Page 1 of 48 · 2015. 10. 6. · Aspire Health Plan 46156 Y N 46156 Y N ASR 38265 N N 38265 N N ASR...
Transcript of Page 1 of 48 · 2015. 10. 6. · Aspire Health Plan 46156 Y N 46156 Y N ASR 38265 N N 38265 N N ASR...
Payer Code
Accepts
Secondary
Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
1199 National Benefit Fund 13162 N N 13162 N N
1st Medical Network - Atlanta GA 29076 Y N 29076 Y N
1st MN--Atlanta GA 29076 Y N 29076 Y N
21st Century Health and Benefits 59069 N N 59069 N N
21st Century Insurance and Financial Services 51028 N N 51028 N N
3P ADMIN 20413 Y N 20413 Y N
A & I Benefit Plan Administrators 93044 N N 93044 N N
A.G.I.A. Inc. 95241 N N 95241 N N
AAG Benefit Plan Administrators Inc. 75240 Y N 75240 Y N
AAG-American Administravie Group ( Formerly Icon Benefit Admin) 75185 Y N 75185 Y N
AARP - UnitedHealthcare Insurance Company 36273 Y N 36273 Y N
AARP MedicareComplete through UnitedHealthcare/AARP MedicareComplete 87726 Y N 87726 Y N
AARP MedicareComplete thru UnitedHealthcare (formerly Lifeprint Arizona) LIFE1 Y N LIFE1 Y N
ABMA (Alta Bates Medical Assocs) Medical Corp (Hnet Sr. and Secure Horizon) E3510 N Y
Abrazo Advantage Health Plan 03443 Y N 03443 Y N
Absolute Total Care 68069 Y N 68069 Y N
Access Community Health Network. Chicago IL Family Health Network patients 51909 N N 51909 N N
Access Medical Group 95424 Y N
Access Medicare 19305 N N 19305 N N
Acclaim 64071 Y N 64071 Y N
ACMG 37118 N N 37118 N N
ACS Benefit Services Inc. 72467 N N 72467 N N
Activa Benefit Services LLC 38254 N N 38254 N N
Administration Systems Research Corporation 38265 N N 38265 N N
Administrative Concepts Inc. 22384 N N 22384 N N
Administrative Services Inc. 59141 N N 59141 N N
ADVANCED DATA SOLUTIONS 58202 N N 58202 N N
Advanced Physician's Association Chicago IL MG#118 51909 N N 51909 N N
Advantage by Bridgeway Health Solutions 68069 Y N 68069 Y N
Advantage by Buckeye Community Health Plan 68069 Y N 68069 Y N
Advantage by Managed Health Services 68069 Y N 68069 Y N
Advantage by Peach State 68069 Y N 68069 Y N
Advantage by Sunshine State 68069 Y N 68069 Y N
Advantage by Superior HealthPlan 68069 Y N 68069 Y N
Advantage Health Solutions 35209 N N 35209 N N
Advantek Benefit Administrators 83077 N N 83077 N N
ADVANTICA BENEFITS 59374 Y N 59374 Y N
Advanzeon Solutions 59314 N N 59314 N N
Adventist Health System West - Roseville CA 95340 N N 95340 N N
Advicare 45423 N N 45423 N N
Advocate Medical Group - AMG (Legacy AHC) 36320 N N 36320 N N
Advocate Physician Partners 65093 N N 65093 N N
Aetna 60054 Y N 60054 Y N
Aetna Affordable Health Choices (SM) - SRC 57604 Y N 57604 Y N
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Page 1 of 48
Payer Code
Accepts
Secondary
Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Aetna Better Health - PA Medicaid 23228 Y N 23228 Y N
Aetna Better Health Inc. 34734 N N 34734 N N
Aetna Better Health of Illinois 26337 N N 26337 Y N
Aetna Better Health of Louisiana 128LA Y N 128LA Y N
Aetna Better Health of Michigan 128MI Y N 128MI Y N
Aetna Better Health of Missouri 128MO Y N 128MO Y N
Aetna Better Health of Nebraska 42130 Y N 42130 Y N
Aetna Better Health of New Jersey 46320 Y N 46320 Y N
Aetna Better Health of Ohio 50023 Y N 50023 Y N
Aetna Better Health of Pennsylvania 23228 Y N 23228 Y N
Aetna TX Medicaid & CHIP 38692 N N 38692 N N
Affiliated Physicians Group APG01 N N
Affinity Essentials 23334 Y N 23334 Y N
Affinity Health Plan 13334 N Y 13334 N Y
AFFINITY MEDICAL GROUP 46594 N N 46594 Y N
Affinity Medicare Advantage 13333 N N 13333 N N
Affordable Benefit Administrators Inc. 95426 N N 95426 N N
AFTRA Health Fund 13346 N N 13346 N N
AGA 37280 N N 37280 N N
Agate Resources Inc. (LIPA) 20048 N N
Agency Services Inc 64158 N N 64158 N N
AHPO (Cleveland OH) 31138 N N 31138 N N
Alabama Medicaid 12K01 Y N SKAL0 Y N
Alaska Carpenters Trust 91136 N N
Alaska Children's Services Inc. 91136 N N 91136 N N
Alaska Electrical Health & Welfare Fund 92600 N N 92600 N N
Alaska Laborers Construction Industry Trust 91136 N N 91136 N N
Alaska Pipe Trades Local 375 91136 N N 91136 N N
Alaska United Food & Commercial Workers Health & Welfare Trust 91136 N N 91136 N N
ALICARE 13550 N N 13550 N N
Alivio Family Medical Family Health Network patients only 51909 N N 51909 N N
All Savers/UHC 81400 N N 81400 N N
Allcare PEBB 26158 N N 26158 N N
Allegian Choice 55649 N N 55649 N N
Allegiance Benefit Plan Management Inc. 81040 N N 81040 N N
Alliance Behavioral Health 23071 Y Y 23071 Y Y
Alliance Healthcare/Florida for Stones River Regional IPA 13079 N N
Alliance IPA HCP01 N N
Alliant Health Plans of Georgia 58234 N N 58234 N N
Allianz Global Assistance 50749 N N 50749 N N
Allied Benefit Systems 37308 N N 37308 N N
Alta Bates Medical Group A0701 N N A0701 N N
Alta Senior Care (Hnet Sr and Secure Horizons only) E3510 N Y
Altius Health Plans 25133 Y N 25133 Y N
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Payer Code
Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
AMA Insurance Agency AMAIA N N TH071 N N
Amalgamated Life 13550 N N 13550 N N
Amalgamated Life - PA / Alicare 13343 N N 13343 N N
AMCO 62176 N N 62176 N N
AmeraPlan 38219 N N 38219 N N
AmeriBen Solutions Inc. 75137 N N 75137 N N
Americaid Community Care (Maryland) 27517 Y N 27517 Y N
Americaid Community Care (New Jersey) 27516 Y N 27516 Y N
American Administrative Group 75240 Y N 75240 Y N
American Administrators dba Select Benefit Administrators (W.DesMoines IA) 42137 N N 42137 N N
American Behavioral 63103 N N 63103 N N
American Benefit Plan Administrators 95170 N N 95170 N N
American Community Mutual Insurance 60305 N N 60305 N N
American Family Insurance 12T31 N N TH095 N N
American Family Medicare Sup and PPO Policies Administered by Am Rep 56071 N N 56071 N N
American Fidelity Assurance Company 60801 N N 60801 N N
American General 62030 N N 62030 N N
American Healthcare Alliance 01066 N N 01066 N N
American Heritage 77083 N N
American Imaging Management Inc. 36369 N N 36369 N N
American National Ins. Co. (ANICO) 74048 N N 74048 N N
American National Property and Casualty Company (ANPAC) 43101 N N 43101 N N
American Postal Workers Union Health Plan 44444 N N 44444 N N
American Progressive Life and Health Insurance Company 48055 N N 48055 N N
American Republic Insurance 42011 N N 42011 N N
American Sentinel Co. 17965 Y N
American Specialty Health Plans 43146 N N
American Trust Administrators Inc. 56195 N N 56195 N N
American Worker Health Plan 37322 Y N 37322 Y N
Americas 1st Choice Health Plans of South Carolina Inc. 20553 N N 20553 N N
Americas 1st Choice of South Carolina, Inc 55349 N N 55349 N N
America's Choice Health Plans 20029 N N 20029 N N
America's PPO 16120 N N 16120 N N
America's TPA 41178 N N 41178 N N
Amerigroup Community Care 27514 Y N 27514 Y N
AMERIGROUP Community Care of New Mexico 27514 Y N 27514 Y N
Amerigroup Corporation (Ft Worth) 27514 Y N 27514 Y N
Amerigroup Corporation (Houston) 27515 Y N 27515 Y N
Amerigroup Florida 27519 Y N 27519 Y N
AMERIGROUP Georgia 27514 Y N 27514 Y N
Amerigroup Illinois 27518 Y N 27518 Y N
Amerigroup Ohio 27518 Y N 27518 Y N
AmeriHealth Administrators 54763 Y N 54763 Y N
AmeriHealth Caritas Pennsylvania 22248 Y N 22248 Y N
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Claims
Enrollment Payer Code
Accepts
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Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
AmeriHealth Caritus VIP Care Plus (Michigan) 77013 N N 77013 N N
Amerihealth District of Columbia 77002 N N 77002 N N
Amerihealth NJ/DE – HMO 23037 Y N 23037 Y N
AmeriHealth NorthEast 77001 Y N 77001 Y N
AmeriHealth VIP Care 22355 Y N 22355 Y N
AmeriHealth VIP Care - DC 77007 Y N 77007 Y N
AmeriHealth VIP Care - LA 77006 Y N 77006 Y N
AmFirst Insurance Company (Secondary Claims Only) 64090 Y Y 64090 Y Y
Amida Care 24818 N N 24818 N N
Amida Care Medicare 79966 N N 79966 N N
Anchor Benefit Consulting Inc. 53085 Y N 53085 Y N
Ancillary Benefit Services (ABS) 86062 Y N 86062 Y N
Ancillary Care Management/ACM 03172 N N
Angeles IPA (SynerMed) 75299 N N 75299 N N
Antares Management Solutions 34192 Y N 34192 Y N
Anthem Blue Cross Blue Shield of Connecticut 12B04 Y N SB560 Y N
Anthem Blue Cross Blue Shield of Georgia 12015 Y N SB600 Y N
Anthem Blue Cross Blue Shield of Indiana 12B09 Y N SB630 Y N
Anthem Blue Cross Blue Shield of Kentucky 12B11 Y N SB660 Y N
Anthem Blue Cross Blue Shield of Maine 12B13 Y N SB680 Y N
Anthem Blue Cross Blue Shield of Missouri SB741 Y N SB741 Y N
Anthem Blue Cross Blue Shield of Missouri (Blue Choice) 12B65 Y N
Anthem Blue Cross Blue Shield of Nevada 12B20 Y N SB765 Y N
Anthem Blue Cross Blue Shield of New Hampshire 12B21 Y N SB770 Y N
Anthem Blue Cross Blue Shield of Ohio 12B24 Y N SB338 Y N
Anthem Blue Cross Blue Shield of Virginia 12002 Y N SB923 Y N
Anthem Blue Cross Blue Shield of Wisconsin 12B29 Y N SB950 Y N
Anthem Blue Cross of California 47198 Y N 47198 Y N
Anthem Blue Cross of Colorado 12B03 Y N SB550 Y N
Apex Benefit Services 34196 Y N 34196 Y N
APS Healthcare Inc. 54160 N N 54160 N N
AR Medicare Part A (JH) 12022 Y Y
AR Medicare Part B (JH) SMAR0 Y Y
Araz Group 16120 N N 16120 N N
Arbor Health Plan 52312 Y N 52312 Y N
Arcadian Management Services Inc 77045 N N 77045 N N
Arch Health Partners ARCH1 N N ARCH1 N N
Argus Dental Plans, Inc. ARGUS N N ARGUS N N
ARISE 39185 N N 39185 N N
Arizona Foundation for Medical Care (AFMC) 86062 Y N 86062 Y N
Arizona Priority Care Plus 27154 N N 27154 N N
Arkansas Best Corporation - Choice Benefits 75278 N N 75278 N N
Arkansas Medicaid 12023 Y N SKAR0 Y N
ARM Grp 88035 N N 88035 N N
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Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
ASAGEHA 06603 N N 06603 N N
Asian Human Services Family Family Health Network patients only 51909 N N 51909 N N
Aspen Medical Associates 16180 Y N 16180 Y N
Aspire Health Plan 46156 Y N 46156 Y N
ASR 38265 N N 38265 N N
ASR Corporation 38265 N N 38265 N N
ASR Health Benefits 38265 N N 38265 N N
ASRM Corporation ASRM1 N N
Associates for Health Care Inc. (AHC) 36326 N N 36326 N N
Assurant Health (IM & GROUP FULLY-INSURED) 39065 N N 39065 N N
Assurant Health (Repricing for HealthSpan Network Only) ASNTH N N ASNTH N N
Assurant Health Self Funded 75068 Y N 75068 Y N
Assurant Health Self-Funded (Ft. Mill SC) 37313 Y N 37313 Y N
Assurant Health/ASA (Assurant Health members with ASA PPO Network) 58730 N N 58730 N N
Assured Benefits Administrators 74240 Y N 74240 Y N
Asuris NW Health 93221 N N 93221 Y N
ATA-FL 65064 Y N 65064 Y N
Athens Area Health Plan Select 95691 N N 95691 N N
Atlantic Medical Insurance 22285 N N 22285 N N
AultCare MNAUL N Y
Aultra Administrative Group 37242 N N 37242 N N
Automated Benefit Services 38259 Y N 38259 Y N
Automated Group Administration Inc. 37280 N N 37280 N N
Avera Health Plans 46045 N N 46045 N N
AveraAdvantage 48055 N N 48055 N N
Avesis Third Party Administrators 87098 Y N
AvMed Inc. 59274 Y N 59274 Y N
AXA Assistance_USA 65101 N N 65101 N N
Azeros Health Plans Inc. 16644 N N 16644 N N
Banker's Life 99999-0178 N N
Banner Health 12X42 Y N 12X42 Y N
Banner Health AZ SX145 Y N
Banner Health Co - ROCKY MOUNTAIN HMO GREELEY SX145 Y N
Banner Health Co. - ANTERO GREELEY SX145 Y N
Banner Health Co. - ANTERO HIGH PLAINS SX145 Y N
Banner Health Co. - ANTERO MOUNTAIN SHADOWS SX145 Y N
Banner Health Co. - CHOICE PLUS SX145 Y N
Banner Health Co. - HMO GREELEY SX145 Y N
Banner Health Co. - HMO HIGH PLAINS SX145 Y N
Banner Health Co. - HMO MOUNTAIN SHADOWS SX145 Y N
Banner Health Co. - PACIFICARE GREELEY SX145 Y N
Banner Health Co. - PACIFICARE HIGH PLAINS SX145 Y N
Banner Health Co. - PACIFICARE MOUNTAIN SHADOWS SX145 Y N
Banner Health Co. - ROCKY MOUNTAIN HMO HIGH PLAINS SX145 Y N
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Payer Code
Accepts
Secondary
Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Banner Health Co. - SECURE HORIZONS GREELEY SX145 Y N
Banner Health Co. - SECURE HORIZONS HIGH PLAINS SX145 Y N
Banner Health Co. - SECURE HORIZONS MOUNTAIN SHADOWS SX145 Y N
Baptist Health South Florida 65026 N N 65026 N N
Bass Administrators Inc. 37248 N N 37248 N N
BCBS of AZ Advantage 77078 Y N 77078 Y N
BEACON HEALTH STRATEGIES 43324 Y N 43324 Y N
Beech Street 95377 N N 95377 N N
Behavioral Health Systems 63100 N N 63100 N N
Bellflower Hospital (Synermed) 75299 N N 75299 N N
Benefit & Risk Management Services 99320 N N 99320 N N
Benefit Administrative Systems 36149 N N 36149 N N
Benefit Coordinators Corporation (Pittsburgh PA) 25145 N N 25145 N N
Benefit Management Admin (BMA) BMATP N N
Benefit Management Group-NV 36459 Y N 36459 Y N
Benefit Management Inc. of KS 48611 N N 48611 N N
BENEFIT MANAGEMENT SERVICES 56139 N N 56139 N N
Benefit Management Systems Inc 37212 N N 37212 N N
Benefit Plan Administrators 88052 N N 88052 N N
Benefit Plan Administrators Co. (Eau Claire WI) 39081 N N 39081 N N
Benefit Plan Administrators Inc 37118 N N 37118 N N
Benefit Systems & Services Inc. 36342 N N 36342 N N
Benesight 87265 Y N 87265 Y N
Benesys 37248 N N 37248 N N
Benesys Inc. 37248 N N 37248 N N
Berkshire Health Partners - PPO Wyomissing PA (IHS Gateway Payer) 23243 Y N 23243 Y N
Berkshire Intergroup 10956 Y N 10956 Y N
Berkshire Lehigh Partners 95606 Y N 95606 Y N
Best Life & Health Insurance Co. 95604 N N 95604 N N
