealthSpring HMO/HealthSprin Medicare + Choice |
25193 |
No |
No |
An EDI application must be submitted prior to submitting
claims. Please contact
Provider Relations at 615-291-7035 or visit www.myhealthspring.com to
obtain an application. This
payer ID is NOT for PPO claims. |
| |
HealthSpring of Alabama |
63092 |
P |
T |
Formerly The OATH - A Health Plan for Alabama. Please note that all claims
submitted require a 4-6 digit Rendering Provider ID. Please contact HealthSpring of
Alabama Provider Call Center at (800)743-7141 for provider
enrollment |
| |
HealthStar, Inc. |
36332 |
No |
No |
|
| |
Healthy Options (DSHS) |
91051 |
P |
T |
Western Washington State. Please call (206)901-6347 prior to
first submission of production claims. |
| |
HEP Administrators (PPO) |
Call |
P |
T |
Prior enrollment is required. Please call customer service at
(262) 567-9695. |
| |
HEP Administrators, Inc. (Non-PPO) |
Call |
P |
T |
Prior enrollment is required. Please call customer service at
(262) 567-9695. |
| |
Heritage Consultants |
59230 |
No |
No |
For faster payment, please be sure to use only the 9-digit
subscriber ID on all claims. |
| |
HFN, Inc. |
36335 |
No |
No |
|
| |
Hill Physicians Medical Group |
Call |
P |
T |
Please contact Tina Loftus at (800) 445-5747 for Payer ID. |
| * |
Hillcrest Benefit Administrators |
59347 |
No |
No |
|
| |
Hinsdale Physician Healthcare |
37115 |
No |
No |
|
| |
HIP - Health Insurance Plan of Greater New York |
55247 |
No |
No |
|
| |
HMO Central NY |
N3BLS |
No |
No |
|
| |
HMO of Colorado (HMOC) |
COHMO |
No |
No |
Prior approval by HMOC required prior to sending claims
electronically |
| |
HomeTown Health Network |
34150 |
No |
No |
|
| |
Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) |
22099 |
A |
A |
|
| |
Horizon HealthCare Admin (HHA) |
22304 |
No |
No |
|
| * |
Horizon NJ Health |
22326 |
No |
No |
Medicaid managed care.
For EDI support, please email edi.hm@kmhp.com:Formerly Horizon
Mercy Health Plan |
| * |
Hospital Benefits, Inc |
Pilot |
No |
No |
|
| |
Horizon Mercy |
22326 |
No |
No |
Medicaid managed care. |
| |
Hotel Employees & Restaurant Employees Health Trust |
91136 |
No |
No |
Please enter Group Number (F19) when submitting claims. |
| |
HPS Paradigm, Inc. |
58227 |
No |
No |
|
| |
HRM |
41170 |
No |
No |
|
| |
HRM Claim Management |
41170 |
No |
No |
Formerly Health Risk Management (HRM) |
| |
Humana - Employers Health Insurance |
73288 |
No |
No |
As of December 1, 2002, please send all medical and hospital
claims to payer ID 61101.
Please submit all Humana encounters and information claims to payer
ID 61102 |
| |
Humana Emphesys |
61101 |
No |
No |
|
| |
Humana Employers Health Insurance |
61101 |
No |
No |
|
| |
Humana Inc |
61101 |
No |
No |
|
| |
Humana Insurance Company Choice Care Network |
61101 |
No |
No |
Does not include Humana ChoiceCare of Cincinnati (Humana Health
Plans of Ohio) |
| |
Humana Military - Tricare:Regions 3 and 4 |
61125 |
No |
No |
Participating Payer for TRICARE Regions 3 and 4 |
| |
Humana Puerto Rico |
65018 |
P |
No |
|
| |
Hunt Insurance Group/HRH TPA Services |
37260 |
No |
No |
|
| |
IAA |
37279 |
No |
No |
|
| |
IBA Self Funded Group |
38234 |
No |
No |
|
| |
IBEW Western Utilities or Local 57 |
CMPUU |
No |
No |
|
| |
IBI |
41124 |
No |
No |
|
| |
IBM Medical Plans |
68241 |
No |
No |
|
| |
ICM |
37296 |
No |
No |
|
| |
Idaho Tru Blue |
TRUEB |
No |
No |
|
| |
I.E. Shaffer (West Trenton, NJ) |
22175 |
No |
No |
|
| |
Illinois Central Hospital Association (Tinley Park, IL) |
36600 |
No |
No |
|
| |
I'Mcare |
41600 |
No |
No |
|
| * |
INDECS Corporation |
40585 |
No |
No |
|
| |
Indiana Health Network |
35204 |
No |
No |
|
| |
Indiana ProHealth Network |
35161 |
No |
No |
|
| |
Individual Health Insurance Companies |
31053 |
No |
No |
|
| |
Informed, LLC |
52196 |
No |
No |
|
| |
InHealth, Inc |
31112 |
No |
No |
|
| |
Innovative Healthware Solutions |
