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CLAIMS & ERA PAYER LISTMay 07, 2021LEGEND:I Institutional, P Professional, D DentalCOB Coordination of BenefitsTransaction Column: 837 Claims, 835 ERAAvailable Column: A Check-mark indicates that the transaction type is available.Enrollment Column: A Check-mark indicates that enrollment is required for the transaction type.COB Column: A Check-mark Indicates that the payer accepts secondary claims electronically for the transaction type.Attachments: A Check-mark indicates that the payer accepts medical attachments electronically for the transaction type.Payer NameAvailablePayer CodeTransactionIP1199 National Benefit Fund13162837 1199 National Benefit Fund13162835 21st Century Health and Benefits59069837 6 Degrees Health20446837 A & I Benefit Plan Administrators93044837 A-G Administrators LLC11370837 A.G.I.A. Inc.95241837 AAG Benefit Plan Administrators Inc.75240837 EnrollmentDI PDIP 75185837 AARP - UnitedHealthcare Insurance Company36273837 AARP - UnitedHealthcare Insurance Company36273835 AblePay HealthABLPY837 AblePay HealthABLPY835 99999-0748837 ACC01837 Access IPAACC01835 Access Medicare19305837 Acclaim64071837 Acclaim64071835 Accountable Healthcare IPA (AHCIPA)AHIPA837 ACMG37118837 Experian Health Payer ListIPDEffective immediately, please send all claims for Payer 75185to HealthSmart Benefit Solutions (EDI Payer ID #37283).Claims submitted under payer ID 75185 will be subject toclaim rejection effective Q1 2019. Access IPAAccelerated Claims Inc.D AAG-American Administravie Group (Formerly Icon Benefit Admin) Attachments NotesCOB Page 1 of 103
Payer NameAvailablePayer CodeTransactionIPACS Benefit Services Inc.72467837 ACS Benefit Services Inc.72467835 Activa Benefit Services LLC38254837 Administration Systems Research Corporation38265837 Administration Systems Research CorporationTLU02835 Administrative Concepts Inc.22384837 Administrative Concepts Inc.22384835 Administrative Services Inc.59141837 ADVANCED DATA SOLUTIONS58202837 Advantage Care IPAACIPA837 Advantek Benefit Administrators83077837 Advantek Benefit Administrators83077835 ADVANTICA BENEFITS59374837 ADVANTICA BENEFITS59374835 Advanzeon Solutions59314837 Adventist HanfordMPM36837 Adventist Health Care NetworkMPM51837 95340837 Adventist Health System West - Roseville CAEnrollmentD IP 835 837 Advocate Medical Group - AMG (Legacy AHC)36320837 Advocate Medical Group - AMG (Legacy AHC)36320835 Advocate Physician Partners65093837 Advocate Physician Partners65093835 Aetna60054837 Aetna60054835 Aetna Better Health of California128CA837 Aetna Better Health of California128CA835 Aetna Better Health of Florida128FL837 Aetna Better Health of Florida25133835 Aetna Better Health of Illinois68024837 Aetna Better Health of Illinois68024835 Aetna Better Health of Kansas128KS837 Aetna Better Health of Kansas128KS835 Aetna Better Health of Kentucky128KY837 Experian Health Payer List D 95340Adventist White Memorial - Southland Gabriel ValleyPDIPDERA Payer Code TLU02MPM34Adventist Health System West - Roseville CAIAttachments NotesCOB ERA Payer Code 25133 Formerly IlliniCare Page 2 of 103