Better Health Plan of Florida 20488 N N 20488 N N
Better Health Plans Inc. 62183 Y N 62183 Y N
Better Health Plans of South Carolina 32006 N N 32006 N N
Blue Benefit Administrators of MA 03036 N N 03036 N N
Blue Choice Medicaid Managed Care 00403 Y N 00403 Y N
Blue Cross Blue Shield of Alabama 12B54 Y Y SB510 Y Y
Blue Cross Blue Shield of Arkansas 12021 Y Y SB520 Y Y
Blue Cross Blue Shield of Illinois 12B08 Y N SB621 Y N
Blue Cross Blue Shield of Kansas 47163 Y Y 47163 Y Y
Blue Cross Blue Shield of Kansas City 47171 Y Y 47171 Y Y
Blue Cross Blue Shield of Massachusetts 12B14 Y N SB700 Y N
Blue Cross Blue Shield of Michigan 00210 Y N 00710 Y N
Blue Cross Blue Shield of Mississippi SB730 Y Y
Blue Cross Blue Shield of North Carolina 12B23 Y N SB810 Y N
Blue Cross Blue Shield of Oklahoma 00840 Y N 00840 Y N
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Blue Cross Blue Shield of South Carolina 12B55 Y Y SB880 Y Y
Blue Cross Blue Shield of Tennessee 00390 Y Y 00390 Y Y
Blue Cross Blue Shield of Texas 84980 Y N 84980 Y N
Blue Cross Community Option MCDIL Y N MCDIL Y N
Blue Shield of California BSCAI N N BS001 Y N
BlueChoice HealthPlan 00922 Y N 00922 Y N
Bluegrass Family Health 61124 N N 61124 N N
Boilermakers National Health & Welfare Fund 36609 N N 36609 N N
Bollinger, INC. - BOLLINGER BOLL1 Y N
Boon-Chapman Benefit Administrators Inc. 74238 N N 74238 N N
Boston Health Net 13337 Y N 13337 Y N
Bravo Health 52192 N N 52192 N N
Bravo Health Star Plus 52192 N N 52192 N N
Bridgeway Arizona 68069 Y N 68069 Y N
BritCay 22286 N N 22286 N N
Brodart 35182 Y N 35182 Y N
Brokerage Concepts 51037 Y N 51037 Y N
Broward Health 37314 N N 37314 N N
Brown & Toland Medical Group 94316 N N 94316 N N
Brown and Toland Health Services BTHS1 N N BTHS1 N N
Brown and Toland Medical Group BTSS1 N N
Buckeye Community Health 68069 Y N 68069 Y N
Butler Benefit 42150 Y N 42150 Y N
C&O Employees Hospital Association 23708 N N
C. L. Frates & Co - OSMA Health 73071 N N 73071 N N
CA Medicare 12M64 Y Y
California Health and Wellness 68047 Y Y 68047 Y Y
California IPA CAIPA N N CAIPA N N
California Medicaid (Medi-Cal) CAMC1 N Y SKCA0 Y Y
California Pacific Medical Center 94056 Y N 94056 Y N
Cannon Cochran Management Services Inc. Metairie LA 71057 N N 71057 N N
CAP Management Systems 95399 Y N 95399 Y N
Capital Blue Cross/CAIC 23045 Y N
Capital Health Plan 95112 N N 95112 N N
Capitol Administrators 68011 N N 68011 N N
Care 1st Health Plan of Arizona 57116 N N 57116 N N
CARE 1ST HEALTH PLAN OF CA 57115 N N 57115 N N
Care Access Health Plan (CAHP) 65062 N N
Care Access PSN 65063 N N
Care Improvement Plus 77082 N N 77082 N N
Care To Care 41222 N N 41222 N N
Care Wisconsin Health Plan (Trizetto) 27004 N N 27004 N N
CareCentrix 11345 N Y 11345 N Y
CareCore National 14182 N N
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
CareCore National LLC (Aetna Radiology Claims) 14179 N N 14179 N N
CareCore National LLC (Oxford Radiology Claims) 14180 N N
CareCore/WCNY RAD 14188 N N
CareFirst Administrators/NCAS (Charlotte, NC) 75191 N N 75191 N N
CareFirst Administrators/NCAS (Fairfax, VA) 75190 N N 75190 N N
CareFirst BlueCross BlueShield MD Region 12011 N N SB690 Y N
CareFirst BlueCross BlueShield NCA Region 12000 N N SB580 Y N
CareFlorida 65088 N N 65088 N N
Carelink Medicaid 25133 Y N 25133 Y N
CareOregon Inc. 93975 N N 93975 N N
CarePlus Health Plans Inc. 65031 Y N
Carepoint Health Plans 77023 N N 77023 N N
CareSource 26160 N N 26160 N N
CareSource Indiana INCS1 N N INCS1 N N
CareSource KY KYCS1 N N KYCS1 N N
CareSource OH 31114 Y N 31114 Y N
Careworks 10010 N N 10010 N N
Carilion Clinic Medicare Health Plan 77015 N N 77015 N N
Cariten Senior Health 62072 Y N 62072 Y N
Carolina Benefit Administrators 00498 N N 00498 N N
Carolina Care Plan 29076 Y N 29076 Y N
Carpenters Health and Welfare Fund of Philadelphia CX101 N N
CBA Blue 03036 N N 03036 N N
CBHNP - HealthChoices 65391 N N 65391 N N
CCAI CCAI N N CCAI N N
CDS Group Health 88022 N N 88022 N N
Cedars Sinai Medical Center 33010 Y N
Cedars-Sinai Medical Network Services 95166 N N 95166 N N
Celtic Insurance 68063 Y N 68063 Y N
CeltiCare 68069 Y N 68069 Y N
Cement Masons & Plasterers Health & Welfare Trust 91136 N N 91136 N N
Cencal Health 99111 Y N
Cenpatico - Arizona 68068 Y N 68068 Y N
Cenpatico - Florida 68068 Y N 68068 Y N
Cenpatico - Georgia 68068 Y N 68068 Y N
Cenpatico - Illinois 68068 Y N 68068 Y N
Cenpatico - Indiana 68068 Y N 68068 Y N
Cenpatico - Kansas 68068 Y N 68068 Y N
Cenpatico - Kentucky 68068 Y N 68068 Y N
Cenpatico - Massachuetts 68068 Y N 68068 Y N
Cenpatico - Mississippi 68068 Y N 68068 Y N
Cenpatico - Missouri 68068 Y N 68068 Y N
Cenpatico - Ohio 68068 Y N 68068 Y N
Cenpatico - South Carolina 68068 Y N 68068 Y N
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Claims
Enrollment Payer Code
Accepts
Secondary
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Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Cenpatico - Texas 68068 Y N 68068 Y N
Cenpatico - Wisconsin 68068 Y N 68068 Y N
CountyCare (Cenpatico TPA) 42138 N N 42138 N N
Centegra Health System 36474 N N 36474 N N
Centene Advantage Plans 68068 Y N 68068 Y N
CountyCare (Centene TPA) 42139 N N 42139 N N
Center for Elders Independence 94312 Y N 94312 Y N
CenterLight Healthcare 13360 Y N 13360 Y N
CenterPoint Human Services 56122 Y N 56122 Y N
CentraCare 66698 N N 66698 N N
Central & Southwest Services 75177 Y N
Central DuPage Physician Group 36314 N N 36314 N N
Central Mass Heath Care 02041 Y N
Central Reserve Life 34097 N N 34097 N N
Central Reserve Life Ins Co-Medicare Supplement 13193 Y N 13193 Y N
Central SeniorCare 62218 N N 62218 N N
Central States Health & Welfare Funds 36215 N N 36215 N N
Central Susquehanna Healthcare Providers (CSHP) 55731 Y N 55731 Y N
Central Valley Medical Group 77035 Y N 77035 N N
Centurion 42140 N N 42140 N N
Century Health Solutions 48120 Y N 48120 Y N
Century PHO INC 36393 Y N 36393 Y N
Cerner HealthPlan Services 20356 N N 20356 N N
CHA Health 23171 N N 23171 N N
CHAMPVA - HAC 84146 Y N 84146 Y N
Chautauqua County Healthcare Plan (Mayville NY) 16600 N N 16600 N N
Chesterfield Resources Inc. 34154 N N 34154 N N
Chicago Family Health Center Family Health Network patients only 51909 N N 51909 N N
Childhealth Plus by Healthfirst (CHP) 80141 Y N
Children First Medical Group 94321 N N
Children of Women Vietnam Veterans-VA HAC 84146 Y N 84146 Y N
Children's Medical Security Plan of Massachusetts 80314 Y N 80314 Y N
Children's Medical Services - Broward NORTH 37314 N N 37314 N N
Chinese Community Health Plan 94302 N N 94302 N N
CHOC - Children's Hospital Of Orange County Health Alliance 33065 N N 33065 N N
CHP DIRECT SUPERMED 90441 N N 90441 N N
Christian Brothers Services 38308 N N 38308 N N
Christian Care Ministries 59355 N N 59355 N N
Christie Student Health Plans 75544 N N 75544 N N
Christus Health Medicare Advantage 10629 N N 10629 N N
Christus Health New Mexico HIX 21062 N N 21062 N N
Christus Texas Medicaid 45210 Y N 45210 Y N
CIGNA 62308 Y N 62308 Y N
CIGNA - PPA 62308 Y N 62308 Y N
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Enrollment Payer Code
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CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
CIGNA - PPO 62308 Y N 62308 Y N
CIGNA Behavioral Health MCCBV N N SX071 Y N
CIGNA Health Plan - HMO 62308 Y N 62308 Y N
CIGNA Medicare Advantage 86033 N N 86033 N N
Cincinnati Financial Corporation 46871 Y N 46871 Y N
Claims Development Corporation 43056 N N
ClaimsBridge HPN 11752 Y N 11752 Y N
Claimshop- Employers Coalition on Health - MULTIPLAN PHCS/ECOH 27008 N N 27008 N N
ClaimsWare Inc. dba ManageMed 57080 N N 57080 N N
Clearchoice Health Plan / COIHS 77201 N N
CM Administrators Inc 56211 N N 56211 N N
CMCS Advantage Health Solutions Medicare 35219 N N 35219 N N
CMHC 02041 Y N
CNIC Health Solutions Inc. 37227 N N 37227 N N
CO Medicare Part A (JH) 12M03 Y Y
CO Medicare Part B (JH) SMCO0 Y Y
Coachella Valley Physicians IP079 N N IP079 N N
Coastal Administrative Services 77052 N N 77052 N N
Coastal Care 43141 N Y 43141 N Y
Coastal Care Services Inc 47394 N N
Cofinity 38335 N N 38335 N N
Colonial Medical 22284 N N 22284 N N
Colorado Access 84129 N N
Colorado Health OP 49718 N N 49718 N N
Columbia United Providers 91162 Y N 91162 Y N
Commerce Benefits Group 34181 N N 34181 N N
Commercial Travelers/PHX 88091 N N 88091 N N
Common Ground Healthcare Cooperative 77170 N Y 77170 N Y
Commonwealth Care Alliance 14315 N N 14315 N N
Community Care Alliance CCAI N N CCAI N N
Community Care BHO 23282 N N 23282 N N
Community Care Inc. - Family Care (Wisconsin) 60995 N N 60995 N N
Community Care Inc. (Wisconsin) 39126 N N 39126 N N
Community Care IPA CCI01 N N CCI01 N N
Community Care Managed Health Care Plans of Oklahoma 73143 Y N 73143 Y N
Community Care of Oregon 21455 Y N 21455 Y N
Community Choice of Michigan 38325 Y N 38325 Y N
Community First Health Plan, Inc. COMMF N N COMMF N N
Community Health Alliance 35193 Y N 35193 Y N
Community Health Alliance TN 27905 N N 27905 N N
Community Health Choice 48145 N N 48145 N N
Community Health Electronic Claims/CHEC/webTPA 75261 N N 75261 N N
Community Health Group CHGRI N N
Community Health Plan of Washington 12T30 Y N
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Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Community Health Plan, Inc. 60495 Y N 60495 Y N
Community Medical Group of the West Valley Inc. 66121 N N 66121 N N
CommunityConnect HealthPlan 95192 Y N 95192 Y N
Comp - Ohio (Austintown OH) 34177 N N 34177 N N
Compcare (Wisconsin BadgerCare only) 95192 Y N 95192 Y N
CompManagement Health 15243 Y N 15243 Y N
Compsych 37363 Y N 37363 Y N
Conifer Value-Based Care 55649 N N 55649 N N
Connecticare - Medicare 78375 N N 78375 N N
ConnectiCare Inc 06105 Y N 06105 Y N
Connecticut Carpenters Health Fund 37307 N N 37307 N N
Connecticut General (CIGNA) 62308 Y N 62308 Y N
Connecticut Medicaid 12K04 Y Y SKCT0 Y Y
Consociate Group 37135 Y N 37135 Y N
Consolidated Associates Railroad 75284 N N 75284 N N
Consolidated Health Plans 87843 N N 87843 N N
Constellation Health L0260 N N
Consumer Mutual of Michigan 58112 Y N 58112 Y N
Consumers Choice Health SC 45321 Y N 45321 Y N
Consumers Life Insurance Company 29076 Y N 29076 Y N
Continental General Ins Co-Medicare Supplement 13193 Y N 13193 Y N
Continental General Insurance Company 71404 N N 71404 N N
Continuum (formerly Marrick WRx) 46478 N N 46478 N N
Contractors Laborers Teamsters & Engineers 12B19 Y N SB760 Y N
Conversion Plan-APWU 55544 N N 55544 N N
Cook Children STAR Plan THCP9 N N THCP9 N N
Cook Children's Health 12T58 N N TH104 N N
Cook Group Health Plan 35149 N N 35149 N N
Cooperative Benefit Administrators (CBA) 52132 Y N 52132 Y N
COOPERATIVE MANAGED CARE SERVICES 35199 N N 35199 N N
Coordinated Benefit Plan 14829 Y N 14829 Y N
Coordinated Medical Specialists 58204 N N 58204 N N
Core Administrative Services 58231 N N 58231 N N
CoreSource AZ MN 35182 Y N 35182 Y N
CoreSource Little Rock 75136 N N 75136 N N
CoreSource MD PA IL 35182 Y N 35182 Y N
CoreSource NC IN 35182 Y N 35182 Y N
CoreSource OH 35183 Y N 35183 Y N
CoreSource-Internal 35187 N N 35187 N N
Corizon Health Inc. CORIZ N N CORIZ N N
Corizon Inc. 43160 N N 43160 N N
Cornerstone Benefit Adminstrators 35202 Y N 35202 Y N
Cornerstone Preferred Resources CB268 N N CB268 N N
Corporate Benefits Service Inc. (NC) 56116 N N 56116 N N
Page 11 of 48
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Enrollment Payer Code
Accepts
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Enrollment
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10/06/2015
INSTITUTIONAL PROFESSIONAL
CorrectCare CCIH N N CCIH N N
Country Life Insurance Company 62553 N N 62553 N N
County Services Medical Program CMSP1 N N CMSP1 N N
Covenant Administrators Inc. (Atlanta GA) 58102 N N 58102 N N
Coventry Advantra Texas 25133 Y N 25133 Y N
Coventry Health & Life (Oklahoma) 25133 Y N 25133 Y N
Coventry Health Care 25133 Y N 25133 Y N
Coventry Health Care National Network 25133 Y N 25133 Y N
Coventry Health Care of Florida 128FL Y N 128FL Y N
Coventry Health Care of Georgia Inc. 25133 Y N 25133 Y N
Coventry Health Care of Illinois 25133 Y N 25133 Y N
Coventry Health Care of Iowa Inc 25133 Y N 25133 Y N
Coventry Health Care of Kansas Inc 25133 Y N 25133 Y N
Coventry Health Care of Louisiana Inc 25133 Y N 25133 Y N
Coventry Health Care of Missouri 25133 Y N 25133 Y N
Coventry Health Care of Nebraska Inc 25133 Y N 25133 Y N
Coventry Health Care of Nevada 25133 Y N 25133 Y N
Coventry Health Care of the Carolinas 25133 Y N 25133 Y N
Coventry Health Care of Virginia 25133 Y N 25133 Y N
Coventry Summitt Health Plan Inc. 25133 Y N 25133 Y N
CoventryCares of Kentucky 25133 Y N 25133 Y N
CoventryCares of Michigan 128MI Y N 128MI Y N
CoventryCares of Nebraska 42130 Y N 42130 Y N
CoventryCares of Pennsylvania 23228 Y N 23228 Y N
Cox Health Plan 00119 N N 00019 N N
Creative Medical Systems 64068 N N 64068 N N
Creative Plan Administrators 37320 N N 37320 N N
Crescent Health Solutions 56213 N N 56213 Y N
Croy-Hall Mgmt. Inc. 37266 N N 37266 N N
Crystal Run Health Plans 46120 Y N 46120 Y N
CT Medicare Part A (J13 - NGS) 12M04 Y Y
CT Medicare Part B (J13 - NGS) SMCT0 Y Y
CTI ADMINISTRATORS INC. 42141 Y N 42141 Y N
