Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
1199 NATIONAL BENEFIT
FUND13162 X X X X
360 ALLIANCE PPO GILSBAR 07205 X X
3M CIGNA 62308 X X X X X See Cigna
8th Electrical District 74234 X
A&I BENEFT PLAN ADMIN 93044 X X
AAG BENEFIT PLAN ADMIN 75240 X X X
AARP MEDICARE COMPLETE -
UHC87726 X X X X X See United Healthcare
AARP MEDICARE
SUPPLEMENT - UHC36273 X X X X X See AARP
ABC HEALTH PLAN OF NY 48185 X X
ABRAZO ADVANTAGE
HEALTH PLAN03443 X X
ABRI HEALTHPLAN ABRI1 X
ACCESS ADMINISTRATORS AHS01 X X
ACCESS BEHAVIORAL CARE COACC X
ACCESS IPA CM001 X
ACCESS IPA REGAL X
ACCESS MEDICAL GROUP 95424 X X
ACCESS MEDICARE 19305 X X X
ACCESS ONLY AR BCBS 00520 X X XACCESS PLUS UTMB 76049 X X
ACCLAIM 64071 X X X
ACCLAIM REPRICING 21356 X X X
02/23/2016 Accountable IPA MPM23 X X
ACORDIA NATIONAL 87815 X X X X X See Wells Fargo TPA
ACS CONSULTING SERVICES
INC72467 X
ACS MEDICAID ADDED FEE 77039 X X X X X
ACS MEDICAID ELECTRONIC 77039 X X X X X
ACTIVA BENEFIT SERVICES
LLC38254 X
ADMIN ENTERPRISES,INC 53589 X X XADMINISTRATION SYSTEMS
RESEARCH ASR38265 X X
ADMINISTRATIVE CONCEPTS
INC22384 X X
ADMINONE 37278 X X
ADV HUMANA 61101 X X X X X See Humana
ADV HUMANA GOLD CHOICE 61101 X X X X X See Humana
ADVANCED DATA SOLUTIONS
INC58202 X X
ADVANCED MEDICAL
MANAGEMENTAMM01 X X
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
1 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
ADVANTAGE BUCKEYE
COMM HLTH PLAN68056 X X X
ADVANTAGE BY BRIDGEWAY
HLTH SOL68056 X X X
ADVANTAGE HEALTH
SOLUTION35209 X X
ADVANTAGE MED GRP NMM01 X
ADVANTICA 59374 X X
ADVANTRA FREEDOM 25133 X X X X X See Coventry Health Care
ADVANTRA/HEALTH
AMERICA, INC25133 X X X X X
See Coventry Health Care
ADVICA/NORTHEAST
GEORGIA HEALTH13376 X X
ADVICARE 45423 X X
ADVOCATE HEALTH
CENTERS36320 X X X X
ADVOCATE HEALTH
PARTNERS OPERATIONS65093 X X X X
AETNA 60054 X X X X XAETNA AFFORDABLE HEALTH
CHOICES57604 X X X X
See Aetna (payer ID 60054)
AETNA AFFORDABLE HEALTH
CHOICES57604 X X X X
See Aetna (payer ID 60054)
AETNA ASA PPO
(SIGNATURE ADMIN)58730 X
AETNA BETTER HEALTH - PA
MEDICAID23228 X X X X
AETNA BETTER HEALTH (IL) 34734 X X
AETNA BETTER HEALTH
CONNECTICUT MED23225 X X
03/02/2016AETNA BETTER HEALTH OF
KY128KY
AETNA BETTER HEALTH OF
MISSOURI128MO X X X X
AETNA BETTER HEALTH OF
NEBRASKA42130 X X
AETNA BETTER HEALTH OF
OHIO50023 X X X
AETNA ILLINOIS MEDICAID 26337 X X
AETNA TX MEDICAID AND
CHIP38692 X X
AFFILIATATED DOCTORS OF
ORANGE COUNTYADOCS X
AFFINITY HEALTH PLAN 13334 X X X X
2 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
AFFINITY MEDICARE
ADVANTAGE13333 X X
When submitting to this payer ID please
ensure the following: The claim is for a
Medicare Advantage Member, the date
of service is equal to or greater than
1/1/10 and the subscriber ID you
submit is 9 characters in length.
