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OptumInsight Medical Payer List(06/04/2021)Payer Name(UCS) Masonry Industry Trust1199 SEIU National Benefit Fund21st Century Insurance and Financial Services2020 Eyecare360 Alliance PPO Gilsbar3P ADMIN8th Distric ElectricalA & I Benefit Plan AdministratorsAARP Hospital Indemnity Plans insured by UnitedHealthcareInsurance CompanyAARP Medicare Supplement Plans insured by UnitedHealthcareInsurance CompanyAARP MedicareComplete insured through UnitedHealthcare / OxfordMosaic Network / Oxford Medicare NetworkAARP MedicareComplete insured through UnitedHealthcare(formerly AARP MedicareComplete from SecureHorizons)ABMGAbrazo Advantage Health PlanAbri HealthplanAccess AdministratorsAccess Behavioral CareAccess Medical GroupAccess Medical GroupACCLAIMAcclaim IPAAcclaim IPA (MHCAC)Accountable HC IPA (Customer Service (562) 435-3333 for claims withDOS prior to 5/1/15)Healthsmart Benefit Solutions (Wells Fargo TPA, formerly AcordiaNational)ACS Benefit Services, inc.ACS Benefits Payer CompassActiva Benefits Services, LLC (Formerly Amway Corporation)ActivHealthcareAdministrative Services, Inc.AdminoneAdminstrative Concepts, Inc.Advance Benefit Mgmt Systems USA IncorpAdvanced Data SolutionsAdvanstaff, Inc.Advantage Care IPAAdvantage Health Network IPAAdvantage Health Solutions, Inc.Advantage Preferred Plus (Old payerID of 77070 will be valid for alimited time.)Advantek Benefit AdministratorsAdvantica BenefitsAdvanzeon SolutionsAdventist Health SystemAdvocate Health Centers (AHC)Advocate Health Partners (PHO)Aegis Administrative ServicesAetna Affordable Health Choices (SM) SRCAetna Better Health - PA MedicaidAetna Better Health Medicaid ILAetna Better Health NevadaAetna Better Health NYAetna Better Health KansasAetna Better Health of Illinois IncAetna Better Health of KentuckyAetna Better Health of LouisianaAetna Better Health of MarylandAetna Better Health of MichiganAetna Better Health of New JerseyAetna Better Health of OhioAetna Better Health of VirginiaAetna Better Health of West VirginiaAetna Health Plan - PPOAetna Life & Casualty Company1 of 41Payer ondary**EnrollmentPayerTypeUCS MASONRY IND T1199 NATIONAL BEN21ST CENTURY INS2020 EYECARE360 ALLIANCE PPOG3P ADMIN8TH DIST ELECTRICA AND I BENEFIT GGGGGGGYAARP MEDICARE SUPYFALSECALLYAARP MEDICARE SUPYFALSECNOCDALLYOXFORD MEDICARE P MEDICARECOMPABMGABRAZO ADV HEALTHABRI HEALTHPLANACCESS ADMINISTRAACCESS BEHAVIORALALLIED MED GROUPACCESS MEDICAL GRACCLAIMMEMORIAL HC IPAMEMORIAL HC ABLE HC ALLALLALLALLALLALLCAALLALLYYYYYYNNNYNNYNACORDIA NATIONALACS BENEFIT SERVIACS BENE PAYER COACTIVA BENE SVCSACTIVHEALTHCAREADMIN SVCS INCADMINONEADMIN CONCEPTS INADV BENE MGMT USAADVANCED DATA SOLADVANSTAFF INCADVANTAGE CARE IPADVANTAGE HLTH IPADVANTAGE lAllYYYYYYYYYYYADVANTAGE PREFERRADVANTEK BENEFITADVANTICA BENEFITADVANZEON SOLUTIOADVENTIST HLTH SYADVOCATE HEALTHADVOCATE HLTH PARAEGIS ADMIN SVCSAETNA AFFORDABLEAETNA BH PA MEDICAETNA BH MCAID ILAETNA NVAETNA BET HLTH NYAETNA BET HLTH KSAETNA BETTER HEALTH OFILLINOIS INCAETNA BET HLTH KYAETNA BH LOUISIANAETNA MDAETNA BH MICHIGANAETNA BH NEW JERSAETNA BTTR HLTH OAETNA BH VAAETNA BTR HLTH WVAETNA HEALTH FALSEFALSEFALSEFALSEFALSEGGGGGGGGGGGFor up-to-date payer information, please access the payer list from the OptumInsight website at: http://www.ingenix/connectivityor contact OptumInsight Customer Service and Support at 1-866-367-9778StateReportsEntered As
