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List of Automatic Crossover Trading Partner (Insurers) In ProductionDo Not Include Number Shown Below on Incoming ClaimsCoordination of Benefits AgreementNational Crossover ProcessSupplemental Payers and Insurers (Trading Partners)Trading PartnerGROUP HEALTH, INC. (GHI)- HMO - SUPPLEMENTALWELLMARK BCBS (FEP)WELLMARK BCBS OF IOWA (FEP)WELLMARK BCBS OF IOWA (FEP)WELLMARK BCBS OF IOWA (FEP)THE REGENCE GROUP (IDAHO-FEHBP)THE REGENCE GROUP (BLUE SHIELD--FEHBP)THE REGENCE GROUP (UTAH--FEHBP)THE REGENCE GROUP (OREGON--FEHBP)MONUMENTAL LIFE INSURANCE CO. (FORMERLY UNDER AEGON) - SUPPLEMENTALCONNECTICUT GENERAL LIFE INSURANCE CO. (CIGNA)HORIZON BCBS OF NJ - SUPPLEMENTALWELLMARK BCBS OF IOWAWELLMARK BCBS OF SDWELLMARK BCBS OF SDWISCONSIN PHYSICIAN SERVICES - COMMERCIALWISCONSIN PHYSICIAN SERVICES - COMMERCIALBCBS OF MICHIGANBCBS OF ALABAMA - SUPPLEMENTALBCBS OF SOUTH CAROLINA - SUPPLEMENTALHIGHMARK, INC. - SUPPLEMENTAL PART B & DMERCHIGHMARK, INC. - SUPPLEMENTAL PART A ONLYGROUP HEALTH, INC. (GHI) PPO - SUPPLEMENTALGROUP HEALTH, INC. (GHI) PPO - SUPPLEMENTALGROUP HEALTH, INC. (GHI) PPO - SUPPLEMENTALGROUP HEALTH, INC. (GHI) PPO - SUPPLEMENTALGROUP HEALTH, INC. (GHI) PPO - SUPPLEMENTALGROUP HEALTH, INC. (GHI) PPO - SUPPLEMENTALHEALTH CARE SERVICES CORPORATION (HCSC) BCBS OF ILLINOIS - SUPPLEMENTALHEALTH CARE SERVICES CORPORATION (HCSC) BCBS OF NEW MEXICO - SUPPLEMENTALHEALTH CARE SERVICES CORPORATION (HCSC) BCBS OF TEXAS- SUPPLEMENTALBCBS OF MICHIGANAETNA, INC.BCBS OF MICHIGANBCBS OF MICHIGAN - BCN (BLUE CARE NETWORK)BLUE CROSS AND BLUE OF MISSISSIPPI - SUPPLEMENTALBLUE CROSS AND BLUE OF MISSISSIPPI - SUPPLEMENTALBLUE CROSS OF NORTHEASTERN PA - SUPPLEMENTAL (PART A ONLY)BLUE CROSS OF NORTHEASTERN PA - SUPPLEMENTAL (PART A ONLY)METROPOLITAN HEALTH PLAN - SUPPLEMENTALPRIMEWEST HEALTH PLAN - SUPPLEMENTALPRIMEWEST HEALTH PLAN - SUPPLEMENTALUpdated: 01/31/2015Identification 0070000720007300073Customer ContactCustomer ServiceCustomer/Provider ServicesProvider ServicesCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer/Provider ServicesCustomer/Provider ServicesCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer/Provider ServicesCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCathy StitzerCathy StitzerBonnie HaysProvider ServicesMary WinterContact 0-335-5239
List of Automatic Crossover Trading Partner (Insurers) In ProductionDo Not Include Number Shown Below on Incoming ClaimsCoordination of Benefits AgreementNational Crossover ProcessSupplemental Payers and Insurers (Trading Partners)Trading PartnerTRIPLE S, INC. - SUPPLEMENTALCAREFIRST OF DC - PART A ONLYCAREFIRST OF DC - PART B ONLYBCBS OF NORTH DAKOTABCBS OF WYOMING - SUPPLEMENTAL (PART B & DMERC)BCBS OF NORTH DAKOTAMEDICAL MUTUAL OF OHIO - SUPPLEMENTALBCBS OF TENNESSEE - SUPPLEMENTALUNITED HEALTH CARE-UNET - SUPPLEMENTALUNITED HEALTH