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Institutional Claim Payers d payers are new or have been altered in the last 90 days. Please verify that your system is setup correctly for these payers.1199 National Benefit Fund ##13162Y1199 NATIONAL BENFALSE1ST MEDICAL NETWORK (MEDICALRESOURCES) **YMEDICAL RESOURCEFALSE582032020 Eyecare ##2020EN2020 EYECAREFALSE360 Alliance Gilsbar ##07205Y360 ALLIANCE PPOGFALSEY3P ADMINFALSE3P ADMIN **20413A & I Benefit Plan Administrators ##93044NA AND I BENEFIT PFALSEPayerAAG - American Administrative Group **AARP Hospital Indemnity Plans insured byUnitedHealthcare Insurance Company **AARP Medicare Supplement Plans insured byUnitedHealthcare Insurance Company **IDReportsEnter As Name37283YAMERICAN ADMINIST36273Y36273FormerlyGallagherBenefit 26YAARP MEDICARECOMPFALSEC8772603443YYAARP MEDICARECOMPABRAZO ADV HEALTHFALSEFALSECGAARP MedicareComplete insured throughUnitedHealthcare (formerly AARPMedicareComplete from SecureHorizons) **AARP MedicareComplete insured throughUnitedHealthcare / Oxford Medicare Network /Oxford Mosaic Network, former payer id 06111**Abrazo Advantage Health Plan **Abri Healthplan (Now known as Molina HealthCare of WI) **Access AdministratorsAcclaim **Healthsmart Benefit Solutions (Wells Fargo TPA,formerly Acordia National)**ACS Benefits Payer Compass ##ADMINISTRATIVE CONCEP ##Administrative Services ##Advantage Health Network IPA **ADVANTAGE HEALTH SOLU ##ABRI1AHS0164071NYYABRI HEALTHPLANACCESS 59141NMM0135209YYYNYYACORDIA NATIONALACS BENEFITSADMIN CONCEPTS INADMIN SVCS INCADVANTAGE HLTH IPADVANTAGE e Preferred Plans ##Advantek Benefit Administrators ##Advantica Benefits **ADVENTIST HEALTH SYSTEM ##Advocate Health CentersAdvocate Health PartnersAetna 60054 (Commercial only)Aetna Affordable Health Choices **Aetna Better Health IL Medicaid **Aetna Better Health Nevada ##Aetna Better Health NY NV34734YNAYYYYYNNNADVANTAGEADVANTEK BENEFITADVANTICA BENEFITADVENTIST HLTH SYADVOCATE HEALTHADVOCATE HLTH PARAETNAAETNA AFFORDABLEAETNA IL MCDAETNA NVAETNA BET HLTH 024128KS128KY128LA128MD128MIYNYYYYAETNA BETTER HEALTHOF ILLINOIS INCAETNA BET HLTH KSAETNA BET HLTH KYAETNA BH LOUISIANAETNA MDAETNA BH althHealthHealthofofofofofofIllinois INC **Kansas **Kentucky **Louisiana **Maryland ##Michigan **Claimssubmittedwith oldpayerID of77070 mayneed to beresubmittedafter May23rd, 2014