AFFORDABLE BENEFIT
ADMIN INC95426 X X
AFL CIO FOOD & BEVERAGE
DEALERS34444 X X
AFMC 86062 X X X
AFTRA HEALTH FUND 13346 X X
AGATE RESOURCES LIPA1 X
AGENCY SERVICES INC 64158 X X
AHPO (Cleveland, OH) 31138 X X
AIG LIFE INSURANCE CO 87726 X X X X X See United Healthcare
ALABAMA BCBS 00510 X X X
ALABAMA MEDICAID ET033 X XALABAMA MEDICAL
SURGICAL06311 X
ALABAMA MEDICARE 10102 X X X
ALAMEDA ALLIANCE 95321 X X XALASKA ELECTRICAL HEALTH
AND WELFARE92600 X X
ALASKA LABORERS
CONSTRUCTION INDU91136 X X
ALASKA MEDICAID ET344 X X X X
ALASKA MEDICARE 00831 X X X X X
ALASKA MEDICARE PART B 00831 X X X XALASKA PIPE TRADES LOCAL
37591136 X X
ALASKA UNITED FOOD &
COMMERCIAL91136 X X
ALICARE 13550 X X
ALIGNMENT HEALTHCARE CCHPC X X
ALL SAINTS COVENANT 39160 X
ALL SAVERS INSURANCE CO 37602 X X
ALLEGIANCE 81040 X X X X X X Does not accept Secondary Institutional Claims
ALLEGIANCE BENEFIT PLAN 81040 X X X X X XDoes not accept Secondary Institutional Claims
ALLEGIANCE BENEFIT PLAN
(INTERMOUNT81040 X X X X X X
Does not accept Secondary Institutional Claims
ALLIANCE ALPHA CARE GOLD ADSL1 X X
ALLIANCE BEHAVIORAL
HEALTHCARE23071 X X X
3 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
ALLIANCE HEALTHPLANS OF
WISCONSIN88461 X X
ALLIANCE PARTNERS 23172 X X
ALLIANCE PPO, INC 52149 X X
ALLIANCE SELECT 81400 X
ALLIANT HEALTH PLANS 58234 X X
ALLIED ADMINISTRATORS 94177 X X
ALLIED BENEFIT SYSTEMS 37308 X X
ALLIED PHYSICIANS NMM01 X
ALOHA CARE ALOHA X X
ALOHACARE ALOHA X XALPHA DATA SYSTEMS 75261 X X
ALTA BATES MEDICAL
GROUPA0701 X X
ALTA HEALTH STRATEGIES 25133 X X X X X See Coventry Health Care
ALTERNATIVE TECHNOLOGY
RESOURCES37231 X X
ALTIUS HEALTH PLANS 25133 X X X X X See Coventry Health Care
AMA INSURANCE AGENCY AMAIA X X
AMALGAMATED LIFE 13550 X X
AMERIBEN SOLUTIONS
BCBSAZ53589 X X X
AMERIBEN SOLUTIONS INC 75137 X X
AMERICAID COMMUNITY
CARE DALLAS FTW27514 X X X
AMERICAID COMMUNITY
CARE FORT WOR27514 X X X
AMERICAID COMMUNITY
CARE HOUSTON27515 X X X
AMERICAID COMMUNITY
CARE MARYLAND27517 X X X
AMERICAID COMMUNITY
CARE NEW JERSEY27516 X X X
AMERICAN ADMIN GROUP 75240 X X X
AMERICAN ADMINISTRATIVE
GROUP - AAG37283 X X X
AMERICAN ADMINISTRATIVE
GRP - AAG75185 X X X
AMERICAN BEHAVIORAL 63103 X X
AMERICAN BEHAVIORAL FEP
ITS63106 X
AMERICAN BENEFIT PLAN
ADMIN BCBSAZ53589 X X X
AMERICAN CHIRO IPA NY 41160 X
AMERICAN CHIRO NETWORK 41161 X
4 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
AMERICAN COMMERCIAL
BARGE LINES87726 X X X X X See United Healthcare
AMERICAN FAMILY INS TH095 X
AMERICAN FAMILY
INSURANCE COMPANYAMF11 X X
AMERICAN FAMILY
MEDICARE56071 X X X X
AMERICAN FAMILY PPO 56071 X X
AMERICAN GENERAL 62030 X X X X
AMERICAN HEALTH GROUP AHG99 X
AMERICAN HEALTHCARE
ALLIANCE01066 X X
AMERICAN HERITAGE 77083 X
AMERICAN IMAGING
MANAGEMENT36369 X X
AMERICAN INS ADMIN ET211 X
AMERICAN LIFECARE 72099 X X X
AMERICAN MEDICAL AND
LIFE INS23212 X X
AMERICAN MEDICAL
SECURITY81400 X
AMERICAN NATIONAL
INSURANCE74048 X X
AMERICAN PIONEER
BREVARD PHYSICIANSAPBPN X X
AMERICAN PIONEER SOUTH
FLORIDAAPSFL X X
AMERICAN POSTAL
WORKERS44444 X X
AMERICAN PROGRESSIVE 48055 X X