CWIBENEFITS INC. 57080 N N 57080 N N
Dart Member Care CB987 N N CB987 N N
DC Chartered Health Plan Inc. (Alliance) 95740 N N
DC Chartered Health Plan Inc. (Medicaid & Alliance) 95748 N N 95748 N N
DC Medicare Part A (J12 - Highmark) 12M63 Y Y
DC Medicare Part B (J12 - Highmark) SMDC0 Y Y
DE Medicare Part A 12M76 Y Y
DE Medicare Part B SMDE0 Y Y
Dean Health Plan 39113 N N 39113 N N
DELANO IPA 77124 N N 77124 N N
Delaware Medicaid 12K87 Y Y SKDE0 Y Y
Page 12 of 48
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Accepts
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Enrollment Payer Code
Accepts
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Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Delaware Physicians Care Inc. 27009 N N 27009 N N
Delta Health Systems 94235 Y N 94235 Y N
DentaQuest Vision 63740 Y N
Denver Health - Indigent 84134 N N
Denver Health and Hospital Authority 84133 N N 84133 N N
Denver Health Medical Plan 84135 N N 84135 N N
Denver Health Medical Plan Inc. - Medicare Choice 84131 N N 84131 N N
Deseret Mutual 12X35 N Y UH105 N Y
Desert Medical Group DESRT N N
Detroit Medical Center 56240 N N 56240 N N
Diamond Plan (Maryland Medicaid) 25133 Y N 25133 Y N
District of Columbia Medicaid 12001 Y Y SKDC0 Y N
Diversified Administration Corporation 06102 N N 06102 N N
Downey Select IPA (Applecare Medical Managment) APP01 N N
Dreyer Health DREYR Y N
DRISCOLL CHILDREN'S HEALTH PLAN 74284 N N 74284 N N
Dunn and Associates Benefits Administrators Inc. 35186 Y N 35186 Y N
E.S. BEVERIDGE & ASSOCIATES 34108 N N 34108 N N
Early Intervention Central TH084 N N
EAST CAROLINA BEHAVIORAL HEALTH 56089 N N 56089 N N
East LA - APMG 75299 N N 75299 N N
East Pointe Behavioral Health 08044 Y N 08044 Y N
Eastland Medical Group 66122 N N CMSI1 Y N
Easy Choice Health Plan of New York 24770 N N 24770 N N
EBMC 31074 Y N 31074 Y N
EBMS (Employee Benefit Management Services Inc.) 12X44 N N 81039 Y N
Educators Mutual (EMIA) SX110 N N
Educators Mututal Medicare Advantage SX111 Y N
EGID (Employees Group Insurance Division) 22521 N N 22521 N N
EHI (Employers Health Insurance) 73288 N N
El Paso First - CHIP 12T27 N N TH090 N N
ElderPlan Inc. 31625 N N 31625 N N
Elderwood Health 03964 N N 03964 N N
Elmco 37253 N N 37253 N N
Emerald Health Network Inc. (All PPO Business) 34167 N N 34167 N N
Emergency Medical Services Fund - Orange County CA 95600 N N
EMI-KP Ambulance Claims 59299 N N
EMPHESYS 73288 N N
Empire Blue Cross and Blue Shield of New York SB803 Y N
Empire Medicare Services 12M76 Y Y
Empire Omnipro (BC NY City) 12B36 Y N
Empire Omnipro (BC NY State) 12B35 Y N
Empire Physician's Medical Group EMP01 N N
Employee Benefit Administration & Management Corporation Pilot N N Pilot N N
Page 13 of 48
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Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Employee Benefit Concepts (Farmington Hills MI) 38241 N N 38241 N N
Employee Benefit Consultants Inc. 37257 N N 37257 Y N
Employee Benefit Management Corp (EBMC) 31074 Y N 31074 Y N
Employee Benefit Services 37216 Y N 37216 Y N
Employee Benefit Services of San Antonio TH109 N N
Employee Benefit Systems 42149 N N 42149 N N
Employee Benefits Plan Administration Inc. (E.B.P.A.) 03036 N N 03036 N N
Employee Health System Medical Group 75299 N N 75299 N N
Employee Plans LLC 35112 N N 35112 N N
Employee Security, Inc. 54098 Y N
Employers Direct Health 75232 N N 75232 N N
Employer's Direct Health - Employee Plan 75236 N N 75236 N N
Employer's Direct Health - FI 75235 N N 75235 N N
Employer's Direct Health - SF 75233 N N 75233 N N
Employers Health 73288 N N
Employers Health Insurance 73288 N N
Employers Mutual Inc (Jacksonville Florida) 59298 N N 59298 N N
Employers Mutual Inc. (Stuart Florida) 59331 N N 59331 N N
Encircle PPO 35206 N N 35206 N N
Encore Health Network 35206 N N 35206 N N
Enstar Natural Gas 91136 N N 91136 N N
Entrust 36878 N N 36878 N N
EQUICOR 62308 Y N 62308 Y N
EQUICOR - PPO 62308 Y N 62308 Y N
Equitable Plan Services (Oklahoma City OK) 73126 N N 73126 N N
ERISA TH110 Y N
ESSENCE HEALTHCARE 20818 N N 20818 N N
E-V Benefits Management Inc (Columbus OH) 34159 N N 34159 N N
Everence 35605 Y N 35605 Y N
Evergreen Health Cooperative 45319 N N 45319 N N
Evolutions Healthcare Systems (New Port Richey FL) 59313 N N 59313 N N
Excel MSO EXC01 N N
Excellus - BCBS Central NY-RMSCO 12B71 Y Y
Excellus - BCBS Utica Watertown 12B38 Y Y SB806 Y Y
Excellus - Blue Cross Blue Shield Central NY 12B37 Y Y
Excellus - Blue Cross Blue Shield of Central New York SB805 Y Y
Excellus - Blue Cross Blue Shield Rochester Area 12B40 Y Y
Excellus - Blue Cross/Blue Shield Rochester Area SB804 Y Y
ExclusiCare 71412 N N 71412 N N
Extended Care MLTC 46166 Y N 46166 Y N
Eye Management, Inc. (EMI) 65062 N N
F40 Alaska Carpenters Trust 91136 N N
FABOH (CHP/RPU) 39112 Y N 39112 Y N
Facey Medical Foundation 95432 N N
Page 14 of 48
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Accepts
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Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
FACS Group 37300 N N 37300 N N
Fallon Community Health Plan 22254 N N 22254 N N
Family Care CCO 93121 N N 93121 N N
Family Christian Health Center Family Health Network patients only 51909 N N 51909 N N
Family Health Plan TH045 N N
Farm Family Life 14140 Y N 14140 Y N
FCE Benefit Administrators 33033 N N 33033 N N
Federal Employee Plan of South Carolina (BCBS SC) 00402 N N 00402 N N
Federated Benefits 37300 N N 37300 N N
Federated HR Services 37300 N N 37300 N N
Federated Mutual Insurance 41041 N N 41041 N N
Fidelis Care New York 11315 N N 11315 N N
Fidelis Secure Care 77054 N N 77054 N N
First Agency 88055 N N 88055 N N
First Carolina Care 56196 N N 56196 N N
First Choice Health Administrators 91131 Y N 91131 Y N
First Choice Health Network 91131 Y N 91131 Y N
First Choice of Midwest (PPO) 75138 N N 75138 N N
First Choice VIP Care 37510 Y N 37510 Y N
First Choice VIP Care Plus 77009 N N 77009 N N
First Health Network 73159 Y N 73159 Y N
First Medical Network (FMN) - Atlanta GA 29076 Y N 29076 Y N
First Priority 23241 Y Y
First Priority aka BCBS NEPA 14232 Y Y
FIRST PRIORITY HEALTH 42331 Y N
First Service Administrator's Inc Lakeland Florida 59276 N N 59276 N N
First Source/Arkansas Blue Cross 12047 Y Y
FirstCare 94999 N N 94999 N N
FirstCarolinaCareMedicare 34200 N N 34200 N N
Fitzharris & Company Inc. 11244 N N
FL MCO PHC/PHP 95411 Y N 95411 Y N
FL Medicare Part A (J9 First Coast) 09101 N Y
FL Medicare Part B (J9 First Coast) 09102 Y Y
Florida Blue 00590 Y N 00590 Y N
Florida Health Care Plan 59322 N N 59322 N N
Florida Hospital Healthcare Systems 59321 Y N 59321 Y N
Florida Hospital Waterman 48116 N N 48116 N N
Florida Medicaid 77027 Y Y 77027 Y Y
Florida True Health 26492 Y N 26492 Y N
FMH Benefit Services Inc. 48117 N N 48117 N N
Foreign Service Benefit Plan 25133 Y N 25133 Y N
FOUNDATION BENEFIT ADMINISTRATORS/CONTRACTOR EMPLOYEE BENEFITS ADMIN BOONG N N BOONG N N
Foundation for Medical Care of Tulare & Kings County TKFMC N N
Fox Valley Medicine Site 199 FVMCH N N
Page 15 of 48
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Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Fox-Everett Inc. 64069 N N 64069 N N
Freedom Blue Medicare Advantage 12B44 Y Y
Freedom Blue Medicare Advantage Claims SB942 Y Y
Freedom Health Plan 41212 N N 41212 N N
Freedom Life Insurance 62324 N N 62324 N N
Fresenius Medical Care 23130 N N 23130 N N
Fresno - ENH Medical Group 75299 N N 75299 N N
Fresno PACE 99660 N N 99660 N N
Friant Water Users TKFMC N N
Fringe Benefit Management 59069 N N 59069 N N
Fringe Benefits Coordinators 59204 Y N 59204 Y N
FrontPath Health Coalition 34171 N N 34171 N N
GA Medicare Part A (J10 - Cahaba) 12M05 Y Y
GA Medicare Part B (J10 - Cahaba) SMGA0 Y Y
Galveston County Indigent Health Care 30005 N N 30005 N N
Gardena Memorial Medical Center 75299 N N 75299 N N
Gateway SX078 Y N
Gateway Health PA 05506 N N 05506 N N
Gateway Health Plan - Medicare Assured 60550 N N 60550 N N
Gateway Health Plan Medicaid PA 25169 N N 25169 N N
Gateway Health Plan OH - Medicare Assured 91741 N N 91741 N N
Gateway Healthy PA 05506 N N 05506 N N
Gateway IPA (Pinnacle Health Resources) (Prospect Medical Group) PROSP N N
Geisinger Health Plan 75273 Y Y 75273 Y Y
GEMCare (Golden Empire Managed Care System) MCS01 N N
Gemcare Health Plan 20376 N N 20376 N N
Gemcare IPA 27133 Y N 27133 Y N
Generations Healthcare 46050 N N 46050 N N
Generations-Hillcrest 46051 N N 46051 N N
Genesis Healthcare PROSP N N PROSP N N
Georgia Medicaid 12K05 Y Y SKGA0 Y Y
GHI - New York (Group Health Inc.) 13551 N N 13551 N N
GHI HMO 25531 Y N 25531 Y N
GHP (Group Health Plan) - MULTIPLAN PHCS/GROUP HEALTH 25141 N N
Gilsbar Inc. 07205 N N 07205 N N
Glendale Physician's Alliance AMM02 N N
Global Care Inc. 07689 Y N 07689 Y N
Global Excel Management GEM01 Y N GEM01 Y N
Global Health GHOKC Y N GHOKC Y N
Global Healthcare Alliance 12X59 N N
GMS Inc. 47083 Y N 47083 Y N
Golden State Medical Group MBA01 N N MBA01 N N
Golden Triangle Physician Alliance/SelectCare of Texas (GTPA) 72189 N N 72189 N N
Good Samaritan Medical Practice Association IP086 N N IP086 N N
Page 16 of 48
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Accepts
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Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
GOOD SHEPHERD HOSPICE INC 76923 Y N 76923 Y N
Government Employees Health Association (45235) 45235 N N
Government Employees Health Association (Multiplan) 45235 N N
Government Employees Health Association (PHCS) 45275 N N 45275 N N
Government Employees Hospital Association (GEHA) 44054 N N 44054 N N
Grand Valley Health Plan 95453 N N 95453 N N
Grange Insurance 14060 N N 14060 N N
Great American Life Ins. Co-Medicare Supplement 13193 Y N 13193 Y N
Great Lakes PACE 39640 N N 39640 N N
Greater Covina Medical Group 99284 N N
Greater Orange County Medical Group NMM01 N N
Greater San Gabriel Med Grp NMM01 N N
Greater Valley HCP01 N N
Great-West Healthcare 80705 N N 80705 N N
Great-West Healthcare (formerly American General) 63665 N N 63665 N N
Group Administrators Ltd. 36338 N N 36338 N N
Group and Pension Administrators 48143 N N 48143 N N
Group Benefit Services Inc. CB951 N N CB951 N N
Group Benefits - Louisiana 72087 N N
Group Health Co-op 12X16 Y Y
Group Health Cooperative - WA State 91051 N N 91051 N N
Group Health Cooperative of Eau Claire 95192 Y N 95192 Y N
Group Health Cooperative of South Central Wisconsin 39167 N N 39167 N N
Group Health Options - WA State 91051 N N 91051 N N
Group Insurance Service Center Inc. 37276 N N 37276 N N
Guardian Life Insurance Company of America 64246 N N 64246 N N
Gulf Stream-General Dynamics CB624 Y N CB624 Y N
Gundersen Lutheran Health Plan 39180 N N 39180 N N
H.E.R.E.I.U Welfare Pension Funds 37114 N N 37114 N N
HAA Preferred Partners 65101 N N 65101 N N
HAP/AHL/Curanet 38224 N N 38224 N N
Harbor Advantage (Abrazo Health Care) 58305 N N 58305 N N
Harbor Choice 55649 N N 55649 N N
Harmony Health Plan of Illinois 36406 N N 36406 Y N
Harmony Health Plan of Indiana 36405 N N 36405 Y N
Harpeth IPA - Amerivantage 75126 Y N
Harrimon Jones HCP01 N N
Harrington Health Non-EPO 59143 N N 59143 N N
Harrington Health-Kansas (formerly known as Fiserv Health-Kansas) 62061 N N 62061 N N
Harris Methodist Health Plan 75201 N N
Harvard Community Health Plan 04245 Y N 04245 Y N
Harvard Pilgrim Health Care 04271 N N 04271 N N
Hawaii Blue Cross 12B62 Y Y
Hawaii Medicaid 12K62 Y N SKHI0 Y Y
Page 17 of 48
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Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Hawaii Medical Assurance Association (HMAA/HWMG) 99208 N N 99208 N N
Hawaii Medical Service Association (HMSA) SB971 Y Y
HCC Life Insurance HCCMI N N HCCMI N N
HCH Administration 37111 N N 37111 N N
HCH Administration (formerly John P Pearl and Associates) 37215 N N 37215 N N
HCS - Health Claims Service (Boise ID) 82018 N N 82018 N N
Health Adv/US Able/First Pyramid Life/Arkansas Blue Cross 12049 Y Y
Health Alliance Medical Plans of Illinois 77950 N N 77950 Y N
Health America Inc./Health Assurance/Advantra 25133 Y N 25133 Y N
Health Care Network of Wisconsin (HCN) 42102 N N 42102 N N
Health Care Savings 56142 N N
Health Choice Arizona 62179 N N 62179 N N
Health Choice Generations 62180 N N 62180 N N
Health Choice Insurance Co 46221 Y N 46221 Y N
Health Choice Integrated Care 22100 Y N 22100 Y N
Health Choice Utah 45399 N N 45399 N N
Health Cost Solutions 62111 N N 62111 N N
Health Design Plus (Hudson OH) 34158 N N 34158 N N
Health Economics Corp 75196 N N 75196 N N
Health First TPA 95019 N N 95019 N N
Health Management Administrators (HMA) TH049 N N
Health Net - VA Patient Centered Community Care Program 68021 N N 68021 N N
Health Net of Arizona 38309 N N 38309 N N
Health Net of California and Oregon - Claims 95567 N N 95567 N N
Health Network One 65062 N N
Health New England 04286 N N 04286 N N
Health Options Inc (FL - BCBS HMO) 12B26 Y N
Health Options of Florida SX030 Y N
Health Partners - Jackson TN 62157 N N 62157 N N
Health Partners PA 80142 N N 80142 N N
Health Payment Systems Inc. 20270 N N 20270 N N
Health Plan of Michigan 83253 N N 83253 N N
Health Plan of Nevada 76342 Y N 76342 Y N
Health Plan of San Joaquin 68035 Y N 68035 Y N