Institutional Claim Payers d payers are new or have been altered in the last 90 days. Please verify that your system is setup correctly for these payers.Aetna Better Health of New Jersey **46320YAETNA BH NEW JERSFALSEAetna Better Health of Ohio **50023YAETNA BTTR HLTH OFALSEAetna Better Health of Pennsylvania Medicaid**23228YAETNA BH PA MEDICFALSEAetna Better Health of Virginia **128VAYAETNA BH VAFALSEYAETNA BTR HLTH WVFALSEAetna Better Health of West Virginia **128WVAETNA TEXAS MEDICAID ##38692YAETNA TX MEDICAIDFALSEAffiliated Doctors of Orange County **ADOCSYAFFILIATED DRSFALSEYAFFILIATED PHYSFALSEAffiliated Physicians GroupM3CA1PayerAffinity Health Plan ##AffinityAccess**Agency Services Inc ##AHPO (Cleveland, OH) ##AIG Chartis ##ALAMEDA ALLIANCE##Alaska Children's Services, Inc. - Group # P68##Alaska Laborers Construction Industry Trust Group # ortsYYYYYYYYEnter As NameAFFINITY HEALTH OContactEDI@Affinityplan.org or(718)7947592 prior tosendingclaims. (ForMedicaid,Child HealthPlus andEssential PlanMembers AMEDA ALLIANCEProvidermust contactpayer to beapproved.Contact atAlameda isAnetQuiambao at510-7476153 oraquiambaoalamedaalliance.comTRUETALASKA CHILD SVCSPleaseinclude GroupNumber whensubmittingclaims.FALSEGAK LABORERS TRUSTPleaseinclude GroupNumber whensubmittingclaims.FALSEGAFFINITYACCESSAGENCY SERVICESAHPO CLEVELAND OHAIG CHARTIS(For QualifiedHealth PlanMembers )
Institutional Claim Payers d payers are new or have been altered in the last 90 days. Please verify that your system is setup correctly for these payers.PayerAlaska Pipe Trades Local 375 - Group # F24##ID91136ReportsYEnter As NameAK PIPE LOCAL 375Pleaseinclude GroupNumber whensubmittingclaims.Pleaseinclude GroupNumber aska United Food & Commercial WorkersHealth & Welfare Trust - Group # F45 ##Albuquerque Public Schools ##Alexian Brothers Community Services ofTennessee ##ALICAREAliera Health Care ##Alignment Healthcare ##AllCare PEBB ##Allegian Choice ##9113685600YAAK UNITED FOOD TRALBUQUERQUE PS4442313550ALH01CCHPC2615855649yYNYYYALEXIAN BROTHERSALICAREALIERA HEALTHALIGNMENT HCAREALLCARE PEBBPHOENIX ce Benefit Plan Management, Inc. ##81040YALLEGIANCE BENEFALSEGAlliance Coal Health Plan ##93658NALLIANCE COALFALSEGAlliance, The (Only for ID Cards showing PO Box44365 Madison WI 53744 as mailing address.Call 608-210-6656 for Payer ID. **Alliant Health Plans of Georgia ##Allied Benefit Systems ##Allied Physicians of California IPA **Call5823437308NMM01YYYYALLIANCEALLIANT GEORGIAALLIED BENEFITALLIED PHYS OF GGGTFALSEGAlphacare Medical Group**AltaMed **Alternative Opportunities ##AMA Insurance Agency##AMA Insurance Agency, Inc.Amalgamated Life ##Amalgamated Life - PA / Alicare ##Ambetter of Arkansas **ClaimChoice AdministratorsAmeriben - IEC Group ##AMERIBEN SOLUTIONSAmerican Plan Administrators ##Americaid CC Tampa **Americaid Community Care (Dallas/Ft. 21997661751379560606161NYYNYYNYYYYNYALPHACARE MEDICALALTAMEDALTERNATIVE OPPAMA INSURANCEAMA INSURANCEALICAREAMALGAMATED LIFEAMBETTERAMERAPLANAMERIBEN IECAMERIBEN SOLUTIONAMERICAN PLANAMERICAID CC27514YAMERIGROUP GAEffective12/1/17, allAlphaCareMedicalGroup claimsshould besubmitted toPayer IDMPM32.SynerMed nolongermanagesAlphaCare.)