CARE - SUPPLEMENTALGROUP HEALTH COOPERATIVE - SUPPLEMENTALBLUE CROSS AND BLUE SHIELD OF MINNESOTA - SUPPLEMENTALBLUE CROSS AND BLUE SHIELD OF MINNESOTA - SUPPLEMENTALBLUE CROSS AND BLUE SHIELD OF MINNESOTA - SUPPLEMENTALEMPIRE BCBS - SUPPLEMENTALEMPIRE BCBS - SUPPLEMENTALBCBS OF KANSAS - SUPPLEMENTALKPS HEALTH PLANS- SUPPLEMENTALANTHEM BCBS OF CT - SUPPLEMENTALANTHEM BCBS OF NH - SUPPLEMENTALANTHEM BCBS OF ME - SUPPLEMENTALBCBS OF LOUISIANA - SUPPLEMENTALNEW JERSEY CARPENTERS HEALTH FUND - SUPPLEMENTALMAYO MEDICAL SYSTEMS, INC. (MMSI) - SUPPLEMENTALWEA INSURANCE COMPANY - SUPPLEMENTALCAREFIRST OF DC - SUPPLEMENTALCAREFIRST OF DC - SUPPLEMENTALCAREFIRST OF MD - SUPPLEMENTALEMPIRE BCBS - SUPPLEMENTALEMPIRE BCBS - SUPPLEMENTALCARPENTERS TRUST OF WESTERN WASHINGTONBLUE SHIELD OF CALIFORNIA - SUPPLEMENTALBCBS OF NORTH CAROLINACAPITAL BLUE CROSS - SUPPLEMENTALBCBS OF WESTERN NEW YORK - SUPPLEMENTALBCBS OF WESTERN NEW YORK - SUPPLEMENTALBCBS OF WESTERN NEW YORK - SUPPLEMENTALBCBS OF WESTERN NEW YORK - SUPPLEMENTALBCBS OF WESTERN NEW YORK - SUPPLEMENTALBCBS OF WESTERN NEW YORK - SUPPLEMENTALBCBS OF WESTERN NEW YORK - SUPPLEMENTALBLUE CROSS AND BLUE SHIELD OF DELAWARE - SUPPLEMENTALUpdated: 01/31/2015Identification 0115001150011600118Customer ContactJeannette Irizarry VelezProvider ServicesProvider ServicesGina BercherlAmber ZowadaGina BercherlSue RobinsonCustomer ServiceCustomer ServiceCustomer ServiceKim MitchellCustomer ServiceCustomer ServiceCustomer ServiceAnnie Pressley-MitchellAnnie Pressley-MitchellCustomer ServiceTeresa Hiagh-BragetAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellCustomer ServiceRachel CorradiCustomer ServiceSheryl ShilbauerPart A onlyPart B onlyPart B onlyCustomer ServiceCustomer ServiceMin-Sug (Darren) KongTammy RutterseSolutions Help DeskNancy HermanBuffalo (CNY West)Albany Region IIAlbany (CNY East)Traditional MemberManaged Care MemberProvider ServicesMelissa DebothCustomer ServiceContact 848-2185800-392-4089732-417-3900 ext. 44-4552716-887-8443302-429-0260
List of Automatic Crossover Trading Partner (Insurers) In ProductionDo Not Include Number Shown Below on Incoming ClaimsCoordination of Benefits AgreementNational Crossover ProcessSupplemental Payers and Insurers (Trading Partners)Trading PartnerHEALTH ALLIANCE PLAN OF MICHIGAN - SUPPLEMENTALBCBS OF ARIZONA - SUPPLEMENTALMARSH AFFINITY GROUP SERVICESALLEGIANCE BENEFIT PLAN MANAGEMENTEMPLOYEE BENEFIT MANAGEMENT CARE - SUPPLEMENTALANTHEM BCBS-CENTRAL (FACETS) -IN, KY, OH - SUPPLEMENTALHEALTH DESIGN PLUSANTHEM NATIONAL BCBS OF OHIO - SUPPLEMENTALANTHEM NATIONAL BCBS OF KENTUCKY - SUPPLEMENTALANTHEM NATIONAL BCBS OF INDIANA - SUPPLEMENTALANTHEM BCBS OF ME - SUPPLEMENTALANTHEM BCBS OF NH - SUPPLEMENTALANTHEM BCBS OF CT - SUPPLEMENTALEXCELLUS HEALTH PLAN (INCLUDING BCBS OF UTICA, SYRACUSE, & ROCHESTER) - SUPPLEMENTALIdentification 013400136001390014000141Customer