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1540 W Edgewood DriveIndianapolis, IN 46217Tel: (800) 724-7240Tesia Clearinghousewww.Tesia.comPayer Identification InformationPayer IDPayer 724237280A2051TLY50770783P AdministratorsA & I Benefit Plan AdministratorsA&D Charitable Foundation Inc (dba GreatLakes PACE)Acceptius (Benefit Management Inc of MO)Access DentalAcclaimsACEC Health Plan (Clinton IA) / TrustmarkACS Benefit Consulting Services, Inc.ACS Benefit SolutionsInsight Benefit AdministratorsAdministration Systems Research CorporationAdvantage by SuperiorAdvantek Benefit Administrators (Fresno, CA)Adventist Health System West - Roseville, CAAetna Better Health of West VirginiaAetna MedicareAffordable Benefit Administrators, Inc.AFLAC of GeorgiaAFLAC of New YorkAGC International Union of Operating Engineers Local 701 (F07)AK United Food and Commercial Workers (AK UFCW) (F45)Alaska Carpenters (F40)Alaska Electrical Health & Welfare FundAlaska Hotel Employees, Restaurant & Camp Employees (AK HERE) (F41)Alaska Laborers Construction Industry Health & Security Trust (F23)Alaska Machinists Health and Welfare Trust (F21)Alaska Pipe Trades U A Local 375 (F24)Alaska Public Employees Association (APEA/JESS Health & Welfare Trust) (F60)Alexian Brothers Community Services of TNAliera HealthcareAllCare CCO DentalAllegiance Benefit Plan ManagementAlliance CoalAlliant Services (aka Voluntary Benefits Plan and US Life Ins Co)Allied Benefit SystemsAllied Metal Crafts Security Plan Trust Fund (F18)Always Care BenefitsAmerican Administrative Group, Inc. (AAG)American Administrators (IA)American Postal Workers Union Health Plan (APWU)America's TPAAmeriHealth AdministratorsAmway Corporation / DentalAnchor Benefit Consulting IncAnthem Blue Cross (Blue Cross of California)Apex Benefit ServicesARC AdministratorsArgus Dental Plan (Encounters)Arkansas Municipal Health Benefit FundARM LTDArrow Benefits GroupASR CorporationASR Health BenefitsAssurant Health Supplemental DentalAssured Benefit AdministratorsAsurisAtlantic Dental (ADI)ATPA - Associated Third Party Administrators (CA offices)AultCare Dental (OH)Aultra Administrative GroupAutomated Group Administration (AGA)BAC Local 15 Welfare Fund (Kansas)Banner Health SystemsBanner Plan AdministrationCHSBABay Area Automotive GroupCHSBDCBAL1Bay Area Delivery DriversBCBS - AlabamaTBX01TFQ4584099BCBS - ArizonaBCBS - Arkansas FEP Claims ONLYBCBS - ColoradoTo submit to Payors not on this list, use Payor ID "06126"and be sure to submit all required fields, including Payor Name and Complete Address.Clearinghouse Payer ListClaims ProcessingAdditional Infoa Mediture Payera Mediture PayerA Performance Health Technology PayerAdministered by Health Services BenefitAdministratorsAdministered by Health Services BenefitAdministratorsIncludes BCBS Arizona FEP Claims PreviouslySubmitted Under Payer ID chBatchBatchBatchBatchBatchBatchBatchNon ParBatchNon ParNon ParBatchBatchNon ParNon ParNon ParOBatchBatchBatch(C) 2014 Tesia ClearinghouseEligibility and Benefits Information270sEnrollmentAvailable RequiredTypeLevel ofResponseEligibility NotesRemittance Information835sAvailableTRUETRUEPaper ETRUEWTRUETRUETRUETRUEWWOTRUEeAttachmentsERA NotesAccepts TesiaeAttachmentsTRUETRUERTGeneralTRUETesia Dental Payer Listing - Website (v 6.28.19).xlsx1 of 16