04320 |
No |
No |
|
| |
InProNet |
93112 |
No |
No |
|
| |
Institutes of Quality |
68241 |
No |
No |
|
| |
Insurance Administrators of America, Inc. |
37279 |
No |
No |
|
| |
Insurance Claims Services, Inc. (Birmingham, AL) |
63082 |
No |
No |
|
| |
Insurance Design Administrators |
13315 |
No |
No |
|
| |
Insurance Management Services (Elko, Nevada) |
88006 |
No |
No |
Only claims with the following submission address can be sent to
Payer ID 88006: Insurance Management Services, PO Box 71, Elko NV
89803 |
| |
Insurance Services of Lubbock |
ISL11 |
No |
No |
|
| |
Integra Administrative Group (Seaford, Delaware) |
51020 |
No |
No |
Only claims with the following submission address can be sent
electronically using Payer ID 51020:
Integra Administrative Group 110S. Shipley St. Seaford, DE 19973 |
| |
Integra Group |
31127 |
No |
No |
|
| |
Integra Group-CHA |
31129 |
No |
No |
|
| |
Integrated Benefit Services |
37124 |
No |
No |
|
| |
Integrated Care Network (ICN) by Emerald Health |
34167 |
No |
No |
|
| |
Interactive Diagnostic Services, Inc. |
94315 |
No |
No |
|
| |
InterCare Health Plans Inc. |
37227 |
No |
No |
|
| * |
Interface (IEAP) |
60280 |
No |
No |
|
| |
Intergroup Services Corporation |
23287 |
No |
No |
|
| |
Intermountain Ironworkers Trust Fund |
CMPUU |
No |
No |
|
| |
International Brotherhood of Boilermakers |
36609 |
No |
No |
|
| |
International Union of Operating Engineers, Local 4 Health &
Welfare Fund |
37241 |
No |
No |
|
| |
International
Union of Operators Engineers Local 15, 15A, 15C & 15D |
37269 |
No |
No |
Located in New York, NY |
| |
Iowa Benefits Inc. |
41124 |
No |
No |
|
| |
IUOE Local 4 |
37241 |
No |
No |
Payer ID valid only if payer address is 177 Bedford St. P.O.Box
4 Lexington, MA 02420 and group number =300. Contact Jamie Maclauchian at (781)
861-1600 ext 24 with questions |
| |
J. F. Molloy and Associates, Inc. |
61271 |
No |
No |
|
| |
John Alden Life Insurance Co. |
41099 |
No |
No |
|
| |
John Deere Health Care/Heritage National Healthplan |
95378 |
P |
T |
Prior to initial submission, provider must first contact John
Deere at (309) 765-1593 - toll free (866)509-1593 to receive provider
id. |
| |
John P Pearl & Associates |
37215 |
No |
No |
|
| |
John Hancock Health Security Plan |
65099 |
No |
No |
|
| |
John Hancock Mutual Life Insurance Company |
65099 |
No |
No |
|
| |
John Hancock Preferred Health Plan |
65099 |
No |
No |
|
| |
Johns Hopkins Healthcare |
Pilot |
No |
No |
|
| |
Joplin Claims |
43178 |
No |
No |
|
| |
JP Farley Corporation |
34136 |
No |
No |
|
| |
JSL Administrators |
37272 |
No |
No |
|
| |
Kaiser Foundation Health Plan of Georgia |
21313 |
No |
No |
|
| |
Kaiser Foundation Health Plan of Northern CA Region |
Call |
No |
No |
Please contact Cheryl G. Robinson at (866)285-0362 or e-mail her at
cheryl.g.robinson@kp.org proir to first submission of claims |
| |
Kaiser Foundation Health Plan of Southern CA Region |
94134 |
P |
T |
Commercial Provider ID required by Kaiser. Please contact Tina
C. Cheung at (626) 405-6404 or
email Tina.C.Cheung@kp.org prior to submitting claims. |
| |
Kaiser Foundation Health Plan of the Mid-Atlantic States,
Inc. |
52095 |
No |
No |
For more information, please contact Kenya Neal at Kaiser at
(301) 625-2264. |
| |
Kaiser Permaanente (Colorado Springs Plan only) |
KSRCS |
No |
No |
|
| |
Kaiser Permanente (Colorado plans only *Except Colorado
Springs*) |
COKSR |
No |
No |
|
| |
Kanawha HealthCare Solutions, Inc. |
57038 |
No |
No |
|
| |
Kanawha Insurance Co. |
57038 |
No |
No |
|
| |
Kansas City Life Insurance Co. |
44030 |
No |
No |
|
| |
Kempton Company |
73100 |
No |
No |
|
| |
Kempton Group Administrators |
73100 |
No |
No |
|
| |
Kapiolani Health Commercial |
KAPO1 |
No |
No |
|
| |
Kepple & Company |
37124 |
No |
No |
|
| |
Key Benefit Administrators |
37217 |
No |
No |
|
| |
Keystone Mercy Health Plan |
23284 |
No |
No |
Medicaid managed care.