ContactKenny DodsonLisa PeppersContact Number248-443-2036602-864-4018Customer ServiceCustomer ServiceCustomer ServiceCustomer ServiceAnnie Pressley-MitchellCustomer ServiceCustomer ServiceAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie ol BumpJill Kohler315-671-6807315-272-121000147Jill 183001840018500188001880018900190Part A onlyEDI DepartmentAngela WinstoneSolutions Help DeskDee McKeeCustomer ServiceAndy GlanklerCindy CargoTeresa BauerAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellCustomer ServiceAmy CookReta WeaverCustomer ServiceCustomer ServiceCustomer ServiceOutside ILIL ResidentCustomer ServiceCustomer -906-8080800-521-1555800-543-7822EXCELLUS HEALTH PLAN (INCLUDING BCBS OF UTICA, SYRACUSE, & ROCHESTER) - SUPPLEMENTALEXCELLUS HEALTH PLAN (INCLUDING BCBS OF UTICA, SYRACUSE, & ROCHESTER) - SUPPLEMENTALANTHEM BCBS OF VIRGINIA - SUPPLEMENTALODS HEALTH PLANS, INC. - SUPPLEMENTALARKANSAS BCBS - SUPPLEMENTALBCBS OF NORTH CAROLINAARKANSAS BCBS (HEALTH ADVANTAGE) - SUPPLEMENTALNATIONWIDE HEALTH PLANS - SUPPLEMENTALPITTMAN & ASSOCIATES, INC. - SUPPLEMENTALHEALTH ALLIANCE MEDICAL PLANS - SUPPLEMENTALGRAPHIC COMMUNICATIONS NAT'LANTHEM BCBS OF NEVADAANTHEM BCBS OF COLORADOBLUE CROSS OF CALIFORNIA - SUPPLEMENTALUNICARE LIFE & HEALTH INSURANCE COMPANY - SUPPLEMENTALHEALTHNET, INC-- CA -SUPPLEMENTALINSURANCE PROGRAMMERS INC.RESERVE NATIONAL INSURANCE COAMA INSURANCE AGENCY, INC. - SUPPLEMENTALBC OF IDAHO - SUPPLEMENTALBC OF IDAHO - SUPPLEMENTALALLIED BENEFIT SYSTEMS, INC - SUPPLEMENTALALLIED BENEFIT SYSTEMS, INC - SUPPLEMENTALNGS AMERICAN - SUPPLEMENTALHIGHMARK WEST VIRGINIAUpdated: 01/31/2015
List of Automatic Crossover Trading Partner (Insurers) In ProductionDo Not Include Number Shown Below on Incoming ClaimsCoordination of Benefits AgreementNational Crossover ProcessSupplemental Payers and Insurers (Trading Partners)Trading PartnerHIGHMARK WEST VIRGINIAUMRPENNSYLVANIA EMPLOYEE BENEFIT TRUST FUND (PEBTF) - SUPPLEMENTALPENNSYLVANIA EMPLOYEE BENEFIT TRUST FUND (PEBTF) - SUPPLEMENTALPREMERA BLUE CROSS - SUPPLEMENTALPOMCO, INC. - SUPPLEMENTALBCBS OF MASSHEALTHSMARTBCBS OF VERMONT - SUPPLEMENTALOXFORD HEALTH - SUPPLEMENTALUNITED HEALTH CARE- COSMOS - SUPPLEMENTALC & R CONSULTING - SUPPLEMENTALCORESOURCE, INC. - SUPPLEMENTALCORESOURCE, INC. - SUPPLEMENTALCORESOURCE, INC. - SUPPLEMENTALBCBS OF KANSAS CITYBCBS OF RHODE ISLANDUNITED HEALTHCARE (SUPPLEMENTAL)MERITAIN HEALTH, INC.ASURISREGENCE BLUESHIELD OF UTAHREGENCE BLUESHIELDREGENCE BCBS OF OREGONREGENCE BLUESHIELD OF IDAHOCLAIMSNET.COM, INC. - SUPPLEMENTALHEALTH CARE SERVICES CORPORATION (HCSC) BCBS OF ILLINOIS - SUPPLEMENTALHEALTH CARE SERVICES CORPORATION (HCSC) BCBS OF NEW MEXICO - SUPPLEMENTALHEALTH CARE SERVICES CORPORATION (HCSC) BCBS OF TEXAS- SUPPLEMENTALKIDNEY DISEASE PROGRAM OF MARYLAND - SUPPLEMENTALAMALGAMATED LIFE/ALICARE - SUPPLEMENTALHUMANA, INC. - SUPPLEMENTALJP