OptumInsight Medical Payer List(06/04/2021)2 of 41Payer IDClaimOfficeNumberAetna Life & Casualty CompanyAetna Life & Casualty CompanyAetna Life & Casualty CompanyAffiliated Doctors of Orange CountyAffiliated Physicians IPAAffinity EssentialsAffinity Health Plans (Contact Affinity EDI Coordinator beforesubmitting claims electronically at EDI@Affinityplan.org or call 718794-7592.)AFFINITY MEDICAL GROUPAffordable Benefit Administrators, Inc. (Claims with the followingaddress should only be sent to this payerID: ABA, PO BOX 10787,Burbank, CA 91510-0787)Agewell New YorkAgua CalienteAHPO (Cleveland, OH)AIG ChartisAIG Educational Markets (Formerly Maksin ManagementCorporation)AKM Medical GroupAlameda Alliance for Health (Provider must contact payer to beapproved. Contact at Alameda is Anet Quiambao at 510-747-6153 oraquiambao@alamedaalliance.com)Alamitos IPA (Customer Service 562-602-1563)Alaska Childrens Services, IncAlaska Laborers Construction Industry TrustAlaska Pipe Trades Local 2195IP080Secondary**EnrollmentPayerTypeAETNA LIFEAETNA LIFE INSURAETNA LIFE INSURAAFFIL DOCS OF OCAFF PHYSICIANS IPAFFINITY YNAFFINITY HEALTH OAFFINITY MED GROUYNFALSEFALSEGGALLALLALLOHALLNYYYYAFFORDABLE BENE AAGEWELL NEW YORKAGUA CALIENTEAHPO CLEVELAND OHAIG ALLCAYNAIG EDUC MARKETSAKM MEDICAL CDNOCDNOCDNOCDALLCAAKAKAKYNYYYALAMEDA ALLIANCEALAMITOS IPAALASKA CHILD SVCSAK LABORERS TRUSTAK PIPE LOCAL 375NYYNNTRUEFALSEFALSEFALSEFALSETGGGGAlaska United Food & Commercial Workers Health & Welfare TrustAlbuquerque Public SchoolsAlexian Brothers Community Services of TennesseeAliCareAlignment HealthcareAll Savers Insurance / NOCDNOCDNOCDNOCDNOCDAKALLALLALLALLALLYAYYYNAK UNITED FOOD TRALBUQUERQUE PSALEXIAN BROTHERSALICAREALIGNMENT EFALSEGGGGGCAllCare (Must contact AllCare, 800-564-6901 for setup and payerID.)AllCare PEBBAlivi HealthAliera Health CareAllegian ChoiceAllegiance Benefit Plan Management, Inc.Alliance Coal Health PlanAlliance Physicians High DesesttAlliant Health Plans of GeorgiaAllied Benefit SystemsAllied Physicians of California IPAAlohaCareAlpha Care Medical GroupAlphaCareAlphacare Medical GroupAlta Bates Medical GroupAltaMedAlternative OpportunitiesAmalgamated Life - NYYCONTACT SUPPORTALLCARE PEBBALIVI HEALTHALIERA HEALTHALLEGIAN CHOICEALLEGIANCE BENEFIALLIANCE COALALL PHYS HIGH DESALLIANT GEORGIAALLIED BENEFITALLIED PHYS OF CAALOHACAREALPHA CARE MEDICAALPHACAREALPHACARE MEDICALABMGALTAMEDALTERNATIVE OPPORAMALGAMATED SEFALSEFALSEFALSEGGGGGGGGGGGNGGGGGGGAmalgamated Transit Union Division 1001 Health & Welfare FundAmbetter of ArkansasAmeraPlanAmeriben - IEC GroupAmeriben SolutionsAmericaid Community Care (Houston)American Administrative Group - AAG (Formerly known as UICIAdministratorsAmerican Administrative Group (formerly Gallagher Benefit)American BehavioralAmerican Benefits Plan Administrators (Las Vegas, NV)American Family (administered by American Republic)American Family Health ProvidersAmerican Family InsuranceAmerican