For EDI support, please email edi.kmhp@kmhp.com |
| |
Kindred Health Care |
73288 |
No |
No |
(Formerly known as VENCOR) 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 |
| |
Klais and Company |
KLAIS |
No |
No |
|
| |
Lake Forest Managed Care Associates |
37112 |
No |
No |
|
| |
Lakeside Health Services |
95415 |
No |
No |
|
| |
Landmark Healthcare |
LNDMK |
No |
No |
|
| |
Leggett and Platt |
75279 |
No |
No |
|
| |
LHP Claims Unit |
37248 |
No |
No |
|
| |
Liberty Union |
37281 |
No |
No |
|
| |
Life Assurance Company |
37281 |
No |
No |
|
| |
Life Trac |
41136 |
No |
No |
|
| |
LifeGuard |
94245 |
No |
No |
|
| |
LifeWise HealthPlan of Oregon |
93093 |
No |
No |
|
| |
LifeWise Washington/Employers Trust |
37294 |
No |
No |
Claims are printed and mailed to the payer |
| |
Lincoln National (EMPHESYS, Green Bay and Madison, WI only) |
73288 |
No |
No |
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 |
| |
Linn County |
75283 |
No |
No |
|
| |
Local 135 Health Benefits Fund (Indianapolis, IN) |
35107 |
No |
No |
|
| |
Loma Linda University Adventist Health Sciences Center Employee
Health Plan |
37267 |
No |
No |
|
| |
Loma
Linda University Adventist Health Sciences Centers |
37267 |
No |
No |
|
| |
Loma Linda University Behavioral Medicine Center Employee Health
Plan |
37267 |
No |
No |
|
| |
Loma Linda University Employee Health Plan |
37267 |
No |
No |
|
| |
Loma Linda University Health Care Employee Health Plan |
37267 |
No |
No |
|
| * |
Loma Linda University Helathcare - ManagedCare Claims |
33036 |
No |
No |
Claims are printed and mailed to the payer |
| |
Loma Linda Medical Center Employee Health Plan |
37267 |
No |
No |
|
| |
Loma Linda University Medical Center Residents Health Plan |
37267 |
No |
No |
|
| |
Loma Linda University Student Health Plan |
37267 |
No |
No |
|
| |
Lovelace Salud! (NM Medicaid) |
DLVLC |
No |
No |
|
| |
Lumenos, Inc |
54195 |
No |
No |
|
| |
Machinist District 9 Welfare |
37292 |
No |
No |
|
| |
Magellan Behavioral
Health |
01260 |
|
|
PROVIDER ID REQUIRED |
| |
Magnacare |
Pilot |
No |
No |
|
| |
Mail Handlers Benefit Plan |
62413 |
No |
No |
|
| |
MAMSI Life and Health Insurance Co. (MLH) |
52148 |
No |
No |
Also known as Mailhandlers/CAC. |
| |
Managed Care Services, LLC |
35162 |
No |
No |
|
| |
Managed Health Services Indiana (Medicaid HMO) |
39186 |
|
|
Please contact Debbie Sandberg at (800)225-2573 ext 25306, prior
to sending claims |
| |
Managed Health Services Wisconsin |
39187 |
No |
No |
|
| |
Managed Physical Network (MPN) |
41159 |
No |
No |
|
| |
Manatee Service Center (Bradenton, FL) |
41555 |
No |
No |
Payer ID valid only fo claims with a billing submission address
of P.O. Box 1098, Brandenton, FL 34206 |
| |
MAPCO Inc. |
75258 |
No |
No |
|
| |
Marriott |
68241 |
No |
No |
|
| |
Matthew Thornton Health Plan |
02030 |
No |
No |
|
| |
Maryland Health Partners |
SX069 |
E |
No |
Contact Bouveia Porter at Maryland Health Partners
410-953-1836 or beporter@magellan health.com |
| |
Mashantucket Pequot Tribal Nation |
37121 |
No |
No |
|
| |
Mayo Management Services, Inc. |
41154 |
No |
No |
|
| |
MBS (MedCost Benefit Services) |
56205 |
No |
No |
|
| |
MCC Behavioral Care |
MCCBV |
No |
No |
|
| |
Mcare |
38264 |
No |
No |
|
| |
McLaren Health Plan |
38338 |
No |
No |
|
| |
MD - Individual Practice Association, Inc. (M.D. IPA) |
52148 |
No |
No |
For plan and claim requirements, please contact the McCreary
Corporation Customer Service Department at (561) 287-7650, ext.