AMERICAN REPUBLIC INS CO 42011 X X X X
AMERICAN SERVICE LIFE
INSURANCE59227 X X X X
AMERICAN SPECIALTY
HEALTH NETWORKET393 X
AMERICAN WHOLEHEALTH
NETWORKS58213 X
AMERICAN WORKER HEALTH
PLUS37322 X X X
AMERICAS 1ST CHOICE HP
OF SC20553 X X
AMERICAS 1ST CHOICE PH
OF NC26078 X X
AMERICAS 1ST CHOICE S
CAROLINA20553 X X
AMERICAS CHOICE NMA 20029 X
AMERICAS HEALTH CHOICE 21810 X X
5 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
AMERICAS TPA 41178 X X
AMERICHOICE OF NEW
JERSEY86047 X X X X
AMERICHOICE OF NEW
YORK, INC86048 X X
AMERICHOICE OF NJ PERS
CARE PLUS86001 X X
AMERICHOICE OF NY PERS
CARE PLUS86002 X X
AMERICHOICE OF PA
MEDICAID AND KI86049 X X X X
AMERICHOICE OF PA PERS
CARE PLUS86003 X X
AMERIGROUP COMM CARE
NM27514 X X X
AMERIGROUP COMMUNITY
CARE27514 X X X
AMERIGROUP CORP AUSTIN
DALLAS FTWOR27514 X X X
AMERIGROUP CORP
GEORGIA27514 X X X
AMERIGROUP CORP
HOUSTON CCSA27515 X X X
AMERIGROUP FLORIDA INC 27519 X X X
AMERIGROUP ILLINOIS OHIO 27518 X X X
AMERIGROUP VIRGINIA 10262 X X
AMERIGROUP/AMERICAID -
FORT WORTH27514 X X X
AMERIGROUP/AMERICAID -
HOUSTON26374 X X
AMERIGROUP/AMERICAID -
HOUSTON27515 X X X
AMERIHEALTH DE HMO/PPO
INST23037 X
AMERIHEALTH - DELAWARE 93688 X X X
AMERIHEALTH DISTRICT OF
COLUMBIA77002 X X
For EDI support, please e-mail edi.dc@
amerihealthdc.com or call 1-888-656-2383
AMERIHEALTH - NEW JERSEY 60061 X X X
AMERIHEALTH
ADMINISTRATORS54763 X X X X X
02/10/2016AMERIHEALTH CARITAS
IOWA77075 X X
AMERIHEALTH HMO NEW
JERSEY23037 X X X
AMERIHEALTH MERCY
HEALTH PLAN22248 X X X X
6 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
AMERIHEALTH NORTHEAST 77001 X X X X X
Payer effective 3/1/2013 Managed Medicaid Plan part
of the AmeriHealth Caritas Family of Companies.
For EDI Support please email [email protected]
or call 1-877-234-4272
AMERIHEALTH VIP CARE - DC 77007 X X
Amerihealth VIP Select and Amerihealth VIP Care,
payer is effective 1/1/2014, Medicare Advantage Plan
part of the AmeriHealth Caritas Family of Companies.
All claims prior to 1/1/14 will be rejected.
AMERIHEALTH VIP CARE - LA 77006 X X
Amerihealth VIP Select and Amerihealth VIP Care,
payer is effective 1/1/2014, Medicare Advantage Plan
part of the AmeriHealth Caritas Family of Companies.
All claims prior to 1/1/14 will be rejected.
AMERIHEALTH VIP GROUP 22355 X X X X XAMERIKIDS - DALLAS/FT
WORTH26375 X X X X
AMIL/ARIA AMILR X X
ANCHOR BENEFIT
CONSULTING53085 X X X
ANCILLARY BENEFIT
SERVICES86062 X X X
ANGELES IPA 75299 X X
ANTARES MANAGEMENT
SOLUTIONS34192 X X X X
ANTHEM BCBS IN 00630 X X X X
ANTHEM BCBS ME 00680 X X X
ANTHEM BCBS OF NH 00770 X X X
ANTHEM BCBSCO 00050 X X X
ANTHEM BCBSCT 00060 X X X
ANTHEM BCBSNV 00265 X X X X
ANTHEM BCBSVA 00265 X X XANTHEM HEALTH & LIFE
INSURANCE80705 X X X X See Great West Life & Annuity
APA PARTNERS 16140 X X
APEX BENEFIT SVCS 34196 X
APIPA 03432 X X X
APPLECARE MEDICAL MGMT APP01 X
APS HEALTHCARE INC 54160 X X
APWU 44444 X X
AR MEDICARE 07102 X X X XARAZ 16120 X
ARBOR HEALTH PLAN 52312 X X X X
Medicaid Managed Care Plan, part of the
Amerihealth Caritas Family of Companies.For EDI
support, please e-mail
[email protected] or call 1-877-693-
8483.