Fidelity Assurance OCDNOCDNOCDCOALLALLALLALLTXNYYYYYAMALG TRANSIT UNIAMBETTERAMERAPLANAMERIBEN IEC GROUAMERIBEN SOLUTIONAMERICAID YAAGAMERICAN ADMINISTAMERICAN BEHAVIORAM BENEFITS PLANAM FAMILY INSURANAM FAMILY HLTH PRAMERICAN FAMILY IAMERICAN EFALSEGGGGGGGGPayer NameFor up-to-date payer information, please access the payer list from the OptumInsight website at: http://www.ingenix/connectivityor contact OptumInsight Customer Service and Support at 1-866-367-9778StateReportsEntered As
OptumInsight Medical Payer List(06/04/2021)Payer NameAmerican GeneralAmerican Healthcare AllianceAmerican Insurance Company of TXAmerican LIFECARE (Group Number required. Valid only for claimswith a billing address of 1100 Poydras ST. #2600, New Orleans, LA70163)American National Insurance CoAmerican Plan AdministratorsAmerican Postal Workers Union Health PlanAmerican Postal Workers Union Health PlanAmerican Republic Insurance CompanyAmerican Specialty HealthAmerican Therapy Administrators ATA WisconsinAmerican Worker Health PlanAmericas 1st Choice Health Plans of South CarolinaAmericas 1st Choice of South Carolina, Inc.America's Choice NMAAmerica's Health ChoiceAmerica's PPO (Formerly known as ARAZ.)America's PPO / America's TPAAmeriChoice NJ, Medicaid, NJ Family Care (UnitedHealthcareCommunity Plan)Amerigroup - IlllinoisAmerigroup - Maryland and District of ColumbiaAmerigroup - New JerseyAmerigroup of IowaAmerigroup / Americaid - HoustonAmerigroup Houston (Claims and Encounters)Amerigroup Illinois (Claims and EncountersAmerigroup Multiple States (Claims and Encounters)Amerigroup of FloridaAmerigroup Ohio (Claims and EncountersAmeriHealth - New Jersey (Non-HMO Claims)AmeriHealth AdministratorsAmeriHealth Caritas Louisiana (Formerly known as LA Care)AmeriHealth Caritas Healthplan New HampshireAmeriHealth Caritas VIP CareAmeriHealth Caritus VIP Care Plus (Michigan)Amerihealth DelawareAmerihealth District of Columbia (For EDI Support, please emailedi.dc@amerihealthdc.com or call 1-888-656-2383)AmeriHealth HMO New Jersey and DelawareAmerihealth HMO NJ and DelawareAmeriHealth Mercy Health Plan (Name has changed to AmeriHealthCaritas Pennsylvania. Claims containing Dates of Service on or afterJan. 1, 2021 will need to be sent under this payer ID).AmeriHealth NorthEast (Dates of Service on or before Dec. 31, 2020,may continue to use the following until Dec. 31, 2021. For dates ofservice 01/01/21 or after use payer ID 22248}Amerikids-Dallas/Ft. WorthAmerivantageAmfirst Insurance CompanyAM-First Insurance Morgan White (Payer accepts secondary claimsonly, and Medicare cannot be primary payer.)Amida Care (Formerly Vida Care.)Amida Care MedicareAMVIAmway CorporationAnaheim Memorial IPA (MHCAN)Anchor Benefit ConsultingAncillary Benefits/Arizona Foundation for Medical CareAnerican Founders Life Ins Co (NFL Plans only)Angeles IPA (SynerMed)Antares Management SolutionsAnthem BCBS IndianaAnthem BCBS VirginiaAnthem Blue Cross of CaliforniaAnthem Medicaid (WI) (Formerly BadgerCare)Anthem of Colorado3 of 41Payer CAN GENERALAM HEALTHCARE ALLAMER INS OF TEXASYYNFALSEFALSEFALSEGGGYYNYYNYYNRYYYYYAMERICAN LIFECAREAMER NAT INSURANCAMERICAN PLANAMERICAN POSTAL WAPWUARICAM