Payer NameAvailablePayer CodeTransactionIPAetna Better Health of Kentucky128KY835 Aetna Better Health of Louisiana128LA837 Aetna Better Health of Louisiana128LA835 Aetna Better Health of Maryland128MD837 Aetna Better Health of Maryland128MD835 Aetna Better Health of Michigan128MI837 Aetna Better Health of Michigan128MI835 42130837 25133835 Aetna Better Health of New Jersey46320837 Aetna Better Health of New Jersey46320835 Aetna Better Health of New York34734837 Aetna Better Health of New York34734835 Aetna Better Health of Ohio50023837 Aetna Better Health of Ohio50023835 Aetna Better Health of Pennsylvania23228837 Aetna Better Health of Pennsylvania23228835 Aetna Better Health of Texas (Medicaid & CHIP)38692837 Aetna Better Health of Texas (Medicaid & CHIP)38692835 Aetna Better Health of VirginiaAetna Better Health of Nebraska (for claims with DOS prior to 1/1/17)Aetna Better Health of Nebraska (for claims with DOS prior to 1/1/17)EnrollmentDIP 128VA837 Aetna Better Health of Virginia128VA835 Aetna Better Health of West Virginia128WV837 Aetna Better Health of West Virginia128WV835 Aetna Better Health Premier Plan (JVHL)M5JVH837 Aetna Better Health Premier Plan (JVHL)M5JVH835 Aetna Better Health Premier Plan MMAI26337837 Aetna Better Health Premier Plan MMAI26337835 Aetna U.S. Healthcare (JVHL)J1JVH837 J1JVH835 Aetna-Senior Supplemental Insurance (ERA Only)62118835 Affiliated Doctor's of Orange County ADOCS837POP09837Affiliated Physicians GroupAPG01837 Affinity Health Plan13334837 Experian Health Payer List DIPDERA Payer Code 25133 Aetna U.S. Healthcare (JVHL)Affiliated Partners IPAP I DAttachments NotesCOBProvider must be an approved JVHL labProvider must be an approved JVHL labERA Only Page 3 of 103
Payer NameAvailablePayer CodeTransactionIPAffinity Health Plan13334835 AFFINITY MEDICAL GROUP46594837 Affordable Benefit Administrators Inc.95426837 AFLAC (ERA Only)52080835 Agate Resources Inc. (LIPA)EnrollmentDIP 83764158837 AgeRight AdvantageARA01837 AgeRight AdvantageARA01835 Agewell New YorkAWNY6837 Agewell New YorkAWNY6835 AHP Provider NetworkMPM38837AHPO (Cleveland OH)31138837 Alabama Medicaid IPD 837SKAL0837Alabama Medicaid12K01835Alabama MedicaidSKAL0835Alameda Alliance for Health95327837 AIPAZ837 Alan Sturm & Associates DentalR7003837Alaska Children's Services Inc.91136837 Alaska Children's Services Inc.91136835 Alaska Medicaid77200837 Alaska Medicaid77200835 Alaska MedicareSMAK0837 Alaska MedicareSMAK0835 Albuquerque Public Schools85600837 Albuquerque Public Schools85600835 Alexian Brothers Community Services of TN44423837 ASMI1837 ASMI1835 Alignment Health PlanCCHPC837 Alignment Health PlanCCHPC835 Alignment HealthcareAHCA1837 Experian Health Payer ListD 12K01Align Senior Care (MI)P Alabama MedicaidAlign Senior Care (MI)I 20048Agency Services IncAlamitos IPADAttachments NotesCOB For DOS Prior to 5/1/2020. Claims with DOS 5/1/20 and afteruse payer code CAPMN. Payer returns ERA's automatically once electronic claimsubmission begins.Payer returns ERA's automatically once electronic claimsubmission begins. Page 4 of 103