Institutional Claim Payers d payers are new or have been altered in the last 90 days. Please verify that your system is setup correctly for these payers.PayerReports27515YAMERICAID HOUSTONFALSEG27517YAMERICAID MDFALSEGAmericaid Community Care (New Jersey) **American Behavior ##American Family Insurance ##American Family Insurance (Administered byAmerican Republic)275166310312T31YNYAMERICAID NJAMERICAN BEHAVIORAMERICAN FAMILYFALSEFALSEFALSEGGG56071NAM FAMILY INSURANFALSEGAmerican Fidelity Assurance Company ##60801YAMERICAN FIDELITYFALSEGAMERICAN GENERAL LIFE AND ACCIDENT ##American Healthcare Alliance ##6203001066YYAMERICAN GENERALAM HEALTHCARE ALLFALSEFALSEGGFALSEGAmericaid Community Care (Houston)Americaid Community Care (Maryland)****Enter As NamePayerTypeIDValid forbillingaddress of1100 PoydrasStreet, Suite2600, NewOrleans, LA70163-2602American Lifecare72099YAMERICAN LIFECAREAmerican NatIonal Insurance (ANICO) ##74048YAMER NAT INSURANCFALSEG44444YAMERICAN POSTAL WFALSEGAmerican Republic Insurance Company ##42011YARICFALSEGAMERICAN WORKER HEALTH PLUS **Americas 1st Choice Health Plans of SouthCarolina ##37322YAMERICAN WORKER HFALSEG20553NAMERICAS FIRST CHFALSEGAmericas 1st Choice of South Carolina, Inc ##America's Choice Health ##America's Health ChoiceAmerica's PPO (Formerly ARAZ) ##America's PPO / America's TPA ##Amerigroup ##553492002921810161204117828804YNYNYYAM FIRST CHOICE SAMERICAS CHOICE NAMERICAS HEALTH CAMERICAS PPO ARAZAMERICAS merigroup Houston ##26374YAMERIGROUP HOUSTFALSEGAmerigroup Illinois ##Amerigroup Iowa ##2751826375YYAMERIGROUP ILAMERIGROUP IOWAFALSEFALSEGGAmerigroup Multiple States ##26378YAMERIGROUP MULTIFALSEGAmerigroup Ohio ##Amerigroup Vantage ##Amerihealth Administrators, Inc. **AmeriHealth Caritas Healthplan New Hampshire##AmeriHealth Caritas Louisiana(Formerly knownas LA Care)##AmeriHealth Caritas VIP Care ##275182637554763YYYAMERIGROUP OHIOAMERIGROUP IOWAAMERIHEALTH ADMINFALSEFALSEFALSEGGT87716YNH CARITASFALSEG2735777062YNLA CAREAMERIHLTH CARITASFALSEFALSEGGAmeriHealth Caritus VIP Care Plus (Michigan) #77013YAH CARITUS VIP CAFALSEGAmerican Postal Workers Union Health Plan##Claims andEncountersClaims andEncountersClaims andEncountersClaims andEncounters
Institutional Claim Payers d payers are new or have been altered in the last 90 days. Please verify that your system is setup correctly for these payers.PayerIDReportsEnter As NameAmerihealth DC ##Amerihealth Delaware **Amerihealth HMO NJ and DE**AmeriHealth Mercy Health Plan (Name haschanged to AmeriHealth Caritas Pennsylvania.Claims containing Dates of Service on or afterJan. 