SPECIALTY HLTHATA WISCONSINAMERICAN WORKER HAMERICAS FIRST CHAM FIRST CHOICE SAMERICAS CHOICE NAMERICAS HEALTH CAMERICAS PPO ARAZAMERICAS IALLYYNNYYYYYYYYYYYNYNUHC COMMUNITY NJAMERIGROUPAMERIGROUP MDAMERIGROUP NJAMERIGROUP IOWAAMERIGROUP HOUSTOAMERIGROUP HOUSTAMERIGROUP ILLINOAMERIGROUP MULTIAMERIGROUP OF FLAMERIGROUP OHIOAMERIHEALTH NJAMERIHEALTH ADMINLA CARENH CARITASAMERIHLTH CARITASAH CARITUS VIP CAAMERIHEALTH ALSEFALSECGTGGTGGGTGNGGGGGGNOCDNOCDNOCDALLNJ,DENJ DEYYYAMERIHEALTH DCAMERIHEALTH HMOAHLTH HMO NJ & DENYYFALSETRUETRUEGGN22248NOCDAllYAMERIHEALTH LTXALLALLYYYYAMERIHEALTH NEAMERIKIDS DALLASAMERIGROUP IOWAAMFIRST INS LLALLINVACAWICOYNYNYNAYNYYYYYNYAM FIRST INS MORGAMIDA CAREAMIDA CARE MEDICAAMVIAMWAYMEMORIAL HC IPAANCHOR BENEFIT COANCILLARY BENEFITAMERICAN FOUNDERSANGELES IPA SYNERANTARES MGMT SOLNANTHEM BCBS INANTHEM BCBS VACA BLUE CROSSANTHEM WI MEDICAICO SEGGGGGGGPGGGGGGNNFor up-to-date payer information, please access the payer list from the OptumInsight website at: http://www.ingenix/connectivityor contact OptumInsight Customer Service and Support at 1-866-367-9778StateReportsEntered As
OptumInsight Medical Payer List(06/04/2021)Payer Name4 of 41Payer IDClaimOfficeNumberStateReportsEntered AsSecondary**EnrollmentPayerTypeAnthem of NevadaNVBLSApex Benefit Services (Claims must contain the rendering provider IDor the claim will reject.)34196NOCDNVNNV ANTHEMYFALSENNOCDALLNAPEX BENE SERVICEYFALSEGAPEX Healthcare (Now knows as Access Community Health Network)ApostropheARAZ (Now known as America's PPO.)Arbor HealthArcadian Management Services, Inc (Group number should beentered if available. )Argus Dental and VisionArise Health Plan (Formerly Prevea Health)Arizona Foundation for Medical CareArizona Medicaid (AHCCCS)Arizona Pipe Trades Health and Welfare Trust Fund Local Union Nos.469 & 741 Metal Trades Health PlanArizona Pipe Trades Health and Welfare Trust Fund Local Union Nos.469 & 741 Pipe Trades Health PlanArizona Priority Care LLYNYNAPEX HEALTHCAREAPOSTROPHEARAZARBOR ADIAN MGMT SVSARGUSARISE HEALTH PLANAZ FOUNDATION MEDAZ CDAZNAZ METAL TRADESNFALSEG7423427154NOCDNOCDAZALLNNAZ PIPE TRADESAZ PRIORITY LLALLALLYYYYYNYNNYYYARKANSAS BEST CORAR MCOAK TOTAL CAREARNETT HEALTH PLAARROYO VISTA FAMARTA HLTH NETWORKASAGEHAASIAN AMERICAN MGASPIRE HEALTH PLAASR CORPORATIONASRM CORPASSOC 4240NOCDNOCDALLALLNYASSURANT HLTH SLFASSURED ASURIS NW MEDADVAASURIS NW HEALTHATLANTIC COASTATLANTIC MEDICALATLANTIS EYE CAREATLAS LIFE INS N POLK HP ADAULTCAREAUTOMATED BEN SVCAUTOMATED GROUP ANYNYFALSETRUEFALSEFALSEGNGGAutomotive Machinists Local 289 Health & Welfare Trust - Grp#F32Avalon Healthcare Solutions (Must contact the payer directly atProvider Services @ 855-895-1676 prior to sending claims.)Avalon Healthcare Solutions North CarolinaAvalon IPAAvante Health (Customer Service 559-261-9060)Avectus Healthcare Solutions (Call 855-AVECTUS)Avera Health PlansAvesis Third Part AdministratorsAVMEDAVMED-Parity Healthcare (OB/GYN only)Axminister Medical GroupAZ Integrated PhysiciansBakersfield Family Medical Center91136NOCDALLYAUTO GRP YNNNNYYYYNNNAVALON HC SOLUTIOAVALON HEALTHCAREAVALON IPAAVANTE HEALTHMEDPAY FIRST ONEAVERA HEALTH PLANAVESIS TPAAVMEDAVMED