FARLEYBCBS OF MONTANAKEY BENEFITS ADMINISTRATORS - SUPPLEMENTALCOMPREHENSIVE BENEFITS CONSULTANTS (A.K.A. "FEDERATED ALLIED RETIREE ASSOCIATION")SUPPLEMENTALUCARE MINNESOTA - SUPPLEMENTALUCARE MINNESOTA - SUPPLEMENTALC & O EMPLOYEE HOSPITAL - SUPPLEMENTALBCBS OF NORTH CAROLINAPIPE FITTERS WELFARE FUNDCONNECTICUT GENERAL LIFE INSURANCE CO. (CIGNA)Updated: 01/31/2015Identification 02980029900300Customer ContactCustomer ServiceCustomer ServiceRest of U.S.In PennsylvaniaCustomer ServiceVivie PrichardCustomer ServiceContact 7410800-722-1471800-830-2528800-258-2226Chantal ParentCustomer ServiceStewart McGeheeC&R CustomerOne Beacon Ins GrpCrompton CorpAll othersKathy CurreyCustomer ServiceStewart McGeheeCustomer ServiceRebecca ThornRebecca ThornRebecca ThornRebecca ThornRebecca ThornCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCarol ManningCustomer ServiceCustomer ServiceAmanda SmolkaTeha HatfieldBrooke CurrenceLorraine 0792866-889-7286866-318 49-0500Provider Customer ServiceMember AssistanceAnna BrooksESolutions Help 8594Customer Service800-244-6224
List of Automatic Crossover Trading Partner (Insurers) In ProductionDo Not Include Number Shown Below on Incoming ClaimsCoordination of Benefits AgreementNational Crossover ProcessSupplemental Payers and Insurers (Trading Partners)Trading PartnerPLUMBER LOCAL 130 UANATIONAL ELEVATOR INDUSTRY HEALTH BEBCBS OF NORTH CAROLINAANTHEM BCBS OF VIRGINIA - SUPPLEMENTALTHE LOOMIS COMPANYBCBS OF WYOMING -(PART A)WEB TPASECURITY HEALTH PLAN OF WI, INC.HEALTH CARE SERVICES CORPORATION (HCSC) BCBS OF OK (OTHER A ONLY)HEALTH CARE SERVICES CORPORATION (HCSC) BCBS OF OK (OTHER B ONLY)CAPITOL DISTRICT PHYSICIANS’ HEALTH PLANWEBTPA EMPLOYER SERVICESRMSCO INCTIC – BAC LOCAL UNION 15 W.F.TIC – IBEW LOCAL 117 HEALTH W.F.TIC – IBEW LOCAL 461 WELFARE FUNDTIC – UFCW LOCAL 400 HEALTH W.F.TIC – ELECTRICAL WORKERS FUNDBLUE CROSS OF NORTHEASTERN PABLUE CROSS OF NORTHEASTERN PABLUE CROSS OF NORTHEASTERN PABLUE CARE COOPERATIVEPLUMBERS’ AND PIPEFITTERS’ WELFARE FUNDDANA NON UNION RETIREE VEBA TRUSTBLUE CROSS OF NORTHEASTERN PAG.M.P. - EMPLOYERS RETIREE TRUSTMEDICA (PART B ONLY)MEDICA (PART A ONLY)UMR ONALASKACONNECTICUT GENERAL LIFE INSURANCE CO.VANTAGE HEALTH PLAN, INC.BCBS OF MINNESOTABCBS OF MINNESOTABCBS OF MINNESOTABCBS OF MINNESOTABCBS OF MINNESOTAAVMED HEALTH PLANSPIPELINE INDUSTRY BENEFIT FUNDTHE WILLIAM C. EARHART CO., INCMID CENTRAL OPERATING ENGINEERS HEALTH & WELFARE FUNDSOUTHWEST LIFE & HEALTH INS. CO.FIRSTCAREUpdated: 01/31/2015Identification 0374003750037700378Customer ContactContact NumberESolutions Help DeskMichael Bristoe1-888-333-8594502-727-7280Amber ZowadaLisa SmithShelia Nelson-SeyboldCustomer ServiceCustomer ServiceBrian FreerLisa SmithJen SpringlerMichelle CockerhamAmy PierceSusan EsterhaiLinda JividenJackie NeibleCathy StitzerCathy StitzerCathy StitzerCathy StitzerNancy WinerLorraine PiazzaCathy StitzerAmy ThomasStephanie KellyStephanie KellyWendy WiggertCustomer ServiceProvider RelationsCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceLuis ArangurenClaims SupervisorPam FleischmanKatricia HeltonMelinda RodriguezMelinda 244-6224318-361-0900 X 12-232-4384806-784-4378806-784-4378