Health Plans Inc. 44273 N N 44273 N N
Health Risk Management 41170 N N 41170 N N
Health Services for Children with Special Needs 37290 N N 37290 N N
Health Services Management 41150 N Y
Health Services Preferred (HSP) by Emerald Health 34167 N N 34167 N N
Healthcare Partners HCP01 N N HCP01 N N
HealthCare Partners IPA 11328 Y N 11328 Y N
Healthcare Resources NW 56731 N N 56731 N N
Healthcare Solutions Group 73147 Y N 73147 Y N
Healthcomp Inc. 85729 N N 85729 N N
Page 18 of 48
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Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Healthease/Wellcare of FL 59608 N N 59608 N N
HealthEdge Administrators (Bakersfield CA) 95213 N N 95213 N N
HealthEZ 41178 N N 41178 N N
Healthfirst 65 Plus 80141 Y N
Healthfirst Family Health Plus (FHP) 80141 Y N
Healthfirst Health Plan of New Jersey 80141 Y N 80141 Y N
Healthfirst Inc. (New York) 80141 Y N 80141 Y N
Healthfirst New York (COMMERCIAL) 80141 Y N
Healthfirst PHSP 80141 Y N
Healthgram Inc. 56144 N N 56144 N N
HealthGroup Limited 23274 Y N 23274 Y N
HealthGuard of Lancaster 23226 Y N 23226 Y N
Healthlink HMO 96475 N N 96475 N N
Healthlink PPO 90001 Y N 90001 Y N
HealthNow - BCBS Northeastern NY 12B68 Y Y SB800 Y Y
HealthNow - Blue Cross Blue Shield of Western NY 12B39 Y Y SB801 Y Y
Healthnow Division 55204 Y Y
HealthPartners MN 12X51 Y Y SX009 Y Y
HealthPlan Services 59140 N N 59140 Y N
HealthPlus Amerigroup 27514 Y N 27514 Y N
HealthPlus of Michigan 38216 N N 38216 N N
Healthscope Benefits - EHC Repricing 52429 N N 52429 N N
HealthSCOPE Benefits Inc. 71063 Y N 71063 N N
HealthSelect IPA (IL) SB621 Y N
Healthsmart Accel 75237 Y N 75237 Y N
HealthSmart Benefit Solutions 37272 N N 37272 N N
HealthSmart Benefit Solutions 37283 Y N 37283 Y N
HealthSmart Benefit Solutions fka Wells Fargo TPA.Inc. 87815 Y N 87815 Y N
HealthSmart -Noble Mid Orange HSM01 N N
HealthSmart Preferred Care Inc. 75250 Y N 75250 Y N
Healthsource AR (Med) (CIGNA) 71075 Y N 71075 Y N
Healthsource CMHC 02041 Y N 02041 Y N
Healthsource GA (CIGNA) 58210 Y N 58210 Y N
Healthsource KY 61127 Y N 61127 Y N
Healthsource Massachusetts Inc. 02041 Y N 02041 Y N
Healthsource ME 01041 N N 01041 N Y
Healthsource N. TX (CIGNA) 75255 Y N 75255 Y N
Healthsource NC (CIGNA) 56147 Y N 56147 Y N
Healthsource NH 02038 Y N
Healthsource OH 31141 Y N 31141 Y N
Healthsource Provident 68195 Y N 68195 Y N
Healthsource SC 06119 Y N 06119 Y N
Healthsource TN (CIGNA) 62129 Y N 62129 Y N
HealthSpan Network Repricing HSPAN N N HSPAN N N
Page 19 of 48
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Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Healthspan 34092 N N 34092 N N
HealthSpan, Inc. 31434 Y N 31434 Y N
HealthSpring HMO/HealthSpring Medicare+Choice 63092 N N 63092 N N
Healthsun Health Plans HESUN N N
Healthways WholeHealth Networks 58213 N N
Healthy CT 77180 N Y 77180 N Y
Healthy Texas 68064 Y N 68064 Y N
Healthy York Network 22251 Y N 22251 Y N
Heritage Consultants 59230 N N
Heritage Physician Network TH011 N N
Heritage Provider Network DESRT N N
Heritage Victor Valley Medical Group 30862 N N 30862 N N
HFN Inc. 36335 N N 36335 N N
HHH Choices Gold 20552 N N 20552 N N
HI Medicare Part B (J1 - PGBA) SMHI0 Y Y
High Desert Medical Group 95393 N N 95393 N N
Highmark Blue Cross & Blue Shield of Pennsylvania SB865 Y Y
Highmark- Key Family 35145 Y N 35145 Y N
Hill Physicians Medical Group 00046 N N
HIP - Health Insurance Plan of Greater New York 55247 N N 55247 N N
Hispanic Physicians IPA HPIPA N N
HMA - Health Management Admin 12T11 Y N
HMA Hawaii 86066 N N 86066 N N
HMC HealthWorks aka Health Management Co 75318 N N 75318 N N
HMSO-Highline Medical Service Organization 91164 N N 91164 N N
HN1 Therapy Network (HN1TN) 65062 N N
Hollywood Presbyterian (Synermed) 75299 N N 75299 N N
Home Health & Hospice J10 Cahaba 12M53 Y Y
Home Health & Hospice J15 Cigna 12M97 Y Y
Home Health & Hospice J6 NGS RHHWI N Y
Hometown Health Plan Nevada 88023 Y N 88023 Y N
Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) 22099 Y Y 22099 Y Y
Horizon Healthcare of NY 22099 Y Y 22099 Y Y
Horizon NJ Health 22326 Y N 22326 Y N
Hotel Employees & Restaurant Employees Health Trust 91136 N N 91136 N N
HP Administrative Services, LLC 22521 N N 22521 N N
HS1 Medical Management 65062 N N
HSBS Memphis 37224 N N 37224 N N
HSBS Oklahoma City 37256 N N 37256 N N
HSBS World Trade Center Health Program 31172 Y N 31172 Y N
HSHS Medical Group IPA 37137 N N 37137 N N
Hudson Health Plan 13335 N N 13335 N N
Humana Choice Care Network (Batch) 611X1 Y N 611X1 Y N
Humana Choice Care Network (Real-Time) 61101 Y N 61101 Y N
Page 20 of 48
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Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Humana Dermatology - New Century Health NCH02 N N
Humana Emphesys (Batch) 611X1 Y N 611X1 Y N
Humana Emphesys (Real-Time) 61101 Y N 61101 Y N
Humana Employers Health Insurance (Batch) 611X1 Y N 611X1 Y N
Humana Employers Health Insurance (Real-Time) 61101 Y N 61101 Y N
Humana Inc. (Batch) 611X1 Y N 611X1 Y N
Humana Inc. (Real-Time) 61101 Y N 61101 Y N
Humana Military - Tricare South 61125 Y N 61125 Y N
Humana Veterans Healthcare Services 61120 N N 61120 N N
Humboldt-Del Norte Foundation for Medical Care 94154 N N
I. E. Shaffer (West Trenton NJ) 22175 N N 22175 N N
IA Medicare Part A(J5 - WPS) SMIA0 Y Y
IA Medicare Part B (J5 - WPS) SMIA0 Y Y
IAA 37279 N N 37279 N N
IBC Personal Choice 12X26 Y N SX083 Y N
IBEW Local 640 & Arizona Chapter NECA Health & Welfare Trust 74234 N N
IBG Administrators, LLC 81810 N N 81810 N N
IBM Business Transformation Outsourcing Insurance Services Corporate 19028 N N 19028 N N
iCare Health Solutions 26054 Y N
iCircle of New York 33884 Y N
ICW (Insurance Co of the West) 27847 N N 27847 N N
ID Medicare Part A (J2) 12M07 Y Y
ID Medicare Part B (J2) SMID0 Y Y
Idaho Medicaid 12K07 N N SKID0 Y N
IEC Group - AmeriBen 97661 N N 97661 N N
IHG Direct 75274 N N 75274 N N
IL Medicare Part A (J6) 12M08 Y Y
IL Medicare Part B (J6) SMIL0 Y Y
IlliniCare 68069 Y N 68069 Y N
Illinois Health Plan DMG01 N N DMG01 N N
Illinois Medicaid SKIL0 Y N SKIL0 Y N
I'Mcare 41600 N N 41600 N N
Imperial County Physicians Med Group (SCPMCS) SCP01 N N SCP01 N N
IMS Management Services TH099 N N
IMS Management Svcs - Texas 12T64 N N
IMX Easy 86070 N N 86070 N N
IN Medicare Part A (J8) 12M09 Y N
IN Medicare Part B (J8) SMIN0 Y N
INDECS Corporation 40585 N N 40585 N N
Independence Administrators TA720 N N
Independence Care System 64284 N N 64284 N N
Independence Care Systems FIDA-MMP 64284 N N 64284 N N
Independence Medical Group MHM01 N N
Independent Health 12X01 Y Y SX073 N Y
Page 21 of 48
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Enrollment Payer Code
Accepts
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Claims
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CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Independent Health Care Plan 11695 Y Y 11695 Y Y
INDEPENDENT LIVING SYSTEMS 45048 Y N 45048 Y N
Independent Physicians @ Mercy Chicago IL MG#155 51909 N N 51909 N N
Indian Health Services 12X75 Y N SX171 Y N
Indiana Department of Health - Children's Health - Claims 35600 Y Y 35600 Y Y
Indiana Medicaid 12K09 Y N SKIN0 Y N
Indiana ProHealth Network 35161 Y N 35161 Y N
Indiana Teamsters Health Benefits Fund (Indianapolis IN) 35107 N N 35107 N N
Indiana University Health Plan 95444 N N 95444 N N
Individual Health Insurance Companies 31053 N N 31053 N N
INETICO INC. 43471 Y N 43471 Y N
Informed LLC 52196 N N 52196 N N
Informed UHC 50946 N N 50946 N N
Ingalls Provider Group (DOS beginning 5/1/15) 85578 N N 85578 N N
Ingalls Provider Group (DOS prior to 5/1/15) 36348 N N 36348 N N
Ingham Health Plan Corporation 38343 N N 38343 N N
Inland Empire Health Plan IEHP1 N N IEHP1 N N
Inland Valleys IPA 75299 N N 75299 N N
Innovative Physician Associates LLC 80087 N N 80087 N N
Insurance Administrators of America Inc. 37279 N N 37279 N N
Insurance Design Administrators 13315 N N 13315 N N
Insurance Management Administrators 72091 N N
Insurance Management Services (Amarillo TX) 15688 N N 15688 N N
Insurance Services of Lubbock TH012 Y N
InsuranceTPA.com 39182 N N 39182 N N
Insurers Administrative Corp. 86304 N N 86304 N N
Integra Administrative Group (Seaford DE) 51020 N N 51020 N N
Integra Group 31127 N Y 31127 N N
INTEGRA GROUP/HOME 31128 N N
Integra Group-CHA 31129 N N
Integral Quality Care 23229 N N 23229 Y N
Integrated Care Network (ICN) by Emerald Health 34167 N N 34167 N N
Integrated Medical Solutions LLC 20050 N N 20050 N N
Inter County Health Plan 54763 Y N
Interactive Medical Systems 56132 N N 56132 N N
Inter-County Health Plan SX079 Y Y
Interface EAP (IEAP) 60280 Y N 60280 Y N
Intergroup Services Corporation 23287 N N 23287 N N
International Brotherhood of Boilermakers 36609 N N 36609 N N
International Brotherhood of Boilermakers Employee Health Care Plan(IBBEHC) 48603 N N 48603 Y N
International Medical Group IMGIN N N IMGIN N N
InterWest Health (Acceptius Gateway payer) 84137 N N 84137 N N
INTotal Health 10262 N Y 10262 N Y
Iowa Medicaid 12K10 Y Y SKIA0 Y Y
Page 22 of 48
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Accepts
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Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
J11 Medicare - HHH Jurisdiction C 12M80 Y Y
J12 MEDICARE PART A LEGACY WPS (DC DE MD NJ PA) 12M99 Y Y
JI Specialties TH033 N N
John Alden Life Insurance Co. 41099 N N 41099 N N
JOHN MORRELL COMPANY CO. - AHPBA 38310 N N 38310 N N
John Muir Mt. Diablo Health System 68036 N N 68036 N N
John Muir Physician Network 68036 N N
Johns Hopkins Healthcare (EHP/PP) 52189 N Y 52189 N Y
Johns Hopkins Healthcare (USFHP) 52123 N N 52123 N N
Joplin Claims / Benefit Management Inc 43178 Y N 43178 Y N
JP Farley Corporation 34136 N N 34136 N N
JP Specialties 12T47 Y N
JPS Preferred Care MWP01 N N
Kaiser Foundation Health Plan of Colorado 91617 N N 91617 N N
Kaiser Foundation Health Plan of Hawaii 94123 N N 94123 N N
Kaiser Foundation Health Plan of Northern CA Region 94135 N N 94135 N N
Kaiser Foundation Health Plan of Southern CA Region 94134 N N 94134 N N
Kaiser Foundation Health Plan of the Mid-Atlantic States Inc. 52095 N N 52095 N N
Kaiser Foundation of the Northwest NW002 N N NW002 N N
Kaiser Permanente of Georgia 21313 N N 21313 N N
Kaiser Self Funded 94320 N N 94320 N N
Kanawha HealthCare Solutions Inc. 57038 N N 57038 N N
Kanawha Insurance Co. 57038 N N 57038 N N
Kane County BCBS KCIPA N N KCIPA N N
Kane County Harmony Medicaid IPAK1 N N IPAK1 N N
Kansas City Life Insurance Company 44030 Y N
Kansas Medicaid MDKSI Y N MDKSP Y N
Katy Medical Claims 81812 N N 81812 N N
Kaweah Delta TKFMC N N
Keenan Associates (CA) 95279 N N 95279 N N
Kelseycare KELSE N N
Kempton Company 73100 N N 73100 N N
Kempton Group Administrators 73100 N N 73100 N N
Kentucky Health Administrators Inc. 27215 Y N 27215 Y N
Kentucky Health Cooperative 77894 Y N 77894 Y N
Kentucky Medicaid 12K11 Y Y SKKY0 Y Y
Kentucky Spirit Health Plan 68069 Y N 68069 Y N
Kern County CDCR 28021 N N 28021 N N
Kern Health Systems 77039 N N 77039 N N
Key Benefit Administrators (Indianapolis IN) 37217 Y N 37217 Y N
Key Health Medical Solutions Inc. 95460 N N
Key Medical Group IP082 N N
Key Select 37321 Y N 37321 Y N
Key Solution 37323 Y N 37323 Y N
Page 23 of 48
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Enrollment Payer Code
Accepts
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Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Key Gap 35317 Y N 35317 Y N
Keystone Connect (Amerihealth) 77050 Y N 77050 Y N
Keystone First 23284 Y N 23284 Y N
Keystone Health Plan East SX055 Y N
Keystone Health Plan East/IBC 12X25 Y N
Keystone Health Plan West SX056 Y Y
Keystone VIP Choice 84223 Y N 84223 Y N
Klais & Company 34145 Y N 34145 Y N
Klais & Company (Repricing for HealthSpan Network Only) 3414A N N 3414A N N
Korean American Medical Group KAMG1 Y N
KPS-Kitsap Physician Services KPS01 N N KPS01 N N
KS - Sunflower State Health 68069 Y N 68069 Y N
KS Medicare Part A (J5 - WPS) 57324 Y Y
KS Medicare Part B (J5 - WPS) SMKS0 Y Y
KY Medicare Part A (J15) 12M11 Y Y
KY Medicare Part B (J15) SMKY0 Y Y
LA Care Health Plan LACAR N N LACAR N N
LA Medicare Part A (JH) 12M12 Y Y
LA Medicare Part B (JH) SMLA0 Y Y
LACare 27357 Y N 27357 Y N
Lake County Physicians Association 37116 N N 37116 N N
Lakeside Comprehensive Healthcare 66127 N N 66127 N N
Lakeside Health Services LMG11 N N
Lakeside Medical Group 66125 N N 66125 N N
Land of Lincoln Health 90096 N N 90096 N N
Land of Lincoln Health Ins. Co. 62741 Y N 62741 Y N
Landmark Healthcare Inc LNDMK Y N
Lawndale Christian Health Center 36333 N N 36333 N N
LBA Health Plans 52193 N N 52193 N N
Leon Medical Center Health Plan 37316 N N 37316 N N
LHP Claims Unit 37248 N N 37248 N N
Liberty Health Advantage 87071 N N 87071 N N
Liberty Union 37281 N N 37281 N N
Life Assurance Company 37281 N N 37281 N N
Life Gift Cards 33LGC Y N 33LGC Y N
Life Investors Insurance 12T67 N N TH120 Y N
Life Investors Insurance of America - Long Term Care 12T39 N N
Life Investors of America - Long Term Care TH093 N N
LIFE Pittsburgh 25181 N N 25181 N N
Life Trac 41136 N N 41136 N N
LifeCircles PACE 71498 N N 71498 N N
LifePath Hospice Inc 76870 Y N 76870 Y N
Lifestyle Health Plans 2700U Y N 27005 Y N