7 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
ARCADIAN MANAGEMENT
SYSTEMS77045 X
ARDADIAN MANAGEMENT
SERVICES77045 X
ARIZONA BCBS 53589 X X XARIZONA FOUNDATION
(AFMC)ET352 X
ARIZONA MEDICAID AZMCD X X
ARIZONA MEDICARE 03102 X X X XARIZONA PHYSICIANS IPA 03432 X X
ARIZONA PRIORITY CARE
PLUS27154 X X
ARKANSAS BCBS 00520 X X XARKANSAS BEST
CORPORATION75278 X X X X
ARKANSAS MANAGED CARE
ORG62176 X
ARKANSAS MEDICARE 07102 X X X XARKANSAS MUNICIPAL
LEAGUE71603 X X
ARM GRP 88035 X X
ARNETT HEALTH PLANS 87726 X X X See United Healthcare
ARROYO VISTA FAMILY HLTH
CTRNMM01 X
ARTA HEALTH NETWORK WMM01 X X
ASAGEHA 06603 X X
ASCENDIA HEALTHCARE
MANAGEMENT56192 X
ASHNET ET393 X
ASRM CORPORATION ASRM1 X
ASSOCIATED BENEFITS
CORPORATIONFAABC X
ASSOCIATED THIRD PARTY
ADATPA1 X
ASSOCIATED THIRD PARTY
ADATPA1 X
ASSOCIATES FOR HEALTH
CARE36326 X X
ASSURANT HEALTH 39065 X X X X
ASSURANT HEALTH SULF
FUNDED75068 X X X
Must verify all claims should go Allied Benefit for
Assurant Health self funded groups with plan
effective dates after 5/1/2013
ASSURANT MINIMED-KEY
FAMILY37323 X X
ASSURED BENEFITS
ADMINISTRATORS74240 X X
ASURIS NORTHWEST
HEALTH93221 X X X X
8 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
ATHENS AREA HEALTH PLAN
SELECT95691 X X
ATHENS AREA HEALTH PLAN
SELECT95961 X X
ATLANTIS HEALTH PLAN 13853 X
ATLAS ADMINISTRATORS ATLAD X X
ATLAS ADMINISTRATORS TH004 X
ATPA ATPA1 X
ATRIO HEALTH PLAN ATRIO X X
AULTCARE MNAUL X XAUSTIN REGIONAL CLINIC
EMPCMSEB X X
AUTOMATED BENEFIT
SERVICES (ABS)38259 X X X
AUTOMATED GROUP
ADMINISTRATION INC37280 X X
AUTOMOTIVE MACHINISTS
LOCAL 28991136 X X
AVALON IPA IP080 X
AVERA ADVANTAGE 48055 X X
AVERA HEALTH PLANS 46045 X X
AVESIS 3RD PARTY 87098 X
AVMED INC 59274 X X X X
Provider must enroll for EFT in order to receive
electronic remittance,
http://www.avmed.org/Providers/Tools/EOP
Enrollement/index.aspx
AWA INSURANCE COMPANY 62324 X
AXA ASSISTANCE USA HAA
PREFERRED PARTNERS65101 X X
AXIA HEALTH MANAGEMENT 58213 X
AXMINSTER MEDICAL GROUP AXM01 X
AZ FOUNDATION FOR
MEDICAL CARE86062 X X X
BAKERSFIELD FAMILY
MEDICAL CENTERBKRFM X
BANKERS UNITED LIFE 74227 X X X
BANKERS UNITED LIFE
STUDENT DIV74227 X X X
BANNER HEALTH OF AZ SX145 X X
BANNER MEDISUN 77078 X X X
BASS ADMINISTRATORS 37248 X X
BC BS MONTANA BCBS X X X X X X
BC BS WYOMING 00960 X X X X X
BC OF CA 47198 X X X
BC OF IDAHO BLUEC X X X X
BC PA 23045 X X X X
9 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
BCBS AL 00510 X X X
BCBS AR 00520 X X X
BCBS AR MEDIPAK 00520 X X X
BCBS AZ 53589 X X X
BCBS CO 00050 X X X
BCBS CT 00060 X X X
BCBS DE INSTITUTIONAL 12B76 X X X
BCBS DE PROFESSIONAL 00570 X X X
BCBS FL 00590 X X X
BCBS GA 00601 X X X
BCBS IA 88848 X X X X
BCBS IN 00630 X X X X
BCBS KANSAS CITY 47171 X X X
BCBS KS 47163 X X X
BCBS KY 00660 X X X
BCBS LA 53120 X X X
BCBS MA SB700 X X X
BCBS MD SB690 X X X
BCBS ME 00680 X X X
BCBS MI 00710 X X X X XBCBS MI BLUE CARE
NETWORK00710H X X X X
BCBS MI FEP 00710F X X X XBCBS MI MEDICARE
ADVANTAGE00710A X X X X
BCBS MN 00720 X X XBCBS MN INST CLAIMS 00220 X X
BCBS MN PROF CLAIMS 00720 X X X
BCBS MO 00241 X X X
BCBS MS 00230 X X X
BCBS NC ET095 X X XBCBS NC MEDICARE
ADVANTAGEET095 X X X
BCBS ND 00820 X X X X
BCBS NE PROFESSIONAL 00760 X X X
BCBS NH 00770 X X X
BCBS NJ 22099 X X X X X
BCBS NM 00790 X X X
BCBS NV 00265 X X X X
BCBS NY CENTRAL 00805 X X XBCBS NY CENTRAL -
FEDERAL 00805A X X X
10 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
BCBS NY EMPIRE 00803 X X X
BCBS NY ROCHESTER 00804 X X X(Taxonomy required at Rendering when Group;
required at Billing when Individual)
BCBS OF W NEW YORK 00801 X X XBCBS of WESTERN MO.