Payer NameAvailablePayer CodeTransactionIPAlignment HealthcareAHCA1835 All Savers/UHCEnrollmentDIP 81400837 All Savers/UHC81400835 AllCare AdvantageMRCHP837 Allcare Health CCOMRIPA837 Allcare Health CCOMRIPA835 AllCare IPAAC101837AllCare IPAAC101835Allegiance Benefit Plan Management Inc.81040837 Allegiance Benefit Plan Management Inc.81040835 Alliance Behavioral Health23071837 Alliance Behavioral Health23071835 Alliance Coal Health Plan93658837 Alliance Coal Health Plan93658835 Alliant Health Plans of Georgia58234837 Alliant Health Plans of Georgia58234835 Allianz Global Assistance50749837 Allied Benefit Systems37308837 Allied Benefit Systems37308835 ALLCA837 ALLCA835 Alpha Care Medical GroupNMM04837 Alpha Care Medical GroupNMM04835 Alta Bates Medical GroupA0701837 AltaMed Allied HealthcareAllied HealthcareP DIPD Former payer ID 26160 ALTAM837ATR01837AMA Insurance AgencyAMAIA837AMA Insurance AgencyTH071837AMA Insurance AgencyAMAIA835AMA Insurance AgencyTH071835Amalgamated Life13550837 Amalgamated Life13550835 Amalgamated Life - PA / Alicare13343837 AMBHN837 Experian Health Payer ListI Always Care VisionAmbay Health Network I & P DAttachments NotesCOB Payer returns ERA's automatically once electronic claimsubmission begins.Payer returns ERA's automatically once electronic claimsubmission begins.Former payer code MPM32. Effective 3/27/19, the new payer ID is ALTAM Page 5 of 103
Payer NameAvailablePayer CodeTransactionIPAMCO62176837 AmeriBen Solutions Inc.75137837 AmeriBen Solutions Inc.75137835 America's Choice Health Plans20029837 America's Choice Health Plans20029835 Americaid Community Care (New Jersey)27516837 American Behavioral63103837 American Benefit Plan Administrators95170837 American Benefit Plan Administrators95170835 American Family Insurance12T31837 American Family InsuranceTH09583756071837 56071835 American Family Medicare Sup and PPO Policies Administered by AmRepAmerican Family Medicare Sup and PPO Policies Administered by AmRepAmerican Fidelity Assurance CompanyEnrollmentDIP DAttachments NotesCOBIP DIPD 60801837 American General62030837 American General62030835 American Health Advantage of Tennessee31130837 American Health Advantage of Texas31155837 American Health Advantage of Texas31155835 American Healthcare Alliance01066837 American Healthcare Alliance01066835 American Heritage77083837American Income Life Insurance Company (ERA Only)60577835 American Insurance Administrators (AIA) (ERA Only)26119835American Insurance Co. of Texas81949American National Ins. Co. (ANICO)American National Ins. Co. (ANICO)Payer returns ERA automatically. ERA Only ERA Only837 74048837 74048835 American Postal Workers Union Health Plan44444837 American Postal Workers Union Health Plan44444835 American Republic Insurance42011837 American Republic Insurance42011835 American Sentinel Co.17965837 American Specialty Health Plans43146837 American Trust Administrators Inc.56195837Experian Health Payer List Page 6 of 103