Lifetime Benefit Solutions EBSRM N N EBSRM N N
Page 24 of 48
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Accepts
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Enrollment Payer Code
Accepts
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Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
LifeWise Healthplan of Oregon 93093 Y N
Lincoln National (EMPHESYS Green Bay and Madison WI only) 73288 N N
LIPA/Agate Resources TH106 N N
Local 135 Health Benefits Fund (Indianapolis IN) 35107 N N 35107 N N
Lockard & Williams CB752 N N CB752 N N
Loma Linda 99255 Y N
Loma Linda University Adventist Health Sciences Center Employee Health Plan 37267 N N 37267 N N
Loma Linda University Adventist Health Sciences Centers 37267 N N 37267 N N
Loma Linda University Behavioral Medicine Center Employee Health Plan 37267 N N 37267 N N
Loma Linda University Employee Health Plan 37267 N N 37267 N N
Loma Linda University Health Care Employee Health Plan 37267 N N 37267 N N
Loma Linda University Healthcare 33036 N N 33036 N N
Loma Linda University Medical Center Employee Health Plan 37267 N N 37267 N N
Loma Linda University Medical Center Residents Health Plan 37267 N N 37267 N N
Loma Linda University Student Health Plan 37267 N N 37267 N N
Louisiana Health Cooperative 88075 N N 88075 N N
Louisiana Healthcare Connections 68069 Y N 68069 Y N
Louisiana Medicaid 12K12 Y Y SKLA0 Y Y
Louisiana Medicaid - Ambulance claims SKLA2 Y Y
Louisiana Medicaid - DME Claims SKLA1 Y Y
Louisiana Medicaid - KidMed Claims SKLA3 Y Y
Louisiana Medicaid - Rehab SKLA4 N N
Louisiana Medicaid-Home Health 12K94 N N
Lovelace Sandia Health Plan (as of 9/27/14) 12B22 Y N SB790 Y N
Loyal American Life Ins Co-Medicare Supplement 13193 Y N 13193 Y N
MA Medicare Part A (J14 - NHIC) 12M14 Y Y
MA Medicare Part B (J14 - NHIC) SMMA0 Y Y
MacNeal Health Providers- CHS 36334 N N 36334 N N
Magan Medical Clinic HCP01 N N
Magellan Health Services 12X27 Y N 01260 Y N
Magnacare 11303 N N 11303 N N
Magnolia 68069 Y N 68069 Y N
Mail Handlers Benefit Plan 25133 Y N 25133 Y N
Maine Community Health Options 45341 Y N 45341 Y N
Maine Medicaid 12K13 Y Y SKME0 Y N
MajestaCare Virginia 26372 N N 26372 N N
Maksin Management Corporation 22195 Y N 22195 Y N
Managed Care Services LLC 35162 N N 35162 N N
Managed Care Systems (Delano Regional Medical Group) MCS02 N N
Managed Care Systems (Gemcare) MCS01 N N MCS01 N N
MANAGED HEALTH CARE ASSOCIATES 36312 N N 36312 N N
Managed Health Network 22771 N N 22771 N N
Managed Health Services Indiana (Medicaid HMO) 68069 Y N 68069 Y N
Managed Health Services Wisconsin 68069 Y N 68069 Y N
Page 25 of 48
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Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Manulife W. J. Sutton Company 98010 N N 98010 N N
Mapfre (Canada Life) L0160 N N L0160 N N
March Vision Care Inc. 52461 N N
Marion Polk Community Health Plan 33711 Y N
Marquette Life Insurance Company 48055 N N 48055 N N
Marrick Medical Finance LLC. 20805 Y N 20805 Y N
MARTINS POINT HEALTH CARE 53275 N N 53275 N N
Maryland Medicaid 12007 Y Y SKMD0 Y Y
Maryland Physicians Care 22348 N N 22348 N N
Maryland Public Mental Health SX069 N Y
Mashantucket Pequot Tribal Nation 37121 N N 37121 N N
Massachusetts Medicaid - Health Safety Net 12K48 N Y SKMA0 N N
Massachusetts Mutual 80314 Y N 80314 Y N
Master Mates & Pilots Program TH111 Y N
Masters Mates and Pilots Program 12T52 N N
Max Specialty Benefits 27320 N N
Mayo Clinic FL/GA 88090 N N 88090 N N
MBA Benefit Administrators Inc (Salt Lake UT) 83028 N N 83028 N N
MBA OF WYOMING INC 87065 N N 87065 N N
MCA ADMINISTRATORS 25160 N N 25160 N N
Mcare Advantage Plan 12M85 Y N
McKinley Medical Group MHM02 N N
MD Medicare Part A J12 12010 Y Y
MD Medicare Part B J12 SMMD0 Y Y
MDI Holdings (Formerly Medical Partners of America) 80026 N N 80026 N N
MDWise Hoosier Alliance 20475 Y N 20475 Y N
Mdwise Inc. (formerly IU Health) 12K81 N N
Mdwise Inc. (formerly IU Medical Group) SX172 N N
MDWise Select Health Network MWSHN N N MWSHN N N
MDX Hawaii MDXHI Y N MDXHI Y N
ME Medicare Part A (J14 - NHIC) 12M13 Y Y
ME Medicare Part B (J14 - NHIC) SMME0 Y Y
Med Partners Precision HMO 12T26 N N TH088 N N
MED PAY 88058 Y N 88058 Y N
MED3000 CMS EARLY STEPS EM350 N N EM350 N N
MED3000 CMS SAFETY NET EM284 N N EM284 N N
MED3000 CMS TITLE 19 REFORM EM843 N N EM843 N N
MED3000 CMS TITLE 21 EM205 N N EM205 N N
MED3000 PEDICARE TITLE 19 EM039 N N EM039 N N
MED3000 PEDICARE TITLE 21 EM522 N N EM522 N N
MedAdmin Solutions 58202 N N 58202 N N
MedBen (Newark OH) 74323 N N 74323 N N
MedCom 59231 Y N 59231 Y N
MedCost Benefit Services 56205 Y N 56205 Y N
Page 26 of 48
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Accepts
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CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
MedCost Inc. 56162 Y N 56162 Y N
MedDirect 38353 N N
Medfocus 95321 N N
Medica 94265 Y N 94265 Y N
MEDICA HEALTH CARE PLAN INC. 78857 N N 78857 N N
Medica2 12422 Y N 12422 Y N
Medicaid Hawaii Waivers 77059 Y Y
Medi-Cal (Vision) SKCA1 N Y
MEDICAL ASSOCIATES HEALTH PLAN MAHC1 N N MAHC1 N N
Medical Benefits Administration MBA01 N N
Medical Benefits Administrators Inc. (Newark OH) 74323 N N 74323 N N
Medical Benefits Companies (Newark OH) 74323 N N 74323 N N
Medical Benefits Mutual (Newark OH) 74323 N N 74323 N N
Medical Benefits Mutual Life Insrance Co. 74323 N N 74323 N N
Medical Card System ( MCS ) L0170 N N L0170 N N
Medical Control Inc. Pilot N N
MEDICAL DEVELOPMENT INTERNATIONAL 52181 N N 52181 N N
Medical Mutual of Ohio 29076 Y N 29076 Y N
Medical Network of Colorado Springs 84600 N N
Medical Reimbursements of America 62177 N N 62177 Y N
Medical Services for Indigents AMM02 N N
Medical Services Initiative 12057 Y N 12057 Y N
Medical Value Plan - Ohio (MVP) 38224 N N 38224 N N
Medicare Blue SX263 N N
Medicare Blue Private SX262 N N
Medicare DME (All Jurisdictions) SDMEB Y Y
Medicare Home Helath & Hospice (J14 - NHIC) 12HHA Y Y
MEDICARE PART A (CAHINV) 12M65 Y Y
Medicare Plus Blue SX170 Y Y
Medicare PPO (BCBS SC) 00C63 N N 00C63 N N
Medicare y Mucho Mas ( MMM ) L0210 N N L0210 N N
Medico Insurance Company 23160 N N 23160 N N
Mediture 20039 N N 20039 N N
Mediview Inc. STAR1 N N STAR1 N N
MedPartners Administrative Services 35205 Y N 35205 N N
MedSolutions Inc 62160 N N 62160 N N
MedSolutions Post Accute Care 15395 N N 15395 N N
MedStar Family Choice 39190 N N 39190 N N
Medstar Select/Medstar Medicare Choice 251MS Y N 251MS Y N
MEGA Life & Health (United Ins. Div.) 97055 N N
Memorial Clinical Associates/ SelectCare of Texas (MCA) 62181 N N 62181 N N
Memorial Herman Health Network Providers TH092 N N
Memorial Herman Health Network Providers 12T40 N N
Memorial Medical Group HCP01 N N
Page 27 of 48
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Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Mercy Benefit Administration 37264 N N 37264 N N
Mercy Care Plan (AHCCCS) 86052 N N 86052 N N
Mercy Health Plans 43166 N N 43166 N N
Mercy Maricopa Integrated Care 33628 Y N 33628 Y N
Mercy Physicians Medical Group (MPMG) (NAMM Southern CA) IP079 N N IP079 N N
Mercy Provider Network 43185 N N 43185 N N
MercyCare 39114 N N 39114 N N
Meridian Health Plan 13189 N N 13189 N N
Meritain Health 64157 N N 64157 N N
Meritain Health / Agency Services 64158 N N 64158 N N
Meritain Health Minneapolis 41124 Y N 41124 Y N
Meritus Health Partners 45150 N N 45150 N N
Methodist Associate Health Plan Pilot N N
MetroPlus Health Plan 13265 N N 13265 N N
Metropolitan Health Plan 10850 Y N 10850 Y N
Metrowest HealthPlan TH068 N N
Metrowest Star Medicaid TH069 N N
MFC & HealthPlus Peoria 23550 N N 23550 N N
MHNET 74289 Y N 74289 Y N
MHP Systems 64068 N N 64068 N N
MI Medicare Part A (J8) SMMI0 Y Y
MI Medicare Part B (J8) SMMI0 Y Y
Michael Reese Physicians Group 37127 N N 37127 N N
Michigan Medicaid 12K37 Y Y SKMI0 Y Y
Mid Rogue Oregon Health Plan 26161 N N 26161 N N
Mid-America Associates Inc. 37281 N N 37281 N N
MidCoast IPA 77012 N N 77012 N N
Mid-County Physicians Medical Group SCP01 N N SCP01 N N
Mid-County Physicians Medical Group (San Diego) (Synermed) 75299 N N 75299 N N
Midlands Choice Inc. 47080 Y N 47080 Y N
Midwest Health Partners 76079 N N 76079 N N
Midwest Health Plans Inc. 12T54 N Y TH074 Y Y
Mills Peninsula Health Services MPHS1 Y N
Mills Peninsula Medical Group MPMG1 N N
MINNESOTA DEPARTMENT OF HEALTH MNDH1 N N MNDH1 N N
Minnesota Medicaid 12K16 Y Y SKMN0 Y Y
MinuteMan Health 01776-NOCD Y N 01776-NOCD Y N
Mission (St. Joseph Heritage Healthcare) STJOE N N
Mississippi Blue Cross - Trispan 12B17 Y Y
Mississippi Health Partners 64068 N N 64068 N N
Mississippi Medicaid 12K17 Y Y SKMS0 Y Y
Mississippi Physicians Care Network 64084 N N 64084 N N
Mississippi Public Entity Employee Benefit Trust 37233 N N 37233 N N
Mississippi Select Health Care 64088 N N 64088 N N
Page 28 of 48
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Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Missoula County Medical Benefits Plan 37275 N N 37275 N N
Missouri Medicaid 12K15 Y N SKMO0 Y N
MMA 35316 Y N 35316 Y N
MMSI 41154 Y N 41154 Y N
MN Medicare Part A (J6) 12M16 Y Y
MN Medicare Part B (J6) SMMN0 Y Y
MO - Missouri Home State Health Care 68069 Y N 68069 Y N
MO Medicare Part A (J5 - WPS) 12M15 Y N
MO Medicare Part B East (J5 - WPS) SMMO0 Y N
Moda Health 13350 Y N 13350 Y N
Molina Healthcare 12X09 N N
Molina Healthcare of CALIFORNIA 38333 Y N 38333 Y N
Molina Healthcare of Florida 51062 Y N 51062 Y N
Molina Healthcare of MICHIGAN 38334 Y N 38334 Y N
Molina Healthcare of New Mexico - Salud 09824 N N 09824 Y N
Molina Healthcare of New Mexico -SCI 04423 Y N 04423 Y N
Molina Healthcare of Ohio 20149 Y N 20149 Y N
Molina Healthcare of Puerto Rico 81794 Y N 81794 Y N
Molina Healthcare of South Carolina 46299 Y N 46299 Y N
Molina Healthcare of Texas 20554 Y N 20554 Y N
Molina Healthcare of WASHINGTON 38336 Y N 38336 Y N
MOLINA HEALTHCARE Of WI ABRI1 N N ABRI1 N N
Molina Healthcare Utah (aka American Family Care) SX109 Y N
Molina Illinois 20934 Y N 20934 Y N
Monarch IPA IP095 Y N
Monitor Life Insurance Company (Secondary claims only) 16098 Y Y 16098 Y Y
Montana Medicaid 12K77 Y N SKMT0 Y N
Montefiore Contract Management Organization 13174 Y N 13174 Y N
Montifiore HMO 46161 Y N 46161 Y N
Monumental Life Insurance Company MMLIC N N
Monumental Life Insurance Company (AR) TLINS Y N TLINS Y N
Monumental Life Insurance Company (IA) TRCLF Y N TRCLF Y N
Monumental Life Insurance Company (IA, MD, PA) TRP1E Y N TRP1E Y N
Monumental Life Insurance Company (TX) TRLTC Y N TRLTC Y N
MORRIS ASSOCIATES 35092 N N 35092 N N
Mosaic IPA Medical Group IP083 N N
Motion Pictures Industry 99282 N N 99282 N N
Mountain State Blue Cross and Blue Shield SB941 Y Y
Mountain State Blue Cross of West Virginia 12B28 Y Y
Mountain States Administrative Services (Tucson AZ) 86040 N N 86040 N N
MPE Services Inc. 37233 N N 37233 N N
MPEEBT 37233 N N 37233 N N
MS Medicare Part A (JH) 12M17 Y Y
MS Medicare Part B (JH) SMMS0 Y Y
Page 29 of 48
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Accepts
Secondary
Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
MSA Care Guard 20572 Y N 20572 Y N
MSC (Medical Service Company) Group, Inc. 80019 N Y 80019 N Y
MSH Reimbursement 05887-NOCD Y N 05887-NOCD Y N
MT Medicare Part A (J3 - Noridian) 12M77 Y Y
MT Medicare Part B (J3 - Noridian) SMMT0 Y Y
Mt. Carmel Health Plan 95655 Y N 95655 Y N
Multicultural Primary Care Medical Group (San Diego) (Synermed) 75299 N N 75299 N N
Multiplan Wisconsin Preferred Provider Network 34080 N N 34080 N N
Municipal Health Benefit Fund 81883 N N 81883 N N
Mutual of Omaha Insurance Company 71412 N N 71412 N N
Mutually Preferred 71412 N N 71412 N N
MVP - Ohio 38224 N N
MVP Health Plan (Mohawk Valley) 14165 N N 14165 N N
MVP Health Rochester 12X04 Y N SX089 Y N
My Family Medical Group 33020 N N 33020 N N
MyNexus, Inc. 32043 N N 32043 N N
N.W. Ironworkers Health & Security Trust Fund 91136 N N 91136 N N
N.W. Roofers & Employers Health & Security Trust Fund 91136 N N 91136 N N
N.W. Textile Processors 91136 N N 91136 N N
NAA (North America Administrators L.P.) (Nashville TN) 65085 N N 65085 N N
NABN (Cleveland OH) 34159 N N 34159 N N
NALC/Affordable 53011 Y N 53011 Y N
NAMCI/Global Care L0110 Y N L0110 Y N
Naperville HealthCare 12T26 N N TH088 N N
NAPHCARE INC. 58182 Y N 58182 Y N
National Association of Letter Carriers 53011 Y N 53011 Y N
National Association of Letter Carriers/NALC 53011 Y N 53011 Y N
National Capital Preferred Provider Organization (NCPPO) 90001 Y N 90001 Y N
National Imaging Assoc Inc / Magellan Health Services 12X27 Y N
National Imaging Associates SX190 N N
National Rural Electric Coop (NRECA) 52132 Y N
National Telecommunications Cooperative Association 52120 N N 52120 N N
National Telecommunications Cooperative Association (NTCA - Staff) 52104 N N 52104 N N
National Telecommunications Cooperative Association (NTCA) 52103 N N 52103 N N
Nationwide Health Plans 31417 Y N 31417 Y N
Native Care Health 19191 Y N 19191 Y N
ND Medicare Part A (J3 - Noridian) 12M82 Y Y
ND Medicare Part B (J3 - Noridian) SMND0 Y Y
NE Medicare Part A (J5 - WPS) 12M19 Y Y
NE Medicare Part B (J5 - WPS) SMNE0 Y Y
Nebraska Medicaid 12K19 Y Y SKNE0 Y Y
Neighborhood Doctors Organization 51909 N N 51909 N N