List of Automatic Crossover Trading Partner (Insurers) In ProductionDo Not Include Number Shown Below on Incoming ClaimsCoordination of Benefits AgreementNational Crossover ProcessSupplemental Payers and Insurers (Trading Partners)Trading PartnerWABASH MEMORIAL HOSPITAL ASSOC.AMERICAN BENEFIT CORPORATIONTIC – NECA IBEW LOCAL 364 HEALTHRIGHT CHOICE BENEFIT ADMIN.BCBS OF NEBRASKABCBS OF NEBRASKAHP ADMINISTATIVE SERVICES, LLCADC 1 WELFARE FUNDBLUE SHIELD OF CALIFORNIA - SFEWIE SCHAFFER & COC & R CONSULTINGARKANSAS BCBSCOVENTRY NATIONAL ACCOUNTSEMBLEMHEALTH SVC CO. LLC - VYTRAEMBLEMHEALTH SVC COMPANY, LLC - HIPM.C.D.C HEALTH FUNDPLUMBERS & PIPEFITTERS LOCAL 630OE LOCAL 139 HBFPIPE TRADES INDUSTRY H&W PLANHEALTHNET OF ARIZONA, INC.HEALTHNET OF THE NORTHEAST, INC.C&R CONSULTINGBLUE SHIELD OF CALIFORNIASCPT HEALTH & WELFARE FUNDLIBERTY NATIONAL LIFE INSURANCE CO. - GMSGUNDERSEN LUTHERAN HEALTH PLANSENTARA HEALTH PLANS INC.INDIANA LABORERS WELFARE FUNDINDIANA LABORERS WELFARE FUNDAMERICAN BENEFIT CORPORATIONBCBS OF LOUISIANAHEALTH CARE SERVICE CORP, BCBSHEALTH CARE SERVICE CORP, BCBSKAISER FOUNDATION HEALTH PLANINDEPENDENCE BLUE CROSSOPERATING ENGINEERS H&W FUNDTIC-NECA IBEW LCL 150 FRINGE BFUMR SAN ANTONIOFABIAN & BYRN LLCDELTA HEALTH SERVICES, INC.Updated: 01/31/2015Identification 046700470Customer ContactDebby KunzeLinda SitesMedical Claims DepartmentCustomer Service Right ChoiceCustomer Service CenterCustomer Service CenterJenny RayYolanda AlzatiLisa SchultzTerri TrasattiContact 30415-263-3670609-883-6688Angela WinstonCustomer ServiceRobyn CallahanRobyn CallahanSandra BelotAmanda RatcliffAnnette KusickPam LewisHealthnet Provider ServiceHealthnet Provider 581800-977-7522800-438-7886Tammy RuttersMarcus ChinCustomer Service DepartmentAnn KielTodd KellyMelissa WadeMelissa WadeLinda SitesCustomer ServiceBlue Cross Blue ShieldBlue Cross Blue ShieldMember ServiceSharelle BondElisabeth SchaeferJan SmithCustomer ServiceTalisha DouglasChristine 3653973-228-4200559-228-4185
List of Automatic Crossover Trading Partner (Insurers) In ProductionDo Not Include Number Shown Below on Incoming ClaimsCoordination of Benefits AgreementNational Crossover ProcessSupplemental Payers and Insurers (Trading Partners)Trading PartnerEXCELLUS HEALTH PLANSHARRINGTON HEALTH SERVICES, INC.NECA FAMILY MEDICAL CARE PLANBLUE CROSS BLUE SHIELD OF GA KCSUPBLUE CROSS BLUE SHIELD OF GA KCSUPEIGHTH DISTRICT ELECTRICAL BENEFMEDICAL ASSOC HEALTH PLAN INCWEST MICH. PLUMBERS, FITTERSNATIONAL BCBS GEORGIADESERET MUTUALWISCONSIN PHYSICIANS SERVICEWISCONSIN PHYSICIANS SERVICEIAHFI LOCAL 17 WELFARE