KANSAS CITY47171 X X X
BCBS OK 00840 X X X X
BCBS OR 00851 X X X X
BCBS RI RIBLS X X X
BCBS SC 401 X X X
BCBS SD ET099 X X X X01/05/2016 BCBS TEXAS MEDICAID 66001 X X
BCBS TN 00390 X X X
BCBS TX 84980 X X X X
BCBS UTICA WATERTOWN 00806 X X XBCBS UTICA WATERTOWN -
FEDERAL 00806A X X X
BCBS VA ET103 X X X
BCBS VT BCBSVT X X X
BCBS W NEWYORK 00801 X X X
BCBS WASH DC PROF SB580 X X X
BCBS WASHINGTON DC INST 12000 X
03/31/2016BCBS WESTERN NY
HEALTHNOW12M39 X
BCBS WI 00950 X X X
BCBS WNY 00801 X X X
BCBSAZ ZENTH ADMIN 53589 X X X
BCBSMT BCBS X X X X X X
BCBSWV 54828 X X XBCI ADMINISTRATORS INC 49153 X X
BEACON HEALTH
STRATEGIES43324 X X Payer requires group number on each claim.
BEECH STREET
CORPORATION95377 X X
BEHAVIORAL HEALTH
SYSTEMS63100 X X
BELL ATLANTIC 60054 X X X X X See Aetna
BELLA VISTA MED GRP IPA MPM10 X
BENEFIT ADMIN SERVICES 88055 X X
BENEFIT ADMINISTRATIVE
SRVCS (BAS)41205 X X
BENEFIT ADMINISTRATIVE
SYSTEMS36149 X X X X
BENEFIT CONCEPTS 51037 X X X
11 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
BENEFIT COORDINATORS
CORP25145 X X
BENEFIT MANAGEMENT
ADMIN74266 X X
BENEFIT MANAGEMENT INC
(MO)43178 X X
BENEFIT MANAGEMENT INC
OF KS48611 X X
This payer will only accept medical and hospital
claims for these groups listed: BMI187, BMI219,
BMI234, BMI236, BMI214, BMI241, BMI617, BMI245,
BMI246
BENEFIT MANAGEMENT
SERVICES 56139 X X
BENEFIT MANAGEMENT
SERVICES INC00999 X
BENEFIT MANAGEMENT
SYSTEMS INC (MS)37212 X X
BENEFIT PLAN (CNA) 25133 X X X X X See Coventry Health Care
BENEFIT PLAN ADMIN OF
RENO88027 X X
BENEFIT PLAN ADMIN OF ST
LOUIS MO13310 X X
BENEFIT PLAN ADMIN OF WI 39081 X X
BENEFIT PLAN
ADMINISTRATOR INC37118 X X
BENEFIT PLAN C.N.A 25133 X X X See Coventry Health Care
BENEFIT PLAN MANAGEMENT 37222 X X
BENEFIT PLANNERS INC 74223 X X X
BENEFIT SERVICES INC 34178 X X
BENEFIT SOURCE INC 38257 X X
BENEFIT SYSTEMS AND
SERVICES36342 X X
BENEFIT TRUST LIFE
INSURANCE61425 X X X X See Trustmark Ins Co
BENEFITS, INC 42148 X X
BENESIGHT THE TPA 87265 X X X
BENESYS 37248 X X
BENESYS DENTAL 58102 X X
BEST LIFE & HEALTH INS CO 95604 X X
BETTER HEALTH PLANS INC 62183 X X
BHP - PREFERRED ONE
NETWORK19993 X
BIG LOTS ASSOCIATES
BENEFIT PLANS31074 X X X
BLAIR MILL BCBS PA ET190 X
BLEDSOE TRUST NWADMIN X X
BLOCK VISION INC BV001 X
12 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
BLOCK VISION OF TEXAS BVTX1 X
BLUE BELL BENEFITS TRUST ECIBB X X
BLUE BENEFIT ADMIN OF MA 03036 X X
BLUE BONNET
ADMINISTRATORS37244 X
BLUE CHIP OF RHODE
ISLANDRICHP X X X
BLUE CHOICE EMPIRE BCBS 00803 X X X
BLUE CHOICE HEALTHPLAN
BCBSSC922 X X
BLUE CHOICE MEDICAID (SC) 00403 X X
BLUE CROSS BLUE SHIELD
MTBCBS X X X X X X
BLUE CROSS GEORGIA INST 3537I X