Neighborhood Health Partnership (NHP) 96107 N N 96107 N N
Neighborhood Health Plan (Boston MA) 04293 N N 04293 N N
Page 30 of 48
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Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Neighborhood Health Plan (Boston, MA) 04293 N N 04293 N N
Neighborhood Health Plan Rhode Island 05047 Y N 05047 Y N
Neighborhood Health Plan Rhode Island - Exchange, Unity, Integrity 96240 N N 96240 N N
Netcare Life and Health Insurance (Hagatna Guam) 66055 N N 66055 N N
Network Health 04332 N Y 04332 N Y
Network Health Insurance Corp-Medicare 77076 N N 77076 N N
Network Health Plan of Wisconsin 39111 N N
Network Health Plan of Wisconsin Inc. 39144 N N 39144 N N
Network Medical Management NMM01 N N NMM01 N N
Network TPA LLC 58204 N N 58204 N N
Nevada Health Coop 90091 Y N 90091 Y N
Nevada Medicaid 12K20 Y Y
Nevada Medicaid First Health Services SKNV0 Y Y
NEW AVENUES INC. 95998 Y N 95998 Y N
New Century Health - IEHP Oncology NCH11 N N
New Century Health - Vista Cardiology NCH09 N N
New Era Employee Welfare Benefit Plan Trust 76031 N N 76031 N N
New Era Life Insurance Company 75281 N N 75281 N N
New Hampshire Medicaid 12K90 Y Y SKNH0 Y Y
New Jersey Medicaid 12006 Y Y
New Jersey Medicaid Part B SKNJ0 Y Y
New Jersey Medicaid-Charity Care CKNJ2 Y Y
New Mexico Blue Cross 12B22 Y Y
New Mexico Health Connections 45129 Y N 45129 Y N
New Mexico Medicaid 12K22 Y N SKNM0 N N
New West Health Plan 84141 N N
New West Health Services SX164 N N
New York Life 12T69 N N TH122 Y N
New York Medicaid 12K35 Y Y SKNY0 Y Y
New York Network Management 11334 N N
NGS American Inc 38225 N N 38225 N N
NGS JK Home Health & Hospice JKHHH Y Y
NH Medicare Part A (J14 - NHIC) 12M21 Y Y
NH Medicare Part B (J14 - NHIC) SMNH0 Y Y
NHBCAUX 88050 N N 88050 N N
NHI BILLING SERVICES INC 14043 Y N
NHP/SHP (Neighborhood Health Providers and Suffolk Health Plan) 11325 Y Y 11325 Y Y
Nippon Life Insurance Company of America 81264 N N 81264 N N
NJ Carpenters Health Fund 22603 Y N 22603 Y N
NJ Medicare Part A J12 12005 Y Y
NJ Medicare Part B J12 SMNJ0 Y Y
NM Medicare Part A (JH) 12M22 Y Y
NM Medicare Part B (JH) SMNM0 Y Y
NMCI Pilot N N
Page 31 of 48
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Accepts
Secondary
Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Noble AMA Select IPA PDT01 N N
North American Benefits Network (Cleveland OH) 34159 N N 34159 N N
North American Medical Management - Southern California IP079 N N IP079 N N
North American Medical Management (NAMM) - Northern California E3510 N N
North American Medical Management (NAMM) - Southern California E3510 N Y
North Broward Hospital District 37314 N N 37314 N N
North Carolina Medicaid 12K23 Y Y SKNC0 Y Y
North Carolina Medicare Part A 12M23 Y Y
North Carolina Medicare Part B SMNC0 Y Y
North County Health Services SCP01 N N SCP01 N N
North County Select 77017 N N 77017 N N
North Dakota Blue Cross (Noridian) 12B78 Y Y
North Dakota Medicaid (Hospital) 12K78 Y N
North Dakota Medicaid (Medical) SKND0 Y N
North Suburban Associated Physicians 36392 N N 36392 N N
North Texas Healthcare Network 35212 Y N 35212 Y N
North West Orange County Medical Group PROSP N N
Northern Illinois Health Plan 36347 N N 36347 N N
Northern Nevada Trust Fund 88027 N N 88027 N N
Northridge Medical Group NMG01 N N
Northshore LIJ Insurance Company 46227 Y N 46227 Y N
NorthShore Physician Associates 48026 Y N 48026 Y N
NorthShore University Health System Medical Group 36364 N N 36364 N N
Northstar Advantage 60058 N N 60058 N N
Northwest Diagnostic Clinic/SelectCare of Texas (NWDC) 62119 N N 62119 N N
Northwest Suburban IPA (Illinois) 36346 N N 36346 N N
Novanet 06226 N N 06226 N N
Novasys Health Network 71080 N N 71080 N N
NPS 22262 N N
Nuestra Familia Medical Group (Prospect Medical Group) PROSP N N
NV Medicare Part B (J1 - PGBA) SMNV0 Y Y
NY Medicare Part A (J13 - NGS) 12M35 Y Y
NY Medicare Part B Downstate (J13 - NGS) SMNY0 Y Y
NY Medicare Part B Queens (J13 - NGS) SMNY2 Y Y
NY Medicare Part B Upstate (J13 - NGS) SMNY1 Y Y
Nyhart 37299 N N 37299 N N
NYLCare Ethix Northwest 91135 N N
NYS DOH UCP 14142 Y N 14142 Y N
Oak West Physician Association 36400 N N 36400 N N
OAK WEST PRIMARY PHYSICIAN ASSOCIATION 36402 N N 36402 N N
Oasis IPA DESRT N N
Occular Benefits L0140 N N L0140 N N
OH Medicare Part A (J15) 12M24 Y Y
OH Medicare Part B (J15) SMOH0 Y Y
Page 32 of 48
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Accepts
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Enrollment Payer Code
Accepts
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Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Ohio Health Choice PPO 34189 N N 34189 N N
Ohio Medicaid SKOH0 Y N SKOH0 Y N
Ohio PPO Connect 74431 Y N 74431 Y N
OK Medicare Part A (JH) 12M37 Y Y
OK Medicare Part B (JH) SMOK0 Y Y
OK State Employees & Educators (EDS) 22521 N N 22521 N N
Oklahoma Medicaid 12K25 Y N SKOK0 Y N
Olympus Managed Health Care 65074 Y N 65074 Y N
OMNI Care Health Care 25150 Y N 25150 Y N
OMNI/Medicore HP 68037 N N 68037 N N
One Call Medical 22321 N N 22321 N N
OneNet PPO (formerly Alliance PPO / MAPSI) 52149 N N 52149 Y N
Operating Engineers Locals 302 & 612 Health & Security Fund 91136 N N 91136 N N
OptiCare Managed Vision 56190 N N
Optima Health Plan 54154 Y N 54154 Y N
Optima Insurance Company 54154 Y N 54154 Y N
Optimum Choice of the Carolinas Inc. (OCCI) 52152 Y N
Optimum Healthcare Inc. 20133 N N 20133 N N
OptumHealth 87726 Y N
OptumHealth Behavioral Solutions (formerly Pacificare Behavioral Health) 33053 N N 33053 N N
OptumHealth Behavioral Solutions (formerly United Behavioral Health) 87726 Y N 87726 Y N
OptumHealth Care Solutions (formerly United Resource Networks) 41194 Y N 41194 Y N
OptumHealth Physical Health - includes Oxford (formerly ACN & ACNIPA) 41160 N N
OptumHealth Vision 00773 Y N
OR Medicare Part A (J2 - Noridian) 12M41 Y Y
OR Medicare Part B (J2 - Noridian) SMOR0 Y Y
Orange County Health Care Agency 65021 Y N 65021 Y N
Oregon Medicaid 12K41 Y Y SKOR0 Y Y
Oregon's Health Co-op 45332 N N 45332 N N
Orthonet - Uniformed Services Family Health Plan 13382 N N
Orthonet- Aetna 13383 Y N 13383 Y N
Orthonet Corporation - CIGNA 13381 N N 13381 N N
Orthonet-HealthNet 25681 N N
OSF Health Plans 62171 N N 62171 N N
OSMA Health - C. L. Frates 73071 N N 73071 N N
PA Medicare Part A J12 12M60 Y Y
PA Medicare Part B J12 SMPA0 Y Y
PACE CNY 70454 N N 70454 N N
PACE Southeast Michigan 86711 N N 86711 N N
Pace Suburban Bus Service (via IDPA) PACE1 N X
Pacific Alliance Medical Center 75299 N N 75299 N N
Pacific Alliance Medical Group and Hospital (Synermed) 75299 N N 75299 N N
Pacific IPA PCFCI N N
PacificSource Community Solutions 20416 N N 20416 N N
Page 33 of 48
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
PacificSource Health Plans 93029 Y N 93029 Y N
PacificSource Medicare 20377 Y N 20377 Y N
Palo Alto Medical Foundation 94115 Y N 94115 Y N
Pan American Life Insurance Group 04218 N N 04218 N N
Paramount SX158 N N SX158 N N
Parkland Community Health Plan 66917 N N 66917 N N
Part A National - Legacy Claims 52280 Y Y
PARTNERS BEHAVIORAL HEALTH MANAGEMENT 52613 Y Y 52613 Y Y
Partners In Health Chicago IL MG#468 51909 N N 51909 N N
Partnership Health of California-CAPHP SX140 N Y
Partnership Health Plan Of CA 12M81 Y Y
Passport Health Plan 61129 Y N 61129 Y N
Patient Advocates LLC 10525 N N 10525 N N
Patient Services Inc CB733 N N CB733 N N
PATIENTPAY 26335 Y N
Payer Fusion 27048 N N 27048 N N
PCC Community Wellness Center Family Health Network patients only 51909 N N 51909 N N
Peach State Health Plan 68069 Y N 68069 Y N
Pegasus Medical Group PROSP N N
Pekin Insurance 37086 N N 37086 N N
Penn Behavioral Health 53226 Y N 53226 Y N
Pennsylvania Highmark Blue Shield - Central 12B81 Y Y
Pennsylvania Medicaid 12008 Y N SKPA0 Y N
Pennsylvania Pace 20172 N N 20172 N N
Peoples Health Network 72126 N N 72126 N N
PerformCare-Select Health MH/SA 25176 N N 25176 N N
Permier Health Plans 43166 N N
Personal Insurance Administrators Inc. (Agoura Hills CA) 95397 N N 95397 N N
PHCS Claims (formerly American LIFECARE) 72099 Y N 72099 Y N
PHCS Savility Payers 13306 N N 13306 N N
Phoenix Choice 55649 N N 55649 N N
Phoenix Health Plan 03440 Y N 03440 Y N
Phoenix Mutual Life 67814 N N 67814 N N
Physician Associates of Louisiana 58204 N N 58204 N N
Physician Associates of the Greater San Gabriel Valley PA513 N N PA513 N N
Physician Care Network LLC 58204 N N 58204 N N
Physician Health Partners PHPMD N N PHPMD N N
Physician Partners IPA PPRT1 N N PPRT1 N N
PHYSICIAN'S ACCOUNTABLE CARE ORG 28943 N N 28943 N N
Physicians Care (ASR Corporation) 38265 N N 38265 N N
Physicians Care Health Plans (ASR Corporation) 38265 N N 38265 N N
Physicians Care Network (ASR Corporation) 38265 N N 38265 N N
Physicians Care Network (Rockford IL only) 36345 N N 36345 N N
PHYSICIANS CARE NETWORK LLC/Polyclinic Seattle PCN12 N N PCN12 N N
Page 34 of 48
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Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Physician's Data Trust PDT01 N N
Physicians Health Association of Illinois 37136 N N 37136 N N
Physicians Health Choice - Claims 12T51 N N
Physicians Health Choice - Encounters 12T44 N N TH114 N N
Physicians Health Claims - Claims TH113 Y N
Physicians Health Collaborative 20398 N N 20398 N N
Physicians Health Network MHM03 N N
Physicians Health Plan 37330 Y N 37330 N N
Physicians Health Plan (PHP) - SC 09173 N N
Physicians Health Plan of Northern Indiana, Inc 12399 N N 12399 Y N
Physicians Medical Group of San Jose EXC01 N N
Physicians Medical Group of Santa Cruz County PMGSC N N
Physicians Mutual Insurance Company 47027 N N 47027 N N
Physicians of Southwest Washington 91171 N N 91171 N N
Physicians Plus Insurance Corporation 39156 N N 39156 N N
Physicians United Plan 10775-NOCD N Y 10775-NOCD N Y
Piedmont Behavioral Health 06607 Y N 06607 Y N
Piedmont Wellstar Health Plan 251PD Y N 251PD Y N
Pinnacle Claims Management Inc. 24735 N N 24735 N N
Pinnacle Health Resources (Prospect Medical Group) PROSP N N
Pinnacle Physician Management ORG 45985 N N 45985 N N
Pinnacol Assurance 84109 N N 84109 N N
Pioneer Medical Group PIONR N N
Pittsburgh Care Partnership Inc. 23283 N N 23283 N N
Plan de Salud Hospital Menonita L0190 N N L0190 N N
Planned Administrators, Inc. (PAI) 37287 Y N 37287 Y N
Podi Care Managed Care 58204 N N 58204 N N
PODIATRY NETWORK FL 59324 N N 59324 N N
POMCO 16111 Y N 16111 Y N
Pomona Valley Medical Group IP057 N N
PPOM LLC 38335 N N 38335 N N
PPOONE UHNDC Y N
PPOPlus LLC 72148 Y N 72148 Y N
PR Medicare Part B (J9 - First Coast) SMPR0 Y Y
Prairie States Enterprises Inc. 36373 N N 36373 N N
Preferred Blue (SC) 00481 N N 00481 N N
Preferred Care Partners Florida 65088 N N 65088 N N
Preferred Community Choice/PCCSelect/CompMed 73145 Y N 73145 Y N
Preferred Health Plan (Louisville KY) 61106 N N 61106 N N
Preferred Health Plan of the Carolinas CB404 N N CB404 N N
Preferred Health Professionals 31478 N N 31478 N N
Preferred Health Systems A Coventry Health Care Plan 60110 N N 61665 N N
Preferred Health Systems Insurance Company 60110 N N
Preferred IPA PFIPA N N
Page 35 of 48
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Accepts
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Claims
Enrollment Payer Code
Accepts
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CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Preferred Network Access Inc. 36401 N N 36401 N N
Preferred Plus of Kansas 60110 N N
PreferredOne (MN) 41147 Y N 41147 Y N
Premera Blue Cross 12B27 Y N
Premier Benefits Inc. 43166 N N 43166 N N
Premier Care IPA PCI01 N N
Premier Eye Care 65054 Y N
Premier Health Plan 251PR Y N 251PR Y N
Premier Health Plans 43166 N N
Premier Health Systems Inc 90440 Y N 90440 Y N
Premier Health Systems Inc. 29076 Y N 29076 Y N
Premier HealthCare Exchange 88056 N N 88056 N N
Premier HealthCare Exchange, Inc. (PHX) 88051 N N 88051 N N
Presbyterian (NM) 05003 Y N 05003 Y N
Presbyterian Health Plan PREHP N N PREHP N N
Prestige Health Choice 77003 Y N 77003 Y N
Prevea 360 Health Plan 39113 N N 39113 N N
Prima Health IPA IP096 N N
Primary Care Associates Medical Group (PCAMG) IP079 N N IP079 N N
Primary Health Network 82048 N N 82048 N N
Primary PhysicianCare Inc. 56144 N N 56144 N N
Prime West Health Plan 61604 Y N 61604 Y N
PrimeCare Medical Network IP079 N N IP079 N N
Priority Health 38217 Y N 38217 Y N
Prism Network Inc. 37268 N N
Prism-Univera 37315 N N
Pro Care Health Plan Inc. (Detroit MI) 38329 N N 38329 N N
ProCare (Prospect) PROSP N N
ProCare Health Plan Medicaid 70259 N N 70259 N N
Professional Benefit Administrators Inc. (Oak Brook IL) 36331 N N 36331 N N
Professional Risk Management 34134 N N 34134 N N
ProMed HealthCare Administrators IP057 N N
Prominence Health Plan of Nevada 93082 N N 93082 N N
Prominence Health Plan of Texas 80095 N N 80095 N N
Prospect Health Network PROSP N N
Prospect Medical Group PROSP N N
Prospect Sherman Oaks Medical Group (Prospect Medical Group) PROSP N N
Protective Life Insurance Company 37309 N N 37309 N N
Providence of Oregon Health Plan SX133 N N SX133 N N
Providence PPO SX187 Y N SX187 N N
Provident American Life & Health Ins Co-Medicare Supplement 13193 Y N 13193 Y N
ProviDRs Care Network 48100 Y N 48100 Y N
Prudential 68241 N N
PSKW Physician Reimbursement Program PSKW0 Y N