1540 W Edgewood DriveIndianapolis, IN 46217Tel: (800) 724-7240Tesia Clearinghousewww.Tesia.comPayer Identification InformationPayer IDPayer utDelawareFlorida - FEDERAL BSBCBSBCBSBCBSBCBSBCBSBCBS-IllinoisIndiana (FEP)Indiana (Anthem)Iowa (aka Wellmark Blue Dental)Iowa (FEP and Farm Bureau ONLY)Kentucky (FEP)Kentucky (Anthem)23739BME01BCBS - LouisianaBCBS - Maine BCBSBCBSBCBS-Maryland / CareFirstMassachusettsMichiganMichigan - Blue Care NetworkMinnesotaMinnesota - Federal Employee Program ippi (SPECIAL)MissouriMontanaNebraskaNevadaNew Hampshire (Anthem)North Carolina (FEP Program & Health Choice for Children)North Carolina DBS (aka ACS Benefit Services)North Dakota (aka North Dakota Dental Service)Ohio (Anthem)New MexicoOhio (FEP)OklahomaRIFEPBCBS - Rhode Island U4384103TLY47BCBS - Utah (Regence)BCBS - Virginia (Trigon)BCBS - Washington 37BCBS - WisconsinBenefit Administration ServicesBenefit Administrative Systems (BAS) (Homewood, IL)Benefit Coordinators Corporation (Pittsburgh, PA)Benefit Inc. (MN)Benefit Management Group (NV)Benefit Management of KansasBenefit Management Services (NC)Benefit Management Systems (MS)Benefit Plan Administrators IncBenefit Systems & Services, Inc. (BSSI) / Insurance Program Mgmt Group (IPMG)Benefits Inc (Construction Suppliers Group only)BeneMaxBest Life & Health Insurance CompanyBlue Care Family Plan (BCBS of CT)Blue Cross Blue Shield of KansasBlue Cross Blue Shield of Kansas CityBlue Cross of IdahoBoilermakers National Health & Welfare Fund (Int'l Brotherhood of Boilermakers)Boon-Chapman Benefit Administrators Inc-South CarolinaSouth DakotaTennessee (Claims ONLY - no PTE)TexasUtah (FEP) (Regence)To submit to Payors not on this list, use Payor ID "06126"and be sure to submit all required fields, including Payor Name and Complete Address.Clearinghouse Payer ListClaims ProcessingAdditional InfoIncludes BCBS Illinois FEP Claims PreviouslySubmitted Under Payer ID TLW12Includes BCBS - Louisiana FEP Claims PreviouslySubmitted Under Payer ID TLU05Includes Claims for BCBS MD CareFirst PreviouslySubmitted under Payer IDs TLX85, TLX86, TLX87,TLZ09, and TLU18Includes BCBS Mississippi FEP Claims PreviouslySubmitted Under Payer ID TBS02Only FEP claims should be submitted under thisPayer IDIncludes BCBS - South Carolina FEP ClaimsPreviously Submitter Under Payer ID TLW74Includes Claims for Regence Blue Cross UTPreviously Submitted Under Payer ID TLU95Includes BCBS WI Claims Previously SubmittedUnder Payer ID CB950 & Claim ManagementServices Claims Previously Submitted Under PayerID atchNon ParNon arParParParParParParParWWSSONon ParNonNonNonNonNonParParParParParLevel ofResponseEligibility hBatchBatchBatchWTypePaper EOBsShutoffEnrollmentwhenRequiredEnrolledONon ParNon ParNon rParParParPar270sEnrollmentAvailable RequiredRemittance InformationTRUEBatchWWEligibility and Benefits Information(C) 2014 Tesia iledTRUERTGeneraleAttachmentsERA NotesAccepts TesiaeAttachmentsTRUEOnly in-state providers mayenroll for UEWTRUETRUETRUETRUETRUETRUEOWWWTRUETesia Dental Payer Listing - Website (v 6.28.19).xlsx2 of 16
1540 W Edgewood DriveIndianapolis, IN 46217Tel: (800) 724-7240Tesia Clearinghousewww.Tesia.comPayer Identification InformationPayer IDPayer 3975TLU48Boston University Dental Health PlanBridgespan HealthBrokerage ConceptsBlue Shield of California (FEP Only)Butler Dental (IA)Cannon Cochran Management Services, Inc. (LA Plan ONLY)Capitol AdministratorsCapitol Dental Plan (OR)Caprock Health PlansCareOregonCarolina Summit Healthcare s TPA LLCCascade Comprehensive Care IncCBA Blue (Comprehensive Benefits Administrator, Inc)CBCA - Comprehensive Benefits & Claims AdministratorsCCPOA Benefit Trust FundCDS Group Health (NV)Cement Masons & Plasterers Health & Welfare Trust (F16)Central Reserve Life Insurance 054532152132TLX807513641045481173518235180CHAMPVA - HACChesterfield Resources, Inc.Children of Women Vietnam Veterans - VA HACChristian Brothers Services (CBS Health Benefits)Citizens Security Life Insurance CoClaims Bridge NorthClaims Bridge NWClaims Bridge SouthCombined Insurance Claims (FL)Community Health Alliance of TNCommunity Health Electronic Claims (CHEC/Webta)Companion LifeCompanion LifeCompBenefits (Chicago, IL)Comprehensive Care ServicesComprehensive