FUNDHEALTHLINK HMO, INCINDEPENDENCE BLUE CROSSPEHPHEALTH CARE SERVICE CORPORATIONHEALTH CARE SERVICE CORPORATIONWELLMARK BCBS OF SDWELLMARK BCBS OF IAMIDWEST OPERATING ENGINEERS HEALTHNEW YORK ISGNEVADA ISGMAINE ISGWISSONSIN ISGKENTUCKY ISGVIRGINIA ISGNEW HAMPSHIRE ISGMISSOURI ISGOHIO ISGCALIFORNIA ISGCOLORADO ISGCONNECTICUT ISGINDIANA ISGCONNECTICUT WGSINDIANA WGSKENTUCKY WGSMISSOURI WGSNEW YORK WGSOHIO WGSVIRGINIA WGSWISCONSIN WGSUpdated: 01/31/2015Identification 0528005290053000531Customer ContactMichael SirniCustomer ServiceVicki BurrowsAnnie Pressley-MitchellMichael BristoeMary KempLaura BogeCustomer ServiceAnnie Pressley-MitchellDonna McreavyKit LeeKit LeeWilliam ManginKaren GotschSharelle BondJosie HallBlue Cross/Blue ShieldBlue Cross/Blue ShieldCustomer/Provider ServicesCustomer/Provider ServicesBarbara GlembinAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellContact 0-401-4677
List of Automatic Crossover Trading Partner (Insurers) In ProductionDo Not Include Number Shown Below on Incoming ClaimsCoordination of Benefits AgreementNational Crossover ProcessSupplemental Payers and Insurers (Trading Partners)Trading PartnerMONUMENTAL LIFE INSURANCE CO.AARP/UNITED HEALTH CARE (DOING BUSINESS AS “UNITED HEALTH GROUP”) MEDIGAPWELLMARK BCBS OF SDWELLMARK BCBS OF IAMONUMENTAL LIFE INSURANCE CO. (FORMERLY UNDER AEGON) MEDIGAPHORIZON BCBS OF NJ - MEDIGAPBCBS OF MICHIGANBCBS OF SCHIGHMARK, INC. - MEDIGAP PAT B & DMERCHIGHMARK, INC. - MEDIGAP PART A ONLYGROUP HEALTH, INC. (GHI) PPO - MEDIGAPGROUP HEALTH, INC. (GHI) PPO - MEDIGAPHEALTH CARE SERVICES CORPORATION (HCSC) BCBS OF ILLINOIS - MEDIGAPHEALTH CARE SERVICES CORPORATION (HCSC) BCBS OF ILLINOIS - MEDIGAPHEALTH CARE SERVICES CORPORATION (HCSC) BCBS OF NEW MEXICO - MEDIGAPHEALTH CARE SERVICES CORPORATION (HCSC) BCBS OF NEW MEXICO - MEDIGAPHEALTH CARE SERVICES CORPORATION (HCSC) BCBS OF TEXAS- MEDIGAPHEALTH CARE SERVICES CORPORATION (HCSC) BCBS OF TEXAS- MEDIGAPLIBERTY NATIONAL LIFE INSURANCE CO. (AFFILIATED WITH TORCHMARK)LIBERTY NATIONAL LIFE INSURANCE CO. (AFFILIATED WITH TORCHMARK)GLOBAL LIFE & ACCIDENT INSURANCE CO. (AFFILIATED WITH TORCHMARK)AMERICAN INCOME LIFE INSURANCE CO. (AFFILIATED WITH TORCHMARK)UNITED AMERICAN INSURANCE COMPANY (TORCHMARK) - MEDIGAPFIRST UNITED AMERICAN LIFE INS. CO.EQUITABLE LIFE & CASUALITY INS. CO.BLUE CROSS AND BLUE OF MISSISSIPPI - MEDIGAPBLUE CROSS OF NORTHEASTERN PA - MEDIGAP (PART A ONLY)BLUE CROSS OF NORTHEASTERN PA - MEDIGAP (PART A ONLY)TRIPLE S, INC. - MEDIGAPBCBS OF WYOMING - MEDIGAP (PART A, B, DMERC)BCBS OF NORTH DAKOTABCBS OF TENNESSEE - MEDIGAPUNITED COMMERCIAL TRAVELERS - MEDIGAPSTANDARD LIFE ACCIDENT INSURANCE COMPANY (SLA) - MEDIGAPSLA/AMERICAN NATIONAL LIFE INSURANCE CO. (ANICO) OF TEXAS - MEDIGAPLOYALAM/UNITEDTEACH/GREATAMLIFEGUARANTEE TRUST LIFE INSURANCE COMPANY - MEDIGAP (DMERC IN ALL STATES AND PART-B INALL STATES EXCEPT MN AND