BLUE CROSS KANSAS CITY
INSTKCBLS X X
BLUE CROSS KANSAS INST KSBLS X X
BLUE CROSS NEBRASKA
INST00260 X X
BLUE CROSS SOUTH
DAKOTA12B33 X X
BLUE CROSS UTAH 12B42 X X
BLUE CROSS WEST VIRGINIA 12B28 X X
BLUE CROSS WNY
COMMUNITY00301 X
BLUE SHIELD HI HIBLS X XBLUE SHIELD ID 00611 X X X
BLUE SHIELD IL 00621 X X X
BLUE SHIELD of CA -INST 94036 X X X
BLUE SHIELD of CA -PROF ET059 X X XBLUE SHIELD of WA 00932 X X
BLUE SHIELD OH PROF 00834 X X X
BLUE SHIELD UT 00910 X X X
BLUEGRASS FAMILY HEALTH 61124 X X
BMC HEALTHNET PLAN 13337 X X
BOILERMAKERS NATIONAL 36609 X X X
BOLLINGER INC BOLL1 X X
BOON-CHAPMAN BENEFIT
ADMINISTRATO74238 X X
BOSTON MEDICAL CNTR
HEALTHPLAN13337 X X
13 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
BOTSFORD HEALTH PLAN 38324 X X
BPS, INC 13310 X X
BRAVO HEALTH 52192 X X
BREATHCO/CSL PULMONARY 65005 X
BRIDGESPAN BRIDG X X X XBRIDGESTONE CLAIMS
SERVICE37285 X X
BRIDGEWAY ARIZONA 68069 X X X X XBRITCAY 22286 X X
BROKERAGE CONCEPTS 51037 X X X
BROWN & TOLAND MEDICAL
GROUP94316 X X
BROWN AND TOLAND
MEDICAL GROUPBTSS1 X
BRYAN INDEPENDENT
SCHOOL DISTRICTBRISD X X
BS of NE NEW YORK 00800 X X XBS of PENNSYLVANIA 54771 X
BUCKEYE COMMUNITY
HEALTH PLAN68069 X X X X X
Prior to sending claims, contact payer to verify your
provider info is in their system.
C&0 EMPLOYEES HOSPITAL
ASSOCIATION23708 X
C.N.A MAILHANDLERS 25133 X X X See Coventry Health Care
CAC (CLAIMS ADMIN CORP) 25133 X X X X XSee Coventry Health Care
CAHABA GBA 00011 X X X Contact HeW Enrollment
CAHABA HOME HEALTH
MEDICARE00011 X X X Contact HeW Enrollment
CAL OMPTIMA DIRECT CALOP X X
CALIFORNIA BLUE CROSS 47198 X X X XCALIFORNIA BLUE SHIELD
INST94036 X X X
CALIFORNIA BLUE SHIELD
PROFET059 X
CALIFORNIA HEALTH &
WELLNESS68047 X X X See Comments
Call Provider Services # is 1-877-658-0305 before
sending claims
CALIFORNIA MEDICAID 610442 X X X XCALIFORNIA MEDICARE
NORTH01112 X X X X
CALIFORNIA MEDICARE PART
A01111 X X X
CALIFORNIA MEDICARE
SOUTH01192 X X X X
CANNON COCHRAN
MANAGEMENT37105 X X
CAP MANAGEMENT SYSTEMS 95399 X X X
CAPE HEALTH PLAN 38245 X X X
14 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
CAPITAL BLUE CROSS 23045 X X
CAPITAL BLUE CROSS -
AMB/FAC24705 X
CAPITAL DISTRICT PHYS HP SX065 X
CAPITAL HEALTH PLAN 95112 X X
CAPITAL INTERNATIONAL
MANAGEMENT SE65067 X
CAPITOL ADMINISTRATORS 68011 X X
CARE 1ST HEALTH PLAN OF
ARIZONA57116 X X
CARE 1ST HEALTH PLAN OF
CA57115 X X
CARE ACCESS HEALTH PLAN
CAHP65062 X X X X See Health Network One
CARE FIRST BCBS MD 12011 X
CARE IMPROVEMENT PLUS 77082 X X
CARE MANAGEMENT GROUP
OF GREATER11331 X
CARECENTRIX 11345 X X X X
Click on the below link to learn more about the
ERA/EFT Enrollment process with CareCentrix.