1, 2021 will need to be sent under thispayer ID) ##Amerihealth NJ/DE - HMO **AmeriHealth NorthEast (Dates of Service on orbefore Dec. 31, 2020, may continue to use thefollowing until Dec. 31, 2021. For dates ofservice 01/01/21 or after use payer ID 22248)**770027779995044YYNAMERIHEALTH DCAMERIHEALTH DEAHLTH HMO NJ & DE2224823037YY77001Amerihealth PPO New Jersey**Amfirst Insurance Company **12X2864090AM-First Insurance Morgan White **Amida Care Medicare ##Anchor Benefit Consulting Inc ##Angeles IPA (SynerMed) ##Antares Management Services **Anthem BCBS Virginia **Anthem Blue Cross of California **Anthem IN **Anthem KYANTHEM MEDICAID (WI) (formerly BadgerCare)**Anthem NHAnthem OH **APEX BENEFITS SERVICE **For EDISupport,please emailedi.dc@amerihealthdc.comor call 1-888656-2383PayerTypeFALSEFALSETRUEGGNAMERIHEALTH MERCYAMERIHEALTH HMOFALSETRUEGGYAMERIHEALTH NEFALSEGNYAMERI HEALTH PPO NJAMFIRST INS M FIRST INS MORGAMIDA CARE MEDICAANCHORANGELES IPA SYNERANTARES MGMT SOLNANTHEM BCBS VABC OF CAANTHEM INANTHEM KYWIBLS007700033234196yYYYANTHEM WI MEDICAIBC OF NHANTHEM OHAPEX BENE SERVICEPayer acceptssecondaryclaims only,and Medicarecannot be theprimarypayerClaims areprinted andmailed to thepayer. Iffiling a claimfor a federalplan member,use payer ID44444APWU Health55544YAPWU HEALTHARAZ (Now known as America's PPO.) ##Arbor Health **1612052312NYARAZARBOR HEALTHFALSEFALSEGGARCADIAN MGMT SERVICE ##Argus Dental and Vision ##61101ARGUSYNARCADIAN MGMT SVSARGUSFALSEFALSEGG
Institutional Claim Payers d payers are new or have been altered in the last 90 days. Please verify that your system is setup correctly for these payers.FormerlyPrevea HealthPlanArise Health Plan ##39185YARISE HEALTH PLANFALSEFALSEYARIZONA FOUNDATArizona Foundation for Medical Care **86062Arizona Priority Care Plus ##27154NAZ PRIORITY CAREFALSEFormerlypayer ID75278. Newpayer IDeffective forclaimssubmittedDecember 15,Arkansas Best Corporation - Choice Benefits2017 and##62308YCIGNA PPOFALSEafterArkansas Managed Care Organization, Inc.(AMCO) **36335YHFNINFALSEAK TOTAL CAREFALSEArkansas Total Care **68069YPayerIDReportsEnter As NameArnett Health Plans ** Former PayerID 95440Arroyo Vista Family Health Center **ASAGEHA ##87726NMM0106603YYYARNETT HEALTH PLAARROYO VISTA FAMASAGEHAASC Benefit Services, Inc. ##Asian American Medical Group ##Aspire Health Plan ##ASR Physicians Care ##72467AAMG14615638265YYYYACS BENEFIT SERVIASIAN AMERICAN MGASPIRE HEALTH PLAPHYS CARE NETWORKAssociates for Health Care, Inc. (AHC) **36326YASSOC HEALTHCAREAssurant Health Self Funded **ASSURED BENEFITS ADMI **Asuris NW HealthAtlantic Medical Insurance ##Automated Benefit Services **7506874240932212228538259NYYNYASSURANT HLTH SLFASSURED BENEFITSASURIS NW HEALTHATLANTIC MEDICALAUTOMATED BEN SVCPayer ID isfor ACSBenefitServices. Inc.ONLYMUST VERIFYALL CLAIMSSHOULD GOTO ALLIEDBENEFIT forAssurantHealth selffundedgroups withplan effectivedates EGGGGG
Institutional Claim Payers d payers are new or have been altered in the last 90 days. Please verify that your system is setup correctly for these payers.PayerIDReportsEnter As NameAutomated Group Administration ##Automotive Machinists Local 289 Health &Welfare Trust -Group #F32 ##Auxiant (Nat’l Health Benefit Corp) ##37280YAUTOMATED GROUP A9113688050YYAUTO GRP F32NHBC02Avectus Healthcare Solutions ##Avera Health PlansAvmed, Inc.Bakersfield Family Medical Center **Bakery & Confectionery Union and IndustryInternational Health ##Banner Health & Aetna Health