PARITYAXMINISTER MED GRAZ INTEGRATED PHYBAKERSFIELD FALSEFALSEFALSEFALSEFALSEGNGGGGGNGGGGBakery & Confectionery Union and Industry International HealthBanner HealthBanner Health & Aetna Health Insurance CompanyBanner Medicare Advantage Plus (PPO)Banner Medicare Advantage Plus ALLALLALLALLALLNYYNNBAKERY UNIONBANNER HEALTHAETNA BANNER HLTHBANNER PPOHMO BANNERNYYYYFALSEFALSEFALSEFALSEFALSEGGGGGArkansas Best Corporation (previous payer ID 75278, new payer ID iseffective for claims submitted December 15, 2017 and after).Arkansas Managed Care Organization (AMCO)Arkansas Total CareArnett Health Plan - former payer id 95440Arroyo Viata Family Health CenterArta Health NetworkASAGEHAAsian American Medical GroupAspire Health PlanASR CorporationASRM CorporationAssociates for HealthcareAssurant Health Self Funded (MUST VERIFY ALL CLAIMS SHOULD GOTO ALLIED BENEFIT for Assurant Health Self Funded groups with Planeffective dates after 5/1/2013)Assured Benefits AdministratorsAsuris Northwest/MedAdvantage (REF*1B*Provider ID in Billing andRendering required even when NPI is submitted.)Asuris NW HealthAtlantic Coast Life InsuranceAtlantic MedicalAtlantis Eye CareAtlas Life Ins Co (NFIC Plan only)Atrio Health Plan (Formerly known as Marion Polk Health PlanAdvantage)AultcareAutomated Benefit Services (ABS)Automated Group Administration, Inc.For up-to-date payer information, please access the payer list from the OptumInsight website at: http://www.ingenix/connectivityor contact OptumInsight Customer Service and Support at 1-866-367-9778
OptumInsight Medical Payer List(06/04/2021)5 of 41Payer IDClaimOfficeNumberBanner Medisun77078NOCDALLNBanner University Family Care (University of Arizona Health Plans)Baptist Health South FloridaBaycare Life ManagementBaycare Select Health Plans IncorpBCBS Of VermontBCBS Of Michigan (Dental Claims Only)BCBS of Texas Medicaid (Plan effective December 1, 2015)BCBS Western NY MedicaidBeacon Health OptionsBeacon of LifeBehavioral Health SystemsBella Vista Med Grp IPABenefit & Risk Management Services (Commercial Medicare underMed3000)Benefit Administration ServicesBenefit Administrative SystemsBenefit ConceptsBenefit Coordinators CorporationBenefit Management LLC/VBABenefit Management ServicesBenefit Management Systems, Inc of CDNOCDNOCDNOCDNOCDNOCDPayer NameBenefit Management, Inc. of KS (Only accepts claims for these I617BMI246,BMI246.)48611Benefit Plan Administrators Co. (Payer ID valid only for claims with abilling submission address of PO Box 1128, Eau Claire, WI 547021128)39081Benefit Systems and Services, Inc.36342Benefit Trust Life Insurance Company61425Benesight (formerly The TPA)87265BeneSys, Inc. (Now known as Sheet Metal Workers Local 104)38238BenmarkBNMK1Berkshire Health Partners23243Berkshire Intergroup10956Best Life & Health Insurance Co.95604Better Health Plan of Florida (For claims rejections, contact payer at800-514-4561 and select pro
Alivi Health ALIVI NOCD ALL N ALIVI HEALTH N FALSE G Aliera Health Care ALH01 NOCD ALL N ALIERA HEALTH N FALSE G Allegian Choice 55649 NOCD ALL Y ALLEGIAN CHOICE N FALSE G Allegiance Benefit Plan Management, Inc. 81040 NOCD ALL Y ALLEGIANCE BENEFI Y FALSE G Alliance Coal Heal