Page 36 of 48
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Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Puget Sound Benefits Trust 91136 N N 91136 N N
Puget Sound Electrical Workers Trust 91136 N N 91136 N N
Pyramid Life Insurance Company 48055 N N 48055 N N
Quad Med LLC (Pewaukee WI) 39197 N N 39197 N N
Qual Choice of Arkansas 35174 Y N 35174 Y N
QualCare Inc. 23342 N N 23342 N Y
Quality Care Partners 89461 Y N 89461 Y N
QuikTrip 73067 N N 73067 N N
QVI Risk Solutions Inc. 57117 N N
R&N Market TKFMC N N
Railroad Medicare (PGBA) SRRGA Y Y
RBMS LLC 91176 N N 91176 N N
Reading Hospital Employer Group 44219 Y N 44219 Y N
Redlands IPA (Synermed) 75299 N N 75299 N N
Regal Medical Group 95449 N N REGAL N N
Regence Blue Cross Blue Shield of Oregon SB850 Y N
Regence Blue Cross Blue Shield of Utah SB910 Y N
Regence Blue Cross of Oregon 12B41 Y N
Regence Blue Shield Idaho 12B88 Y N
Regence Blue Shield of Idaho SB611 Y N
Regence Blue Shield of Washington SB931 Y N
Regency Employee Benefits 38221 N N 38221 N N
Regional Care Inc. 47076 N N 47076 N N
Renaissance Physicians Organization 76066 N N 76066 N N
Reserve National Insurance 73066 Y N 73066 Y N
Resolve Health Plan Administrators LLC RHA01 N N RHA01 N N
ResourceOne Administrators 37278 N N 37278 N N
Resurrection Healthcare Preferred 36396 N N
Resurrection Healthcare Preferred/Family Medical Network 36396 Y N
Resurrection Physician Provider Group RPPG1 N N RPPG1 N N
Retiree Health Trust 26316 N N
Rhode Island Medicaid 12K74 Y Y SKRI0 Y Y
RI Medicare Part A (J14 - NHIC) 12M74 Y Y
RI Medicare Part B (J14 - NHIC) SMRI0 Y Y
Right Care from Scott & White 74205 Y N 74205 Y N
RightChoice Benefit Administrators 37331 N N 37331 N N
RIVER CITY MEDICAL GROUP RCMG1 N N RCMG1 N N
Riverside Health Inc. 45281 N N 45281 N N
RMSCO INC. 16117 Y N 16117 Y N
Rocky Mountain Health Plan - Grand Junction SX141 N Y
Rocky Mountain Health Plan- Grand Junction 84065 N Y
Rosemont of Des Plaines IL 36215 N N
Rural Carrier Benefit Plan 25133 Y N 25133 Y N
Rural Health Clinic - Cahaba GBA 12M53 Y Y
Page 37 of 48
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Accepts
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Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Rush Prudential Health Plans (HMO Only) 36389 N N 36389 N N
Ryan White Network AMM03 N N
S & S Healthcare Strategies 31441 N N 31441 N N
Sacramento - Primary Care Practices of Sacramento - EHS 75299 N N 75299 N N
Sagamore Health Network 35164 N N 35164 N N
Sage Technologies 37105 N N 37105 N N
SAINT MARY'S HEALTH PLAN 88029 N N 88029 N N
Samaritan Health Plans CP001 N N CP001 N N
San Diego County Coverage Initiative (CI) MSO77 N N MSO77 Y N
San Diego County Medical Services (CMS) MSO11 N N MSO11 Y N
San Diego County Ryan White Care Act MSO33 N N MSO33 Y N
San Diego PACE 96400 N N 96400 N N
San Diego Physicians Med Group (SCPMCS) SCP01 N N SCP01 N N
San Joaquin Health Administrators 68035 Y N
San Judas Medical Group IPA HSM01 N N
San Louis Obispo Select 33072 N N 33072 N N
Sanford Health Plan 91184 Y N 91184 Y N
SANTA CLARA FAMILY HEALTH PLAN 24077 N N 24077 N N
Sante Health System and Affiliates 77038 N N 77038 N N
Satellite Health Plan, Inc. 45552 N N 45552 N N
SCAN ENCOUNTERS 99157 Y N 99157 Y N
SCAN Health Plan 72261 N N 72261 N N
Scan Health Plan Arizona 73172 N N 73172 N N
SCAN Long Term Care 20460 N N 20460 N N
SCHC Total Care - ClaimsNet 16146 N N 16146 N N
Scott & White TH002 N N
Scott & White Health Plan 12T05 Y N
Screen Actors Guild 99289 Y N 99289 Y N
Scripps Health Plan Services SHPS1 N N SHPS1 N N
SD Medicare Part A (J3 - Noridian) 12M83 Y Y
SD Medicare Part B (J3 - Noridian) SMSD0 Y Y
Seaside Health Plan 46187 Y N 46187 Y N
Seaview IPA SVIPA N N
Secure Health Plans of Georgia LLC 28530 N N 28530 N N
Secure Health Plans of Georgia, LLC 28530 N N 28530 N N
Security Health Plan 39045 Y Y 39045 Y Y
Select Administrative Services (SAS) 64088 N N 64088 N N
Select Advantage SA704 N N SA704 N N
Select Benefit Administrators Inc. 93031 Y N 93031 Y N
Select Benefit Administrators of America 37282 N N 37282 N N
SELECT HEALTH 12X37 N N
Select Health of South Carolina 23285 Y N 23285 Y N
Select Senior Clinic 20415 N N 20415 N N
SelectCare 00014 Y N 00014 Y N
Page 38 of 48
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Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
SelectCare of Texas (HPN) Heritage Physicians Network 76045 N N 76045 N N
SelectCare of Texas (Kelsey-Seybold) 61225 N N 61225 N N
SelectHealth SX107 N N
Self Insured Plans (Naples FL) 36404 N N 36404 N N
Self Insured Services Company SISCO N N SISCO N N
Self-Funded Plans Inc. 34131 N N 34131 N N
Sendero Health 36426 Y N 36426 Y N
Senior Care Partners 36390 N N 36390 N N
Senior Health Partners (SHP) 80141 Y N 80141 Y N
SENIOR WHOLE HEALTH 83035 N N 83035 N N
Sentara Family Care 54154 Y N 54154 Y N
Sentara Health Management 54154 Y N 54154 Y N
Sentinel Management Services 23249 N N 23249 N N
Sentry Insurance a Mutual Company 39033 N N 39033 N N
Sentry Life Insurance Company 39033 N N 39033 N N
Sentry Life of New York 39033 N N 39033 N N
Seoul Medical Group SMG01 Y N SMG01 Y N
Sequoia Beverage TKFMC N N
Seton CHIP 76056 N N 76056 N N
Seton Health Plan - Exclusive 12T55 Y N TH079 N N
Seton MAP Program 12T57 Y N TH081 N N
Seven Corners 25404 N N 25404 N N
Sharp Community Medical Group SCMG1 N N
Sharp Rees-Sealy Medical Group SRS83 N N SRS83 N N
Shasta Administrative Services 75280 N N 75280 N N
Sheet Metal Workers Local 104 Health Care Plan (San Ramon CA) 38238 N N 38238 N N
Sherman Choice - BLUE CROSS SHERMAN CHOICE SC359 N N SC359 N N
Sierra Family Network (Prospect Medical Group) PROSP N N
Sierra Health and Life 76342 Y N 76342 Y N
Sierra Medical Group 30891 N N 30891 N N
Sierra Nevada Medical Association MBA01 N N
Significa Benefits Services Inc. 23250 N N 23250 N N
Silver Cross Health Connection 65093 N N 65093 N N
Silverback TPA 37228 N N 37228 N N
Simply Healthcare 27094 N N 27094 N N
Sinai Medical Group Chicago IL Family Health Network patients only 51909 N N 51909 N N
Sinclair Health Plan 84076 N N 84076 N N
Sloans Lake Preferred Health Networks 84096 N N 84096 N N
Smith Administrators 02057 Y N 02057 Y N
Smokey Mountain Center 13010 N Y 13010 N Y
Solstice Benefits 76578 N N
Sound Health (now known as First Choice Health Network) 91131 Y N 91131 Y N
Soundpath Health 42172 N N 42172 N N
South Carolina Medicaid 12K55 Y Y SKSC0 Y N
Page 39 of 48
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Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
South Carolina Medicare Part A (J11) 12M55 Y Y
South Carolina Medicare Part B (J11) SMSC0 Y Y
South Dakota Medicaid 12K36 Y Y SKSD0 Y Y
South FL Community Care Network - NBHD 37314 N N 37314 N N
South Indiana Health Operations - HMO SX142 Y N SX142 Y N
South Point Hotel & Casino 35227 N N 35227 N N
SouthCare/Healthcare Preferred 25147 Y N 25147 Y N
Southeast Community Care (Arcadian) 77045 N N 77045 N N
Southeast Texas Govt Employees Benefit Pool TH116 Y N
Southern Benefit Services 37318 N N 37318 N N
Southern CA Children's Network (SynerMed) 75299 N N 75299 N N
Southern Cal Physicians Managed Care Services SCP01 N N
Southern California Physicians Managed Care Services SCP01 N N
Southern Illinois Health Care Association UIHCA Y N SIHCA Y N
Southland BCBS SIPA1 N N SIPA1 N N
Southwest Service Life 37266 N N 37266 N N
Spectera 00773 Y N
Spectrum Administrators Inc. - TPA Allentown PA (IHS Gateway Payer) 23253 Y N 23253 Y N
Spina Bifida - VA HAC 84146 Y N 84146 Y N
Spohn Health 12T63 N N TH100 N N
St Francis IPA APP01 N N
St Joseph IPA STJOE N N
St Jude Yorba Linda STJOE N N
St. Anthony Memorial Healthcare Centers - MDWISE 35199 N N 35199 N N
St. Barnabas System Health Plan 22240 N N 22240 N N
St. Catherine Hospital PHO - MDWISE 35199 N N 35199 N N
St. Francis Health Care Chicago IL MG#112 51909 N N 51909 N N
St. Francis Health Network 35199 N N 35199 N N
St. James PHO 11158 Y N 11158 Y N
St. Joseph Heritage Healthcare STJOE N N STJOE N N
St. Jude (St. Joseph Heritage Healthcare) STJOE N N
St. Margaret Mercy Healthcare Centers - MDWISE 35199 N N 35199 N N
St. Vincent IPA PDT01 N N
Standard Life and Accident (Secondary claims only) 73099 Y Y 73099 Y Y
Starmark 61425 N N 61425 N N
State Auto Insurance Companies 46450 N N 46450 N N
State Employee Plan (SC) 00400 N N 00400 N N
State Farm (Casualty & Property Claims) 31059 Y N 31059 Y N
State Farm Insurance Companies 31053 N N 31053 N N
State of Texas Dental Plan 57254 N N 57254 N N
States General Life Insurance 75087 N N 75087 N N
Sterling Option 1 91151 N N 91151 N N
Stirling & Stirling 06089 N N
Stonebridge Life Insurance Company (IA, PA) TRP1E Y N TRP1E Y N
Page 40 of 48
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Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Stonebridge Life Insurance Company (TX) TRP1P Y N TRP1P Y N
Stoner and Associates (Cincinnati OH) 31121 N N 31121 N N
Stones River IPA - Amerivantage 57492 Y N
Stones River Regional IPA/BCBST 15750 N N
Stones River Regional IPA/BHFG 15754 N N
Stones River Regional IPA/Humana 57549 Y N
Stones River Regional IPA/Windsor 15752 N N
Suburban Health Organization 35199 N N 35199 N N
SummaCare Health Plan 95202 Y N 95202 Y N
Summit Administration Services Inc. 86083 N N 86083 N N
Summit America Insurance Services Inc. 37301 N N 37301 N N
Sunshine State Health Plan 68069 Y N 68069 Y N
Superior Administrators Inc (Santa Ana CA) 23218 N N 23218 N N
Superior Health Plan Texas 68069 Y N 68069 Y N
Sutter Connect Medical Foundation 99308 Y N
Sutter Delta Medical Group 77318 N N
Sutter East Bay Medical Foundation 94269 Y N 94269 N N
Sutter East Bay Regional Hospital 96176 Y N 96176 Y N
Sutter East Bay Regional Hospital- Affinity 94119 Y N 94119 Y N
Sutter Gould Medical Foundation 77302 Y N 77302 N N
Sutter Medical Group of the Redwoods 77304 Y N 77304 Y N
Swedish Covenant Hospital 36411 N N 36411 N N
Talbert Medical Group TALMG N N
Tall Tree Administrators 88067 N N 88067 N N
TASEBA TKFMC N N
TBT 94304 N N 94304 N N
Teachers Health Trust 88019 N N
Team Choice PNS 75133 N N 75133 N N
Teamcare 36215 N N 36215 N N
TEAMSTERS (UT/ ID / MT) - Group Benefit Admin 88054 Y N 88054 Y N
Teamsters Benefit Trust 94304 N N 94304 N N
Teamsters Local Union #301 36612 N N
Temple Community Hospital 75299 N N 75299 N N
Tennessee Medicaid 12K46 N Y SKTN2 N Y
Tethys Health Ventures 20212 N N 20212 N N
TEXAS CHILDRENS HEALTH TXCSM N N
Texas Children's Health Plan 76048 N N 76048 N N
Texas Childrens Health Plan (Medicaid) 75228 N N 75228 N N
Texas Christus 45210 N N 45210 N N
Texas First Health Plans (TIOPA) 76046 N N 76046 N N
Texas Health Insurance Risk Pool SB900 Y N
Texas HealthSpring 33104 N N 33104 N N
Texas Medicaid 12K64 Y N SKTX0 Y N
Texas Mutual Insurance Company WK002 N N WK002 N N
Page 41 of 48
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Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Texas Premier Plan TH089 N N
TexasFirst Health Plan (NTX) 13185 N N 13185 N N
The Alliance 88461 N N 88461 N N
The Care Network/The Savannah Business Group 68423 Y N 68423 Y N
The City of Odessa 75600 N N 75600 N N
The Health Exchange (Cerner Corporation) 20356 N N 20356 N N
The Health Plan/Hometown Health 34150 N N 34150 N N
The Healthcare Group 35206 N N 35206 N N
The Integrity Benefit Group Inc. 58200 N N 58200 N N
The Loomis Company - TPA Wyomissing PA (IHS Gateway Payer) 23223 Y N 23223 Y N
The MEGA Life & Health Insurance Company-OKC 59227 N N
The National Radiology Network 59087 N N 59087 N N
The New England 66893 N N
The Physicians Assurance Corp (TPAC) /Employee Benefit Management Corp (EBM 31074 Y N 31074 Y N
Third Party Administrators 37225 N N
Thomas H. Cooper & Company SX160 Y N
Three Rivers Preferred MP340 Y N
Thrivent Financial THRIV N N THRIV N N
TN Medicare Part A (J10 - Cahaba) 12M53 Y Y
TN Medicare Part B (J10 - Cahaba) SMTN0 Y Y
Today's Options (American Progressive and Pyramid Life) 48055 N N 48055 N N
Today's Options powered by CCRX 48055 N N 48055 N N
Tongass Timber Trust 92620 Y N 92620 Y N
Tooling & Manufacturing Association 61425 N N 61425 N N
Torrance Hospital IPA THIPA N N THIPA N N
Total Broker Benefits 36342 N N 36342 N N
Total Claims Administration 37314 N N 37314 N N
Total Community Care 31182 N N 31182 N N
Total Healthcare Inc. 38201 N N 38201 N N
Total Plan Services 41202 N N 41202 N N
Touchstone Health PSO 23856 N N 23856 N N
TOUCHSTONE HEALTH/HEALTH NET SMART CHOICE 13402 N N 13402 N N
Town & Country TKFMC N N
TPAC/Employee Benefit Management Corp 31074 Y N 31074 Y N
TR Paul Inc. 37230 N N 37230 N N
Transact RX PARTD N N
TransAmerica Financial Life Insurance Company (AR) TLINS Y N TLINS Y N
TransAmerica Financial Life Insurance Company (TX) TRP1P Y N TRP1P Y N
TransAmerica Life Insurance Company (AR) TLINS Y N TLINS Y N
TransAmerica Life Insurance Company (IA, MD, PA) TRP1E Y N TRP1E Y N
TransAmerica Life Insurance Company (TX) TRP1P Y N TRP1P Y N
TransAmerica Premier Life Insurance Company (AR) TLINS Y N TLINS Y N
TransAmerica Premier Life Insurance Company (IA) TRCLF Y N TRCLF Y N
TransAmerica Premier Life Insurance Company (IA, MD, PA) TRP1E Y N TRP1E Y N
Page 42 of 48
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Accepts