Healthcare OptionsComprehensive Medical and Dental Program CMDPConsociate, Inc.Consolidated Group DentalConsumers Choice Health Plan - State of SCCooperative Benefit AdministratorsCORE Administrative ServicesCoreSource ARCoreSource AZ MNCoreSource KC (fka FMH Benefit Services Inc)CoreSource MD PA ILCoreSource NC eSource OH (Clinton, IA)Covenant AdministratorsCoventry Health Care of GeorgiaCoventry Healthcare National NetworkCreative Plan Administrators (MD)Crescent DentalCrescent Health SolutionsCrowe Paradis Services Corp.CTI DVA194235CX04946278DNOAT39148CX014Dart Management CorporationDDS IncDeCare Dental Health InsuranceDelta Dental of MassachusettsDelta Dental of MinnesotaDelta Dental of North DakotaDelta Dental of Puerto RicoDelta Dental of VirginiaDelta Health Systems (CA)Denex/SGDental Health & WellnessDental Network of America (DnOA)Dental Professionals of Wisconsin (fka Southeast Dental Associates (SEDA))DentaQuest - Medicaid (fka Doral Dental Plan)To submit to Payors not on this list, use Payor ID "06126"and be sure to submit all required fields, including Payor Name and Complete Address.Clearinghouse Payer ListClaims ProcessingAdditional InfoOther names related to this payer are HealthyMichigan Dental and DentCapCHAMPVA-HAC is not associated with and does notprocess claims for TRICARE (fka CHAMPUS)Includes Coresource IA Claims Previously SubmittedUnder Payer ID TFQ37Includes Claims for Dart Container CorporationPreviously Submitted Under Payer ID atchBatchBatchBatchBatchBatchBatchBatchBatch(C) 2014 Tesia ClearinghouseEligibility and Benefits Information270sEnrollmentAvailable RequiredTypeLevel ofResponseEligibility NotesRemittance Information835sAvailablePaper ntsERA NotesAccepts UETRUERTRTDetailedDetailedTRUEWTRUETRUETesia Dental Payer Listing - Website (v 6.28.19).xlsx3 of 16
1540 W Edgewood DriveIndianapolis, IN 46217Tel: (800) 724-7240Tesia Clearinghousewww.Tesia.comPayer Identification InformationPayer IDPayer LY84BCAFDTLU63TFZ08R700425059TLU72Denti-Cal (Medicaid of California)Department of Economic SecurityDeseret Mutual Benefit Administrators (DMBA)District Counsel 37 Health & Welfare FundDQ / Emblem (Emblem Health Medicaid)EBMS Employee Benefit Management Services IncEddy SeniorCareEducators Life Ins (EMI) / Educators Mutual (UT)EHIElderwood HealthEMPHESYS Employers Health of WisconsinEmpire Blue Cross Blue Shield (NY)Employee Benefit Management Corp (EBMC) (OH)Employee Benefit Concepts (Farmington Hills, MI)Employee Benefit Plan Administration, Inc. (EBPA)Employee Benefits Consultants (EBC INC - OH)Employee Benefits Services IncEmployee Plan Services, Inc. (EPSI)Employee Plans, LLCEmployers Direct HealthEmployers Health Insurance of Wisconsin (EHI) (EMPHESYS)Employers Mutual, Inc.EPSI Dental II (fka Capital Dental)E-V Benefits Management, Inc.Everence (fka Mennonite Mutual Aid)Evergreen Health Co-opFairbanks North Star Borough (F62)Family DentalFamilyCare CCOFCE Benefit Administrators (TX)FEP Blue Dental (Decare)First Dental Health (FDH)First Plan BlueFlex CompensationForest County PotawatomiFoundation Benefits erett IncFox Valley Welfare FundFraternal Order of Police -- Dental DivisionFringe Benefit Coordinators of FLGallagher Benefit AdministratorsGateway Health PlanGCU Local 8-M & 96B Health & Welfare FundGEGLAC - G.E. Group Life Assurance Company - DentalGenworth Life and Health Insurance CompanyGettysburg Insurance ServicesGIC (Indemnity Plan)Gilsbar, IncGolden West DentalGovernment Employees Health Association (GEHA)Government Employees Health Association (GEHA)Great-West HealthcareGreat-West Healthcare (fka General American Life Insurance Company)Group Dental Service of Maryland, Inc. / GDS-MDGroup Insurance Service Center, Inc.Group Plan SolutionsHamaspik ChoiceHarrington