Payer NameAvailableEnrollmentAttachments NotesCOBPayer CodeTransactionIPAmerican Worker Health Plan37322837 Americas 1st Choice of South Carolina, Inc55349837 AmericasHealth PlanAHP01837 AHP01835 Americhoice Maryland and Washington (ERA Only)04567835 Payer returns ERAs automatically once electronic claimsubmission begins.ERA OnlyAmerico (ERA Only)IAS01835 ERA OnlyAmerigroup Community Care26375837 Amerigroup Community Care26375835 Amerigroup Florida27519837 Amerigroup Illinois27518837 AmeriHealth Administrators54763837 AmeriHealth Administrators54763835 AmeriHealth Caritas Delaware77799837 AmeriHealth Caritas Delaware77799835 Amerihealth Caritas Louisiana (LACare)27357837 Amerihealth Caritas Louisiana (LACare)27357835 AmeriHealth Caritas New Hampshire87716837 AmeriHealth Caritas New Hampshire87716835 AmeriHealth Caritas Pennsylvania22248837 AmeriHealth Caritas Pennsylvania22248835 AmeriHealth Caritas VIP Care77062837 AmeriHealth Caritas VIP Care77062835 AmeriHealth Caritus VIP Care Plus (Michigan)77013837 AmeriHealth Delaware (Non-HMO)93688837 AmeriHealth Delaware (Non-HMO)SX055835Amerihealth District of Columbia77002Amerihealth District of ColumbiaAmeriHealth New Jersey (Non-HMO)AmericasHealth PlanDIPIP 837 77002835 60061837 AmeriHealth New Jersey (Non-HMO)SX055835 Amerihealth NJ/DE – HMO95044837 Amerihealth NJ/DE – HMOSX055835 AmeriHealth NorthEast77001837 AmeriHealth NorthEast77001835 Ameritas Dental47009837Experian Health Payer ListDDI PD ERA payer code 26375 ERA Payer Code 54763 ERA Payer Code SX055 ERA Payer Code SX055 ERA Payer Code SX055 Page 7 of 103
Payer NameAvailablePayer CodeTransaction4700983564090837 64090835 Amica Mutual Insurance12287837 Amica Mutual Insurance12287835 Amida Care24818837 Amida Care Medicare79966837 Anchor Benefit Consulting Inc.53085837 Ancillary Benefit Services (ABS)86062837Ancillary Care Services (ERA Only)A2004IP 835 47198837 47198835 Anthem Blue Cross Blue Shield of Colorado12B03837 Anthem Blue Cross Blue Shield of ColoradoAD050837Anthem Blue Cross Blue Shield of ColoradoSB550837Anthem Blue Cross Blue Shield of Colorado12B03835Anthem Blue Cross Blue Shield of ColoradoAD050835Anthem Blue Cross Blue Shield of ColoradoSB550835Anthem Blue Cross Blue Shield of ConnecticutAmFirst Insurance Company (payer only accepts Secondary claims)AmFirst Insurance Company (payer only accepts Secondary claims)Anthem Blue Cross Blue Shield of California (Claims and Encounters)Anthem Blue Cross Blue Shield of California (Claims and Encounters)12B04837Anthem Blue Cross Blue Shield of ConnecticutSB560837Anthem Blue Cross Blue Shield of Connecticut12B04835Anthem Blue Cross Blue Shield of ConnecticutSB560835Anthem Blue Cross Blue Shield of Georgia12015837Anthem Blue Cross Blue Shield of GeorgiaSB600837Anthem Blue Cross Blue Shield of Georgia12015835Anthem Blue Cross Blue Shield of GeorgiaSB600835Anthem Blue Cross Blue Shield of Indiana12B09837Anthem Blue Cross Blue Shield of IndianaSB630837Anthem Blue Cross Blue Shield of Indiana12B09835Anthem Blue Cross Blue Shield of IndianaSB630835Anthem Blue Cross Blue Shield of Kentucky12B11837Anthem Blue Cross Blue Shield of KentuckySB660837Anthem Blue Cross Blue Shield of Kentucky12B11835Experian Health Payer ListDIP DAttachments NotesCOBIAmeritas DentalPEnrollmentDIPD ERA Only Page 8 of 103