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Enrollment Payer Code
Accepts
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Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
TransAmerica Premier Life Insurance Company (TX) TRP1P Y N TRP1P Y N
Transchoice or TransSmile - First Service Administrator's Inc 20807 Y N 20807 Y N
TransChoice-Key Benefit Administrators 37284 Y N 37284 Y N
Trellis Health Partners 36397 N N 36397 N N
Tribute /SelectCare of Oklahoma 73117 N N 73117 N N
Tribute Health Plan 31118 Y N 31118 Y N
Tricare for Overseas 12X46 N Y
Tricare North Region 57106 Y N 57106 Y N
Tricare Overseas SX163 N Y
Tricare West 99726 Y N 99726 Y N
TriCities IPA PDT01 N N
Trigon Blue Cross and Blue Shield (Virginia) SB924 Y N
TRIHEALTH PHYSICIAN SOLUTIONS 31144 N Y 31144 N Y
TRIHEALTH PHYSICIAN SOLUTIONS - CONCERN 31143 N N 31143 N N
Trilogy Network 62777 Y N 62777 Y N
TRIPLEFIN LLC 64300 N N 64300 N N
Triple-S Inc. 12B48 N Y SB980 N Y
TriWest VAPC3 Region 3 55912 N Y 55912 N Y
TriWest VAPC3 Region 5A 55915 N Y 55915 N Y
TriWest VAPC3 Region 5B 55916 N Y 55916 N Y
TriWest VAPC3 Region 6 55917 N Y 55917 N Y
TRLHN/AS 98514 Y N 98514 Y N
True Blue / Blue Cross of Idaho 12B84 Y Y
TRUSTED HEALTH PLAN L0230 Y N L0230 Y N
Trusteed Plans Service Corporation 91078 N N 91078 N N
Trustmark Insurance Company 61425 N N 61425 N N
Tufts Associated Health 04298 N Y 04298 Y Y
TX Medicare Part A and Indian Health Services JH 12M31 Y Y
TX Medicare Part B and Indian Health Services JH SMTX0 Y Y
TX Premier Plan - Medicaid 12T29 N N
Ucare Minnesota 12X50 N Y SX178 N N
UC-Davis Health 94603 Y N 94603 Y N
UICPG Chicago IL MG#141 51909 N N 51909 N N
Ullico Inc. ULLIC N N ULLIC N N
Ultimate Health Plan 77022 N N 77022 N N
Ultra Benefits Inc. 41206 Y N 41206 Y N
UMC HEALTH PLAN 75130 Y N 75130 Y N
UMR (formerly Lexington / CommonWealth Administrative Group) 37237 Y N 37237 Y N
UMR (formerly UMR Onalaska) 79480 N N 79480 N N
UMR (formerly UMR San Antonio Benefit Planners) 74223 Y N 74223 Y N
UMR (formerly UMR Wausau Fiserv Benesight) 39026 Y N 39026 Y N
UMR Westerville (formerly Harrington Benefit Services - Columbus) 95266 Y N 95266 Y N
UMWA Health & Retirement Funds 52180 Y N 52180 Y N
Unicare Life & Health 80314 Y N 80314 Y N
Page 43 of 48
Payer Code
Accepts
Secondary
Claims
Enrollment Payer Code
Accepts
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Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Unified Group Services 35198 N N 35198 N N
Unified Health Services 62170 N N 62170 N N
Unified IPA HCP01 N N
Unified Physicians Network 34638 Y N 34638 Y N
Uniform Medical Plan 75243 N N 75243 N N
Union Labor Life Insurance Company (IA) TRP1E Y N TRP1E Y N
Union Pacific IPA (SCPMCS) SCP01 N N SCP01 N N
UNION PACIFIC RAILROAD EMPLOYES Health Systems 87042 Y N 87042 Y N
Union Security Insurance Company 70408 N N 70408 N N
Unison Health Plan/Better Health Plans 62183 Y N 62183 Y N
United Agriculture Benefit Trust UABT1 Y N
UNITED FOOD & COMM. WORKERS MIDWEST UNIONS 36659 N N
United Medical Alliance 84132 N N 84132 N N
United of Omaha 71412 N N 71412 N N
United Teacher Assoc Ins Co-Medicare Supplement 13193 Y N 13193 Y N
UnitedHealthcare 87726 Y N 87726 Y N
UnitedHealthcare (Definity Health Plan) 87726 Y N
UnitedHealthcare (Empire Plan) 87726 Y N
UnitedHealthcare (formerly Definity Health Plan) 64159 N N 64159 N N
UnitedHealthcare (MAHP MD IPA Optimum Choice MAMSI) 52148 Y N 52148 Y N
UnitedHealthcare (Oxford Health Plans) 06111 N N 06111 N N
UnitedHealthcare / MAHP - MD IPA Optimum Choice MLH (formerly MAMSI) 87726 Y N 87726 Y N
UnitedHealthcare / UHIS - UnitedHealth Integrated Services 39026 Y N 39026 Y N
UnitedHealthcare / UnitedHealthcare Plan of the River Valley 87726 N N 87726 N N
UnitedHealthcare / UnitedHealthcare StudentResources 74227 Y N 74227 Y N
UnitedHealthcare / UnitedHealthcare West (formerly PacifiCare) 87726 Y N 87726 Y N
UnitedHealthcare Community Plan 87726 Y N 87726 Y N
UnitedHealthCare Community Plan (KS / KanCare) 96385 Y N 96385 Y N
UnitedHealthcare Community Plan / DC DE OH PA SC (formerly Unison) 87726 Y N 87726 Y N
UnitedHealthcare Community Plan / AZ (formerly AZ Physicians IPA APIPA) 03432 N N 03432 N N
UnitedHealthcare Community Plan / FLHI LA MD MS CAN OH RI TX WAWI 87726 Y N 87726 Y N
UnitedHealthcare Community Plan / hawk-i 87726 N N 87726 N N
UnitedHealthcare Community Plan / IA (formerly AmeriChoice of Iowa) 87726 N N 87726 N N
UnitedHealthcare Community Plan / MI (formerly Great Lakes Health Plan) 95467 Y N 95467 Y N
UnitedHealthcare Community Plan / MS CHIP (formerly AmeriChoice MS-CHIP) 87726 N N 87726 N N
UnitedHealthcare Community Plan / NE 87726 Y N 87726 Y N
UnitedHealthcare Community Plan / NJ 86001 N N 86001 N N
UnitedHealthcare Community Plan / NY (formerly AmeriChoice NY Medicaid) 87726 Y N 86048 N N
UnitedHealthcare Community Plan / NY (formerly AmeriChoice Personal Care) 87726 Y N 86002 N N
UnitedHealthcare Community Plan / NYU 87726 Y N 87726 Y N
UnitedHealthcare Community Plan / PA (formerly AmeriChoice PA Medicaid&CHIP 86049 N N 86049 N N
UnitedHealthcare Community Plan / PA (formerly AmeriChoice Personal Care ) 86003 N N 86003 N N
UnitedHealthcare Community Plan / TN (formerly AmeriChoice TN: TennCare) 95378 N N 95378 N N
UnitedHealthcare Community Plan / UnitedHealthcare Dual Complete 87726 Y N
Page 44 of 48
Payer Code
Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
UnitedHealthcare Community Plan / UnitedHealthcare Long Term Care 87726 Y N 87726 Y N
UnitedHealthcare Medicare Solutions 87726 Y N
UnitedHealthcare Medicare Solutions / UnitedHealthcare Chronic Complete 87726 Y N 87726 Y N
UnitedHealthcare Medicare Solutions / UnitedHealthcare Group Medicare Advan 87726 Y N 87726 Y N
UnitedHealthcare Medicare Solutions / UnitedHealthcare MedicareComplete 87726 Y N 87726 Y N
UnitedHealthcare Medicare Solutions / UnitedHealthcare MedicareDirect 87726 Y N 87726 Y N
UnitedHealthcare Medicare Solutions / UnitedHealthcare Nursing Home Plan 87726 Y N 87726 Y N
UnitedHealthcare Vision 00773 Y N
UnitedHealthcare West (formerly PacifiCare of Arizona) 95964 N N 95964 N N
UnitedHealthcare West (formerly PacifiCare of CA - Claims) 95959 N N 95959 N N
UnitedHealthcare West (formerly PacifiCare of Colorado) 95962 N N 95962 N N
UnitedHealthcare West (formerly PacifiCare PPO - All States) 95999 N N 95999 N N
UnitedHealthOne (formerly American Medical Security) 81400 N N 81400 N N
UnitedHealthOne (formerly Golden Rule) 37602 Y N 37602 Y N
UnitedHeathcare Community Plan (formerly Unison Health Plan) 87726 Y N 87726 Y N
Unitrin Direct Property & Casualty Company 16063 N N 16063 N N
Unity Health Insurance 66705 N N 66705 N N
Univera - Health Care Plan/ChoiceCare Buffalo SX087 N Y
Univera - Pre Paid Health Plan of NY SX086 N Y
Univera - Univera Health Southern Tier SX088 N Y
Univera Healthcare CNY 12X17 N Y
Univera Healthcare SSA ENY 12X20 N Y
Univera Healthcare SSA WNY PPO Traditional 12X19 N Y
Univera Healthcare WNY 12X18 N Y
Univera SSA ENY SX090 N Y
Univera SSA WNY SX091 N Y
Universal Benefits (IA, MD) TRP1E Y N TRP1E Y N
Universal Care - California 33001 N N 33001 N N
University Family Care 09830 Y N 09830 Y N
University Family Care - Maricopa Health Plan 09908 Y N 09908 Y N
University Health Alliance 99026 Y Y
University Health Care Advantage 46407 N N 46407 N N
University Healthcare Marketplace 45437 Y N 45437 Y N
University of Illinois at Chicago Div of Specialized Care for Children 37601 N N 37601 N N
University of Missouri 25133 Y N 25133 Y N
University of Utah Health Plans SX155 N N
Upland Medical Group IP056 N N
UPMC Health Plan 23281 Y N 23281 Y N
UPMC Vision Advantage 25184 N N 25184 N N
Upper Peninsula Health Group (TPA) 37324 N N 37324 N N
Upper Peninsula Health Plan (Medicaid) 38337 N N 38337 N N
US Benefits 93092 Y N 93092 Y N
US Department of Labor 12X31 Y N
US Family Health Plan 90551 N N 90551 N N
Page 45 of 48
Payer Code
Accepts
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Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
US Family Health Plan (USFHP) 12T48 N N TH103 N N
USAA (United Services Automobile Association) 74095 N N 74095 N N
USFHP - St. Vincent Catholic Medical Centers of New York 13407 N N 13407 N N
UT- Altius (UHIN) 25133 Y N 25133 Y N
UT Medicare Part A (J3 - Noridian) 12M84 Y Y
UT Medicare Part B (J3 - Noridian) SMUT0 Y Y
Utah Blue Cross (Regence Blue Cross of Oregon) 12B42 Y N
Utah Medicaid 12K42 Y Y SKUT0 Y Y
UW Graduate Appointee Plan 91136 N N 91136 N N
VA Fee Basis Programs 12115 Y N 12115 Y N
VA Medicare Part A (J11) 12004 Y Y
VA Medicare Part B (J11) SMVA0 Y Y
Valir Pace 64009 N N 64009 N N
Valley Baptist Health Plan 12T06 Y N TH022 N N
Valley Care IPA VCIPA N N
Valley Mental Health 94293 N N
Valley Preferred - PPO Allentown PA (IHS Gateway Payer) 23253 Y N
Value Options - Commercial 12X56 Y N 00813 N Y
VALUE OPTIONS (TX NORTHSTAR) 99297 N N
Value Options PA 12K1A N N
ValueOptions Maryland Mental Hygiene Ad 22322 Y Y
ValueOptions/MBHP (MA Behavioral Health Partnership) VALOP Y Y VALOP Y Y
Vantage Health Plan Inc. 72128 N N 72128 N N
Vantage Medical Group PPM01 N N
VentureNet Healthcare 86062 Y N 86062 Y N
Verdugo Hills Medical Group 66126 N N 66126 N N
Verity National Group 75256 Y N 75256 Y N
Vermont Medicaid 12K26 Y Y SKVT0 Y Y
VGM Homelink 50701 N N
VI Medicare Part A (J9 - First Coast) 12M52 N Y
VI Medicare Part B (J9 - First Coast) SMVI0 Y Y
Via Christi HOPE 48123 N N 48123 N N
Victor Valley IPA VVIPA N N
Village Family Practice 73743 N N 73743 N N
VillageCareMAX 26545 N N 26545 N N
Virginia Coordinated Care-VCC 84806 N N
Virginia Medicaid 12003 Y N CVAK1 N N
Virginia Premier Health Plan 12K83 Y Y 54176 Y Y
Vista Health Plan 55248 N N 55248 N N
Vista Oncology - New Century Infusion Solutions NCH08 N N
Viva Health Plan 63114 N N 63114 N N
VNA Homecare Options 31626 Y N 31626 Y N
VNS CHOICE Medicare 77073 N N 77073 N N
VOLUSIA HEALTH NETWORK 59266 N N 59266 N N
Page 46 of 48
Payer Code
Accepts
Secondary
Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
VT Medicare Part A (J14 - NHIC) 12M26 Y Y
VT Medicare Part B (J14 - NHIC) SMVT0 Y Y
Vytra Healthcare 22264 Y N 22264 Y N
WA - Premera Blue Cross SB930 Y N
WA - Washington Coordinated Care 68069 Y N 68069 Y N
WA Medicare Part A (J2 - Noridian) 12M45 Y Y
WA Medicare Part B (J2 - Noridian) SMWA0 Y Y
Wabash Memorial Hospital Association 85256 N N 85256 N N
Washington Medicaid 12K27 Y Y
Washington Medicaid (Provider One) SKWA0 Y Y
WASHINGTON State Dept of LABOR & INDUSTRY SX063 N N SX063 N Y
Waterstone Benefit Administrators (Oklahoma Providers) 73155 N N 73155 N N
Waterstone Benefit Administrators (Outside Oklahoma) 23051 N N 23051 N N
WEA Insurance Group 39151 N N 39151 N N
webTPA/Community Health Electronic Claims/CHEC 75261 N N 75261 N N
Weiss Health Providers 36337 N N 36337 N N
Wellcare Health Plan, Inc. (Fee for Service) 14163 Y N 14163 Y N
Wellcare Health Plan, Inc. (Encounters Only) 59354 Y N 59354 Y N
Wellcare of CT 14164 Y N 14164 Y N
WellChoice of NJ SB803 Y N
Wellmark BCBS - Medicare COB 12B92 Y N SB645 Y N
Wellmark Blue Cross and Blue Shield of Iowa (IASD) SB640 Y Y
Wellmed WELM2 Y N WELM2 Y N
WellSystems LLC 35245 N N 35245 N N
Wenatchee Valley Medical Center 91064 N N 91064 N N
West Covina Medical Group 66124 N N CMSI1 Y N
West Suburban Health Providers 80942 Y N 80942 Y N
West Virginia Family Health Plan 45276 N N 45276 N N
West Virginia Medicaid 12K28 Y N SKWV0 Y N
Western Grower's Assurance Trust 24375 Y N 24375 Y N
Western Grower's Insurance Company 24735 N N 24735 N N
Western Health Advantage 68039 N N 68039 N N
Western Health Inc 37306 N N 37306 N N
Western Mutual Insurance 37247 N N 37247 N N
Western Reserve Life Insurance Company (TX) TRLTC Y N TRLTC Y N
Western Southern Financial Group (Cincinnati OH) 31048 N N 31048 N N
Westlake Financial Group 12T62 N N
WestLake Financial Group Inc. 90560 N N 90560 N N
Weyco Inc. 38232 N N 38232 N N
WI Medicare Part A & FQHC (J6) 12M29 Y Y
WI Medicare Part B (J6) SMWI0 Y Y
William C. Earhart 93050 Y N 93050 Y N
Wilson-McShane 41095 N N 41095 N N
Windsor Medicare Extra 62153 N N 62153 N N
Page 47 of 48
Payer Code
Accepts
Secondary
Claims
Enrollment Payer Code
Accepts
Secondary
Claims
Enrollment
CLAIMS PAYER LIST
10/06/2015
INSTITUTIONAL PROFESSIONAL
Windsor Medicare Extra (as of 5/1/14) 14163 Y N 14163 Y N
WINhealth Partners/Wyoming Health Solutions 27327 Y N 27327 Y N
Wisconsin Chronic Disease Program (WCDP) SKWID Y N SKWID Y N
Wisconsin Department of Corrections 74101 N N 74101 N N
Wisconsin Medicaid SKWI0 Y N SKWI0 Y N
Wisconsin Physician Services-Midlands 95930 Y N
Wisconsin Well Woman Program (WWWP) SKWIW Y N SKWIW Y N
Women's Integrated Network Inc. (WIN Fertility) 13413 N N
Workers Comp of West Virginia SX067 N Y
Workers Comp/Arkansas Blue Cross 12048 Y Y
Worksite Benefit Services LLC 20333 N N 20333 N N
World Insurance Company 75276 Y N 75276 Y N
WPP-ElderCare Wisconsin 77080 N N 77080 N N
WPPN 34080 N N
WPS - Tricare for Life 12X43 Y N SX176 Y N
WPS Commercial 12X29 Y Y SX022 Y Y
WV Medicare Part A (J11) 12M28 Y Y
WV Medicare Part B (J11) SMWV0 Y Y
WY Medicare Part A (J3 - Noridian) 12M30 Y Y
WY Medicare Part B (J3 - Noridian) SMWY0 Y Y
Wyoming Blue Cross 12B30 Y Y
Wyoming Medicaid 12K30 Y Y SKWY0 Y Y
Yale University Heath Plan 60646 Y N
Page 48 of 48