Benefit Services, Inc. (fka HealthPlan Services Oklahoma)Harrington Health Colonial DentalHawaii Dental Services (HDS) / Delta Dental of HawaiiHawaii-Mainland AdministratorsHawaii Medical Assurance Association (HMAA)Hawaii-Western Management Group (HWMG)HCS - Health Claims ServiceHealth Choice Integrated CareHealth First TPAHealth Partners of Minnesota (Commercial Plan)Health Partners of Minnesota (Minnesota Medical Assistance)Health Plan Services (FL)Health Plans, Inc.Health Traditions - MMSIHealthcare Management Administrators, Inc. (HMA)To submit to Payors not on this list, use Payor ID "06126"and be sure to submit all required fields, including Payor Name and Complete Address.Claims ProcessingAdditional Infoa Mediture PayerA Performance Health Technology PayerIncludes Fox-Everett (MS) Claims PreviouslySubmitted Under Payer ID TLY81a Mediture PayerClearinghouse Payer BatchBatchBatchBatchBatch(C) 2014 Tesia ClearinghouseEligibility and Benefits Information270sEnrollmentAvailable RequiredTypeLevel ofResponseEligibility NotesRemittance Information835sAvailablePaper STRUETRUEeAttachmentsERA NotesAccepts ETesia Dental Payer Listing - Website (v 6.28.19).xlsx4 of 16
1540 W Edgewood DriveIndianapolis, IN 46217Tel: (800) 724-7240Tesia Clearinghousewww.Tesia.comPayer Identification InformationPayer IDPayer 8310HealthCare Payer’s CoalitionHealthChoice AZHealthChoice InsuranceHealthChoice of OklahomaHealthE Exchange IncHealthEdge AdministratorsHealthgram Inc (fka Primary Physician Care Inc)HealthShare CCOHealthSmart Benefit Solutions (fka Acordia National, Wells Fargo TPA)HealthTransHeavy & General LaborersHometown Health PlansHorizon BCBS NJ FEP ClaimsHorizon Blue Cross Blue Shield of New JerseyHorizon Healthcare of New YorkHotel Employees Restaurant Employees Health Trust (HERE) (F19)HSBS Memphis (fka Pitman & Associates)HSBS Oklahoma City (fka Mutual Assurance Administrators Inc)Humana DentalI.E. Shaffer (West Trenton, NJ)IATSE - International Association of Theatrical Stage EmployeesIBEW Local 364IBEW Local 461IBEW Local 481Immanuel Pathways - Central IowaImmanuel Pathways - NebraskaImmanuel Pathways - SW IowaIndiana Children's Special Health CareIndiana Teamsters Health Benefit Funds (fka Local 135 Health Benefits Fund)Innovate Benefit AdministratorsInnovation HealthInsurance Administrators of AmericaInsurance Design Administrators (Oakland NJ)Insurance Management ServicesInsurers Administrative Corp / IHC Administrative CorpInteractive Medical Systems, Inc.Itasca Medical CareJensen Administrative Services, Inc.JI Specialty Services CompanyJohn Morrell Company- LCB0184041IAHFI9113662413CX098TLZ3087065Joint Benefit TrustJP Farley CorporationKaiser Permanete Dental ChoiceKalos HealthKanawha Insurance Company (Lancaster and Greenville, SC)Kansas City Laborers Welfare FundKansas City Life Insurance Company / KCL Group BenefitsKeenan AssociatesKentucky Health Co-OpKlais & CompanyLIFE ArmstrongLIFE Beaver & LawrenceLIFE ButlerLife Circles PACELife Insurance Company of Boston & New York (Student Insurance)LIFE St Joseph of the PinesLIFE St MaryLifewise Health Plan of OregonLincoln National (WI) (in Madison or Green Bay)Line Construction Benefit (Line Co)Local 137 Operating Engineers Welfare FundLocal 17 Fund - International Association of Heat and Frost InsulatorsLocals 302 & 612 of the International Union of Operating Engineers (F12)Mail Handlers Benefit Plan (Also known as Mailhandlers/CAC)Masonry Institute/ Administrative D.C. No.1 Welfare FundMBA
Michigan Dental and DentCap Non Par Batch CHA01 Cascade Comprehensive Care Inc Non Par Batch 03036 CBA Blue (Comprehensive Benefits Administrator, Inc) Non Par Batch TLW14 CBCA - Comprehensive Benefits & Claims Administrators Non Par Batch TLZ03 CCPOA Benefit Trust Fund