https://www.carecentrixportal.com/ProviderPortal/ho
mePage.do
Enrollment required prior to claim submission. Please
contact [email protected]
CARECHOICES MICHIGAN
MERCY HLTH PLA38269 X X
CARECORE NATIONAL LLC 14182 X
CAREFIRST BCBS DC 12000 X
CAREFIRST BCBS OF DC/NCA SB580 X X X
CAREFIRST BCBS OF DC/NCA SB580 X X X
CAREFIRST BCBS OF
MARYLANDSB690 X
CARELINK ADVANTRA 25133 X X X X X See Coventry Health Care
CARELINK HEALTH PLAN 25133 X X X X X See Coventry Health Care
CARELINK MEDICAID 25140 X X X
CAREMORE CARMO X
CARENET 25142 X X X
CAREOREGON 93975 X X
CAREPLUS 95092 X X
CAREPLUS ENCOUNTERS 95093 X
CAREPLUS HEALTH PLANS 65031 X X
15 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
CARESOURCE OF INDIANA 37311 X X
CARESOURCE OF OHIO 31114 X X
CARESOURCE OR 26160 X
CARILION CLINIC MEDICARE
HP77015 X X
CARITEN HEALTHCARE 62073 X X
CARITEN SENIOR HEALTH 62072 X X
CAROLINA CARE PLAN 29076 X X X X X See Medical Mutual of Ohio
CAROLINA HEALTH PLAN, INC 57105 X X
CAROLINA SUMMIT
HEALTHCARE INC56195 X X
CARPENTERS TRUST OF
WESTERN WASHINGTON91131 X X
CATERPILLAR INC 37060 X X
CBCA ADMINISTRATORS 55438 X X
CBHA CAROLINA BEHAV
HLTH ALLIANCE56215 X
CBHNP - HEALTHCHOICES 65391 X X
CCEA 88019 X
CCEA WELFARE BENEFIT
TRUST88019 X
CCN 73159 X X X
CDO TECHNOLOGIES 87065 X X
CDPHP SX065 X
CDS GROUP HEALTH 88022 X X
CEDAR VALLEY COMMUNITY
HEALTH PLAN44827 X X
CEDARS-SINAI MEDICAL
ENCOUNTERS95167 X
CEDARS-SINAI MEDICAL
NETWORK95166 X
CEDI - DMERC ALL REGIONS 05655 X X X X
CELTIC INSURANCE CELTC X
CEMENT MASON &
PLASTERERS HEALTH91136 X X
CENCAL HEALTH INST 99111 X
CENCAL HEALTH PROF 98386 X
CENPATICO BEHAVIORAL
HEALTH AZ68048 X X X
CENPATICO GEORGIA 68050 X X X
CENPATICO INDIANA 68052 X X X
CENPATICO KENTUCKY 68068 X X X
CENPATICO MISSOURI 68068 X X X
CENPATICO SOUTH
CAROLINA68059 X X X
CENTENE ADVANTAGE
PLANS68056 X X X
16 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
CENTERLIGHT HEALTHCARE 13360 X X
CENTINELA VALLEY IPA MPM03 X
CENTRA BENEFITS HOUSTON 75196 X X
CENTRAL BENEFITS DALLAS 75243 X X X
CENTRAL BENEFITS LIFE 31118 X X X X X
CENTRAL BENEFITS MUTUAL 31118 X X X X X
CENTRAL BENEFITS
NATIONAL31118 X X X X X
CENTRAL CA ALLIANCE OF
HEALTHCCA01 X X X X
CENTRAL MASS HEALTH
CARE02041 X X X
CENTRAL RESERVE LIFE 34097 X X X XCENTRAL STATES HEALTH 36215 X X
CENTRAL STATES JOINT
BOARD37214 X X
CENTURY HEALTH
SOLUTIONS48120 X X
CHA-COMMONWEALTH
HEALTH ALLIANCE23171 X X
CHAMPUS 99726 X X X X X See your specific state for enrollment forms
CHAMPUS TRICARE NORTH 57106 X X X XSee your specific state for enrollment forms
CHAMPUS TRICARE SOUTH 61125 X X X XSee your specific state for enrollment forms
CHAMPVA 84146 X X X X XCHATWINS HEALTHCARE
ADMINISTRATORSCHAT1 X X
CHAUTAUQUA COUNTY
HEALTHCARE PLAN16600 X X
CHEC 75261 X X
CHEC - A SUBSIDIARY OF
SPRINTCHECS X
CHESTERFIELD RESOURCES 34154 X X