WI)EMPIRE BCBS - MEDIGAPBLUE CROSS AND BLUE SHIELD OF MINNESOTA - MEDIGAPBLUE CROSS AND BLUE SHIELD OF MINNESOTA - MEDIGAPBLUE CROSS AND BLUE SHIELD OF MINNESOTA - MEDIGAPUpdated: 01/31/2015Identification 00573005830059Customer ContactChristine TurmanCustomer ServiceCustomer/Provider ServicesProvider ServicesChristine TurmanCustomer ServiceCustomer ServiceJudith MurrayCustomer ServiceCustomer ServiceGeraldine HolmesGeraldine HolmesCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceLaura SarleCustomer ServiceCathy StitzerCathy StitzerJeannette Irizarry VelezAmber ZowadaGina BercherlVenessa MarshDoris GunnJill DavisJill DavisCustomer ServiceMark PytelAnnie Pressley-MitchellMN onlynon-MNDMERC onlyContact 4-848-2185800-531-6686800-531-6686800-531-6686
List of Automatic Crossover Trading Partner (Insurers) In ProductionDo Not Include Number Shown Below on Incoming ClaimsCoordination of Benefits AgreementNational Crossover ProcessSupplemental Payers and Insurers (Trading Partners)Trading PartnerMEDICAL MUTUAL OF OHIO - MEDIGAPKANSAS BCBS - MEDIGAPPROVIDENCE HEALTH PLANKPS HEALTH PLANS- MEDIGAP (PART B ONLY)BANKERS LIFE AD CASUALITYCONSECO SERVICES, LLC - MEDIGAPANTHEM BCBS NORTHEAST REGIONCONSECO, LLC/ COLONIAL PENN -MEDIGAPSANDFORD HEALTH PLAN OF MINNESOTA - MEDIGAPSANFORD HEALTH PLANHEALTH ALLIANCE MEDICAL PLANS OF URBANA, IL - MEDIGAPCONTINENTAL LIFE INS. CO OF BRENTWOOD, TN - MEDIGAPAMERICAN CONTINENTAL INSURANCEPHYSICIANS MUTUAL INSURANCE COMPANY - MEDIGAPDEAN HEALTH PLAN, INC. - MEDIGAPCAREFIRST OF MD (PART A ONLY) - MEDIGAPPARAMOUNT HEALTH PLANS - MEDIGAPUPMC FOR LIFE MEDICARE SELECT - MEDIGAPBLUE SHIELD OF CALIFORNIA - MEDIGAPBCBS OF NORTH CAROLINACAPITAL BLUE CROSSBLUE CROSS BLUE SHIELD OF WNYBLUE CROSS BLUE SHIELD OF WNYMUTUAL OF OMAHA INSURANCE COMPMUTUAL OF OMAHA INSURANCE COMPBLUE CROSS AND BLUE SHIELD OF DELAWARE - SUPPLEMENTALEVERENCE ASSN A FRATERNALBCBS OF ARIZONA - MEDIGAPSIERRA HEALTH & LIFE - MEDIGAPBCBS OF NORTH DAKOTAANTHEM BCBS-CENTRAL (FACETS) - IN, KY, OH - MEDIGAPGUARANTEE TRUST LIFE INSURANCE COMPANY - MEDIGAP (PART-B IN MN AND WI ONLY)ANTHEM BCBS OF VIRGINIA - MEDIGAPANTHEM BCBS OF VIRGINIA - MEDIGAPANTHEM BCBS NORTHEAST REGIONODS HEALTH PLANS, INC. - MEDIGAPARKANSAS BCBS - MEDIGAPINDEPENDENCE BLUE CROSS - MEDIGAPCENTRAL UNITED LIFE INSURANCE COMPANY - MADIGANAFLAC OF CO - MEDIGAPAFLAC OF NY - MEDIGAPUpdated: 01/31/2015Identification 01113011330114Customer ContactSue RobinsonCustomer ServiceCustomer ServiceTeresa Hiagh-BragetCustomer ServiceCustomer ServiceAnnie Pressley-MitchellCustomer ServiceTami HabererTami HabererCindy CargoKatrina SmithsonKatrina SmithsonAlan SchoeningMurielle SagoProvider ServicesDonya HensleyRon LocyTammy RuttersPam StephensonNancy HermanMelissa DebothMelissa DebothCustomer ServiceCustomer ServiceCustomer ServiceCustomer ServiceLisa PeppersContact 5-1000302-429-0260574-533-9511 ext. 380602-864-4018Gina BercherlAnne Pressley-MitchellMark PytelAnnie Pressley-MitchellAnnie Pressley-MitchellAnnie Pressley-MitchellEDI DepartmentAngela WinstonSharelle BondCustomer ServiceCustomer ServiceCustomer 2