InsuranceCompany **Banner Health **MP0014604559274BKRFMNYYNMEDPAY FIRST ONEAVERA HEALTH PLANAVMEDBAKERSFIELDBCTF1N6789512X42Banner Medicare Advantage Plus (PPO) **Please sendthese EDIclaims to thePayer ID ofthe PPOshown on theMembers IDCard. If youhave anyquestions,please call260-4896447 LSEGGNGBAKERY UNIONFALSEGYYAETNA BANNER HLTHBANNER HEALTHFALSEFALSEGG16663NBANNER PPOFALSEGBanner Medicare Advantage Prime (HMO) **Banner Medisun **Baycare Select Health Plans Incorp **166647707881079NNYHMO BANNERBANNER MEDISUNBAYCARE SELECTFALSEFALSEFALSEGGGBCBS Of South Carolina Planned Admin ##SC886YBCBS SC GNNGGGGGFALSEFALSEFALSENTGFALSEFALSEGGBCBS of Texas Medicaid ##BCBS Western NY MedicaidBeacon Health Options ##Behavioral Health Systems ##BeneFirst ##Benefit & Risk Management Services ##BENEFIT ADMIN. SYSTEM ##Benefit Administration Services BCBS TEXAS MEDICABCBS W NY MEDICAIBEACON HLTH OPTIOBEHAVIORAL HSBENEFIRSTBENE RISK MGMT SVBENE ADMIN SYSTEMBENEFIT ADMIN SVCBenefit Coordinators **Benefit Management Admin (BMA)Benefit Management LLC/VBA **25145BMATP88092YYYBENEFIT COOR CORPBENEFIT MANGBENE MGMT LLC VBABenefit Management Services for Charlotte, NCBenefit Management Systems, Inc. ##5613937212YYBENE MGMT SVCSBENEFIT MANGCall 855AVECTUSPlan effectiveDecember 1,2015Valid forbillingaddress of111 RyanCourt, Suite300,Pittsburgh,PA
Institutional Claim Payers d payers are new or have been altered in the last 90 days. Please verify that your system is setup correctly for these payers.PayerIDReportsEnter As NameBenefit Plan Administrators ##Benefit Planners, Inc. **3908174223NYBENEFIT PLAN WIBENEFIT PLANNERBenefit Systems & Services, Inc. (BSSI) ##36342YBENEFIT SYSTEMSBenefit Management, Inc. of KSBenesight (Formerly TPA) **4861187265NYBENEFIT MGMT KSBENESIGHTBERKSHIRE HEALTH PLANBEST LIFE & HEALTH CO ##2324395604YYBERKSHIRE HLTH PABEST LIFEBetter Health Plan of Florida **BCBSMN Blue Plus Medicaid **BHP Unity **BHSF International ##20488005624421967668NNYYBETER HP OF FLBCBSMN BLUEBHP UNITYBHSF INTERNATIONABIENVIVIR SENIOR HEALTH SERVICES ##BIND (UHC Choice Plus Multiplan) ##12X4025463YYBIENVIVIR SRBINDBlue Choice Medicaid ##00403NBLUE CHOICE MCAIDBlue Cross Blue Shield Of Western New York **Blue Cross Blue Shield of Wisconsin **N1BLSWIBLSYYBC WESTERN NYWI BLUE SHIELDPayer IDvalid only forclaims with abillingsubmissionaddress ofP.O. Box1128, EauClaire, WI54702-1128ONLY acceptclaims BMI241,BMI617,BMI245.BMI246Prior tosubmitting,call (610)372-8044ext. 3019For claimsrejections,pleasecontactBetter Healthof Florida at 1800-5144561 andselect FALSEFALSEFALSEGGGGFALSEFALSEGGFALSENFALSEFALSEGN