Payer NamePayer CodeTransactionAnthem Blue Cross Blue Shield of KentuckySB660835Anthem Blue Cross Blue Shield of MaineAvailableI12B13837Anthem Blue Cross Blue Shield of MaineSB680837Anthem Blue Cross Blue Shield of Maine12B13835Anthem Blue Cross Blue Shield of MaineSB680835Anthem Blue Cross Blue Shield of Missouri12B65837Anthem Blue Cross Blue Shield of MissouriSB741837Anthem Blue Cross Blue Shield of Missouri12B65835Anthem Blue Cross Blue Shield of MissouriSB741835Anthem Blue Cross Blue Shield of Nevada12B20837Anthem Blue Cross Blue Shield of NevadaSB765837Anthem Blue Cross Blue Shield of Nevada12B20835Anthem Blue Cross Blue Shield of NevadaSB765835Anthem Blue Cross Blue Shield of New Hampshire12B21837Anthem Blue Cross Blue Shield of New HampshireSB770837Anthem Blue Cross Blue Shield of New Hampshire12B21835Anthem Blue Cross Blue Shield of New HampshireSB770835Anthem Blue Cross Blue Shield of OhioPEnrollmentDPDIPDIPD 12B24837Anthem Blue Cross Blue Shield of OhioSB338837Anthem Blue Cross Blue Shield of Ohio12B24835Anthem Blue Cross Blue Shield of OhioSB338835Anthem Blue Cross Blue Shield of Ohio DentalAD332837 Anthem Blue Cross Blue Shield of Ohio DentalAD332835 Anthem Blue Cross Blue Shield of Virginia 12002837Anthem Blue Cross Blue Shield of VirginiaSB923837Anthem Blue Cross Blue Shield of Virginia12002835Anthem Blue Cross Blue Shield of VirginiaSB923835Anthem Blue Cross Blue Shield of Wisconsin12B29837 Anthem Blue Cross Blue Shield of WisconsinSB950837 Anthem Blue Cross Blue Shield of Wisconsin00450835 Anthem Blue Cross Blue Shield of Wisconsin00950835Apex Benefit Services34196837 Apostrophe81312837 Apostrophe81312835 ARC AdministratorsCXARC837 Experian Health Payer ListI Attachments NotesCOB ERA Payer Code 00450 ERA Payer Code 00950 Page 9 of 103
Payer NameAvailablePayer CodeTransactionIPArcadian Management Services Inc77045837 Arch Health PartnersARCH1837 Arch Health PartnersARCH1835 Argus Dental Plans, Inc.ARGUS837 ARISEEnrollmentDIP 39185837 ARISE39185835 Arizona MedicaidAZMCD837 Arizona MedicaidMCDAZ835 Arizona MedicareSMAZ0837 Arizona MedicareSMAZ0835 Arizona Priority Care Plus27154837 Arkansas Medicaid12023837 Arkansas MedicaidIP PD 83712023835Arkansas MedicaidSKAR0835 Arkansas MedicareSMAR0837 Arkansas MedicareSMAR0835 ARM, Group88035837 ARM, Ltd63240837 ARM, Ltd63240835 WMM01837ASAGEHA06603837 Asian American Medical GroupAAMG1837 Asian American Medical GroupAAMG1835 Aspen Medical Associates16180837 Aspire Health Plan46156837 Aspire Health Plan46156835 Aspirus Medicare Advantage36483837 Aspirus Medicare Advantage36483835 ASRM LLCASRM1837 ASRM LLCTLU02835 ASSOCIATED ADMINISTRATORS, LLC (ERA ONLY)13788835ERA Payer Code 44054 MPM44837 Associates for Health Care Inc. (AHC)36326837 Assurant Health Self Funded75068837 Experian Health Payer ListI SKAR0Associated Hispanic Physicians of Southern CADERA Payer Code MCDAZArkansas MedicaidArta Health NetworkDAttachments NotesCOBERA ONLY Page 10 of 103
Payer NameAvailablePayer CodeTransactionIPAssurant Health Self Funded75068835 Assured Benefits Administrators74240837 Assured Benefits Administrators74240835 Asuris NW Health93221837 Asuris NW Health93221835 Athens Area Health Plan Select95691837 Atlantic Medical Insurance22285837 ATRIO Health PlansATRIO837 ATRIO Health PlansATRIO835 Aultcare341488123837 AultcareEnrollmentDIP 341488123835 37242837 Aultra Administrative Group37242835 Author by Humana61108837 Author by Humana61108835 Automated Benefit Services38259837 Automated Benefit Services38259835 Automated Group Administration Inc.37280837 Auxiant (ERA