List of Automatic Crossover Trading Partner (Insurers) In ProductionDo Not Include Number Shown Below on Incoming ClaimsCoordination of Benefits AgreementNational Crossover ProcessSupplemental Payers and Insurers (Trading Partners)Trading PartnerHIGHMARK WEST VIRGINIAHIGHMARK WEST VIRGINIAUNIFIED LIFE INS. CO. - MEDIGAPANTHEM BCBS OF NEVADA - MEDIGAPANTHEM BCBS OF COLORADOBLUE CROSS OF CALIFORNIA - MEDIGAPUNIFCARE LIFE & HEALTH INSURANCE COMPANY - MEDIGAPHEALTHPLUS OF MICHIGAN - MEDIGAPRESERVE NATIONAL INSURANCE COAMA INSURANCE AGENCY, INC. - MEDIGAPAMERICAN INSURANCE ADMINISTRATORS - MEDIGAPBANKERS FIDELITY LIFE INS. CO. - MEDIGAPBC OF IDAHO - MEDIGAPBC OF IDAHO - MEDIGAPNORTH AMERICAN INSURANCEPEKIN LIFE INS. CO. - MEDIGAPSTATE FARM AUTOMOBILE INSURANCE COMPANY - MEDIGAPTHRIVENT FINANCIAL - MEDIGAPTHRIVENT FINANCIAL - MEDIGAPBCBS OF MASSBCBS OF VERMONT - MEDIGAPBCBS OF KANSAS CITYAMERICAN REPUBLIC INSURANCE COMPANY - MEDIGAPWORLD INSURANCECENTRAL STATES HEALTH & LIFE CO. OF OMAHA - MEDIGAPBCBS OF RHODE ISLANDMARSH AFFINITY GROUP SERVICES - MEDIGAPASURISREGENCE BLUESHIELD OF UTAHREGENCE BLUESHIELDREGENCE BLUESHIELD OF UTAHBCBS OF FLORIDA - MEDIGAP (FEP)BCBS OF FLORIDA - MEDIGAP (SUPPLEMENTAL)AMERI HEALTH ADMINISTRATOR- MEDIGAPCOMMUNITYCARE LIFE & HEALTH - MEDIGAPAMERICAN REPUBLIC INSURANCE COMPANY - MEDIGAPREGENCE BCBS OF OREGONBCBS OF WISCONSINBCBS OF WYOMING -(PART A)NATIONWIDE MUTUAL INS COAMERICAN REPUBLIC INSURANCE COMPANY - MEDIGAPUpdated: 01/31/2015Identification 02243022530227Customer ContactCustomer ServiceCustomer ServiceJana ShrumAnnie Pressley-MitchellAnne Pressley-MitchellAnnie Pressley-MitchellAnne Pressley-MitchellNicole SalgatReta WeaverCustomer ServiceBob FabbiContact 79800-654-9106800-458-5736727-726-0726Julie TauberCustomer ServiceCustomer ServiceRebecca FreemanRebecca FreemanDebra WilsonChantal ParentKathy CurreyCustomer ServiceCustomer ServiceMelissa MatthysAnne 9Rebecca ThornRebecca ThornRebecca ThornRebecca ThornCustomer ServiceCustomer -4341800-352-2583800-352-2583Roxanne KingCustomer ServiceRebecca ThornAnnie Pressley-MitchellAmber ZowadaTom LittonCustomer -2185307-432-2743614-677-3788800-247-2190
List of Automatic Crossover Trading Partner (Insurers) In ProductionDo Not Include Number Shown Below on Incoming ClaimsCoordination of Benefits AgreementNational Crossover P
kps health plans- supplemental; 00094. teresa hiagh-braget. 360-478-2635 anthem bcbs of ct . excellus health plan (including bcbs of utica, syracuse, & rochester) - supplemental: anthem bcbs of virginia - supplemental; 00148. part a . only : 800-451-0361 ods health plans, inc. - supplemental; 00150. edi department . 800-852-5195 arkansas bcbs .