Institutional Claim Payers d payers are new or have been altered in the last 90 days. Please verify that your system is setup correctly for these payers.PayerIDBlue Cross Community Options ##Blue Cross Complete of Michigan, LLC **MCDIL32002ReportsYYEnter As NameILLINOIS BCBS ICPBLUE CROSS COMPLEFormerlyknows asIllinois BCBSICP, with apayerID of00621For DOS 0101-2017 andlater and forAlphaprefixes YDL,YDJ, XOD,XOJ, ZGD,ZGJ, YID, YIJ,YUX, LSEFALSEFALSEFALSETRUEFALSEFALSENNNNNNNNNNNNBlue Cross Medicare Advantage of Montana,Illinois, Texas and OklahomaBlue Cross of Alabama **Blue Cross of Alaska **Blue Cross of ArizonaBlue Cross of Arkansas **Blue Cross of ColoradoBlue Cross of ConnecticutBlue Cross of FloridaBlue Cross of GeorgiaBlue Cross of Idaho **Blue Cross of Illinois **Blue Cross of Indiana 070062100160NYYYYYYYYYYYBC MCARE ADV MITAL BLUE SHIELDBC OF AKAZ BLUE SHIELDBC OF ARBC OF COBC OF CTBC OF FLBC OF GABC OF IDBC OF ILBC OF sIowa & South Dakota COBof Kansas **of Kansas City **of Kentuckyof Louisiana ##of Maine **of Marylandof Massachusetts **of Minnesotaof Mississippi **of Missouri 1712B65NYYYYYYYYYYBCKSKCBCBCBCBCBCBCBCBCCOBBLUE SHIELDBLUE SHIELDOF KYOF LAOF MEOF MDOF MAOF MIOF MSOF fofofMissouri - Kansas City, MissouriNebraskaNevadaNew HampshireNew Jersey HorizonNew Mexico **New York City (Empire) **New York of EFALSETRUEFALSEFALSEFALSENGGNNNNNof New York of Utica, Watertown **of New York State **of North Carolina **of North Dakota **of Ohio **of Oklahoma **of Oregon Regence **of Pennsylvania Capital **of Pennsylvania Western/Central**of Rhode Island BC OF UTICABC OF NYBC OF NCBC OF NDANTHEM OHBC OF OKBC OF ORBC OF B8112B74YYBC OF HIGHMARKBC OF RITRUEFALSENNBlue CrossBlue CrossBlue CrossBlue CrossBlue CrossBlue CrossBlue CrossBlue CrossBlue CrossHighmarkBlue Cross**MONENVNHNJNMEMPIRECENTRAL
Institutional Claim Payers d payers are new or have been altered in the last 90 days. Please verify that your system is setup correctly for these payers.Cross of South Carolina **12B55YBC OF SCFALSECross of Tennessee5513IYBC OF TNTRUEYHCSC INSURANCE SEFALSECross of Texas84980Cross of Utah **12B42YBC OF UTFALSECross of Utah - FEP **12B1EYBC OF UTTRUEYBC OF VTFALSECross of Vermont **12B32Cross of Washington (Premera) **00934YBC OF WAFALSECross of West Virginia **12B28YBC OF WVFALSEShield of California94036YCA BLUE SHIELDFALSEYMI BLUE SHIELDFALSEShield of BlueBlueIDReportsEnter As NamePayerTypeNNGGGNNNGNBLUECROSS BLUESHIELD (BCBS) IL HCSC **00621YBC OF ILFALSENBLUECROSS BLUESHIELD (BCBS) NM HCSC **00790TBC OF NMFALSENBLUECROSS BLUESHIELD (BCBS) OK HCSC **BMC Health Net PlanBoilermakers National Health & Welfare Fund##Boncura Health Solutions (Dupage MedicalGroup)Boon-Chapman Benefit Administrators, Inc.##Brand New Day (Encounters) ##Brand New Day (FFS) ##Braven Health0084013337YYBC OF OKBOSTON MED CENTERFALSEFALSENG36609YBOILERMAKERS NATLFALSEGDMG01NBONCURA HEALTHFALSEG74238UC001UC00284367YNNNBOON CHAPMANBRAND NEW ENCBRAND NEW FFSBRAVEN HEALTHFALSEFALSEFALSETRUEGGGNBravo HealthBridgeSpan ##BRIDGEWAY NETWORK **Bright Health Advantage Plan ##Brighton Health Plan Solutions (formerlyMAGNACARE) ##BritCay ##52192BRIDG68069BRT01YNYNBRAVO HEALTHBRIDGESPANBUCKEYE COMM HLTHBRIGHT HEALTHFALSEFALSEFALSEFALSETGGG
Allegian Choice ## 55649 Y PHOENIX CHOICE FALSE G Allegiance Benefit Plan Management, Inc. ## 81040 Y ALLEGIANCE BENE FALSE G Alliance Coal Health Plan ## 93658 N ALLIANCE COAL FALSE G Alliance, The (Only for ID Cards