Only)AUX01835 Avalon Administrative ServicesAVA01837 Avalon Administrative ServicesAVA01835 Avante HealthAH001837Avera Health Plans46045837 Avera Health Plans46045835 AVESIS (Part B)87098837Avesis Dental86098837AvMed Inc.59274837 AvMed Inc.59274835 AXA Assistance USA65101837 Axminster Medical GroupAXM01837 Azeros Health Plans Inc.16644837 Azeros Health Plans Inc.16644835 Bakersfield Family Medical CenterBKRFM837 Bakersfield Family Medical Group77005837 99999-0178837Experian Health Payer ListIP DIPD Aultra Administrative GroupBanker's LifeDAttachments NotesCOB Page 11 of 103
Payer NameAvailableEnrollmentPayer CodeTransactionBanker's Life36066835 Banker's Life & Casualty (ERA Only)36066835 Banner Health12X42837 Banner Health12X42835 Banner Health AZSX145837 Banner Health AZSX145835 Banner Medicare Advantage Plus PPO84324837 Banner Medicare Advantage Plus PPO84324835 Banner Medicare Advantage Prime HMO84323837 Banner Medicare Advantage Prime HMO84323835 Basic Plus41204837 Bay Bridge Administrators06941837 Baycare Life Management59279837 BayCare Select Health Plans81079837 BayCare Select Health Plans81079835 BCBSMI Medicare Plus Blue PPO (JVHL)KCJVH837 BCBSMI Medicare Plus Blue PPO (JVHL)KCJVH835 BCBSMN Blue Plus Medicaid00562837 BCBSMN Blue Plus Medicaid00562835 BCBSMN Blue Plus Medicaid WaiverFS802837 BCBSMN Blue Plus Medicaid WaiverFS802835 BCBSMN Non-Emergent TransportationA5143837 BCBSMN Non-Emergent TransportationA5143835 Beacon Health Options (formerly Value Options)VALOP837 Beacon Health Options (formerly Value Options)VALOP835 Beacon Health Strategies43324837 Beacon Health Strategies43324835 Beacon of Life65432837 Beaumont Employee Health Plan (JVHL)IPDI PIP DIP aka Banner Health Network D aka Banner Health Network Provider must be an approved JVHL lab aka Bridgeviewaka Bridgeview JEJVH837 Beaumont Employee Health Plan (JVHL)JEJVH835 Beaver Medical Group45967837Behavioral Health Systems63100837 Bella Vista Medical GroupMPM10837 Ben-e-lect (ERA Only)EDHP1835 Benefit & Risk Management Services99320837 Experian Health Payer ListDAttachments NotesCOB Formerly Value OptionsFormerly Value Options Provider must be an approved JVHL lab ERA OnlyPage 12 of 103
Payer NameAvailablePayer CodeTransactionIPBenefit & Risk Management Services99320835 Benefit Administration Services41205837 Benefit Administration Services41205835 Benefit Administrative Systems36149837 Benefit Administrative SystemsEnrollmentDIP DIP 36149835 Benefit Coordinators Corporation (Pittsburgh PA)25145837 Benefit Management Admin (BMA)BMATP837 Benefit Management Admin (BMA)BMATP835 Benefit Management Group-NV36459837 Benefit Management Inc. of KS48611837 Benefit Management Inc. of KS48611835 Benefit Management LLC/VBA88092837 37212837 Benefit Plan Administrators88052837 Benefit Plan Administrators Co. (Eau Claire WI)39081837 Benefit Plan Administrators Co. (Eau Claire WI)39081835 Benefit Plan Administrators Co. (Eau Claire WI)/UCS46891837 Benefit Plan Administrators Co. (Eau Claire WI)/UCS46891835 Benefit Systems & Services Inc.36342837 Benefit Systems & Ser
I P D I P D I P D I P D 1199 National Benefit Fund 13162 837 1199 National Benefit Fund 13162 835 21st Century Health and Benefits 59069 837