4052. |
| |
MDNY HealthCare |
11338 |
No |
No |
|
| |
MedAdmin Solutions |
58202 |
No |
No |
|
| |
MedAdmin Solutions |
58204 |
No |
No |
|
| |
MedBen (Newark, OH) |
74323 |
No |
No |
|
| |
MedCost, Inc. |
56162 |
No |
No |
For assistance please contact Medcost at (800)433-9178 ext 4189
or 4177 |
| |
Medfocus |
95321 |
No |
No |
|
| |
Medica |
94265 |
No |
No |
Medica requires a unique Medica assigned provider id. See ENVOY
Exhibit 99. |
| |
Medical Benefits Administrators, Inc. (Newark, OH) |
74323 |
No |
No |
|
| |
Medical Benefits Companies (Newark, OH) |
74323 |
No |
No |
|
| |
Medical Benefits Mutual (Newark, OH) |
74323 |
No |
No |
|
| |
Medical Benefits Mutual Life Insurance Co |
74323 |
No |
No |
|
| |
Medical Claims Service, Inc. |
04258 |
No |
No |
|
| |
Medical Network Inc. (Maine) |
Pilot |
No |
No |
|
| |
Medical Network of Colorado Springs |
CSMED |
No |
No |
|
| |
Medical Resource Network (MRN) |
58203 |
No |
No |
|
| |
Medical Select Management |
13375 |
No |
No |
|
| |
Medical Value Plan - Ohio (MVP) |
38224 |
No |
No |
|
| |
Medicare Extra |
95436 |
No |
No |
|
| |
Medicare Smart |
58228 |
No |
No |
|
| * |
Mediversal |
37304 |
No |
No |
|
| |
MedSolutions, Inc |
62160 |
No |
No |
|
| |
Medspan, Inc. |
82160 |
No |
No |
|
| |
Mega Life & Health Insurance Company |
59221 |
No |
No |
Payer ID valid only if the address on the Health ID Card matches
the following: P.O. Box 982009, North Richland Hills, TX 76182 |
| * |
Mega Life & Health Insurance Company - OKC |
59227 |
No |
No |
Claims will be printed and mailed until further notice |
| |
Memphis Managed Care |
36193 |
No |
No |
Providers are no longer required to call MMC before sending
medical or hospital claims electronically |
| |
Mercy Care Plan |
86052 |
No |
No |
|
| |
Mercy Health Plans |
43166 |
No |
No |
|
| |
Mercy Healthplans - Carechoices Michigan |
Pilot |
No |
No |
|
| |
Mercy Physicians Medical Group |
33029 |
P |
T |
Please contact the EDI Dept for North American Medical
Management (NAMM) - Southern California Lead Supervisor at 1-800-956-8000
prior to initial submission of claims |
| |
Meridian Health Care Management |
77042 |
No |
No |
|
| |
MESA Mental Health |
85035 |
No |
No |
|
| |
Met Elect |
65978 |
No |
No |
|
| |
Methodist Associate Health Plan |
Pilot |
No |
No |
|
| |
Metlife HealthCare- PPO/HMO |
65978 |
No |
No |
|
| |
Metro Alliance |
82135 |
No |
No |
|
| |
Metro Plus Health Plan |
13265 |
No |
No |
|
| |
Metropolitian Health Plan |
10850 |
No |
No |
|
| |
Michael Reese Physicians Group |
37127 |
No |
No |
|
| |
Mid Atlantic Psychiatric Services, Inc. (MAPSI) |
52149 |
No |
No |
|
| |
Mid America Associates, Inc |
37281 |
No |
No |
|
| |
Mid-Atlantic Health System |
63079 |
No |
No |
|
| |
Midwest National Life Insurance Co. of Tennessee - Insurance
Center |
59224 |
No |
No |
Payer ID valid only if the address on the Health ID Card matches
the following: P.O. Box 982017, North Richland Hills, TX 76182 |
| |
Mid-West National Life Insurance Co of Tennessee - Student
Insurance |
74227 |
No |
No |
Payer ID only valid if the P.O. Box on the Health ID Card
matches of the following P.O. Boxes: P.O. Box 890025, 809079, 809066,
809036,809081, Dallas, TX 75380-9025 |
| |
Midlands Benefit Administrators |
47081 |
No |
No |
|
| |
Midlands Choice, Inc |
47080 |
No |
No |
|
| |
MidSouth Administrative Group |
62168 |
No |
No |
|
| |
Mid-Valley Carenet |
31140 |
No |
No |
|
| |
Midwest Prefered |
MIDSC |