CHICAGO LABORERS HEALTH
AND WELFARECLW99 X
CHILDREN FIRST MED
GROUP94321 X
For questions regarding claim status, providers will
need to contact payer: CFMG Provider Customer
Service 510-428-3154
CHILDRENS HOSPITAL
ORANGE COUNTY33065 X X
CHINESE COMMUNITY
HEALTH PLAN94302 X X
CHINESE COMMUNITY
HEALTH PLAN94302 X X
17 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
CHIP- CHOICEONE UTMB UHSCH X X
CHIP DRISCOLL CHILDRENS
HEALTH PLANDCHCH X X
CHIP- SETON HP SHPCH X X
CHIPA - COLLEGA HEALTH
IPACHIPA X
CHIROPRACTIC CARE OF MN ACN01 X
CHN EBMS CHNEBMS X X
CHN MARSH CHNMARSH X X
CHN MBA CHNMBA X X
CHN NRECA CHNNRECA X X
CHN WCH CHNWCH X X
CHN WMI 91131 X X
CHOICE 65 (MEM SISTER OF
CHARITY)MSC22 X
CHOICE PLUS 60054 X X X X X See Aetna
CHP DIRECT SUPERMED 90441 X X
CHRISTIAN BROTHERS
SERVICES38308 X X
CHRISTIAN CARE MINISTRIES
- MEDISHARE59355 X X
CIGNA 62308 X X X X X
CIGNA - HEALTHSPRING 52192 X X X X See Bravo Health
CIGNA BEHAVIORAL HEALTH SX071 X X
CIGNA HOME HEALTH
MEDICARE15004 X X X X
CIGNA SENIOR HEALTH PLAN 86033 X X
CIMARRON SALUD 09824 X X X
CINCINNATI FINANCIAL CORP 46871 X
CITRUS HEALTH TH130 X X
CITY OF AMARILLO COA01 X
CITY OF ODESSA 75600 X X
CITY OF WICHITA FALLS 37251 X X
CL FRATES CLFR2 X
CLAIM MANAGEMENT
SERVICES INC39141 X X
CLAIMSWARE INC 57080 X X
CLARENDON KIDS CHIP
PROGSHP11 X X
CLEAR CHOICE 77201 X
CLEARCHOICE HEALTH PLAN 77201 X
CMCS ADVANTAGE HLTH
SOLUTIONS MCARE35219 X X
CMDP CMDP1 X
CMHC 02041 X X X
18 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
CNA HEALTH PARTNERS
REPRICING48153 X X
CNA MAILHANDLERS 25133 X X X X X See Coventry Health Care
CNIC 37227 X X
CO ROCKY MTN HEALTH
PLANRMHMO X X X X
COAST HOTELS & CASINO
INC37310 X
COASTAL ADMINISTRATIVE
SVC77052 X X
COIHS 77201 X
COLONIAL HEALTHCARE 37123 X X X
COLORADO ACCESS 84129 X
COLORADO BCBS 00050 X X XCOLORADO HEALTH INS
COOPERATIVE49718 X
COLORADO KAISER
PERMANENTECOKSR X X X X
COLORADO MEDICAID 77016 X X XCOLORADO MEDICARE PART
A04111 X X
COLORADO MEDICARE PART
B04102 X X X X
COLUMBIA CORNELL CARE
LLC25351 X X
COLUMBIA UNITED
PROVIDERS91162 X X
COLUMBINE HEALTH PLAN CHP02 X
COMMERCE BENEFIT GROUP 34181 X X
COMMONWEALTH
ADMINISTRATORSCATPA X X
COMMONWEALTH CARE
ALLIANCE14315 X X
COMMUNITY CARE
BEHAVIORAL HEALTH25179 X X
COMMUNITY CARE BHO 23282 X X
COMMUNITY CARE MANAGED
HEALTHCARE73143 X X X
COMMUNITY CARE
ORGANIZATION39126 X
COMMUNITY CARE PLUS 71079 X X
COMMUNITY CHOICE OF
MICHIGAN38325 X X
COMMUNITY FIRST COMMF X X
COMMUNITY FIRST TH005 X
COMMUNITY HEALTH
ALLIANCE TN27905 X X
COMMUNITY HEALTH CHOICE 48145 X X
19 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
COMMUNITY HEALTH ELEC
CLMS75261 X X
COMMUNITY HEALTH NTWRK
CT62149 X X
COMMUNITY HEALTH PLAN
NY23742 X
COMMUNITY HEALTH PLAN
WACHPWA X X X
COMMUNITY HEALTH
SOLUTIONS (LA)CLA11 X
COMMUNITY PREMIER FOR
NEIGHBORHOOD32481 X X
COMMUNITY PREMIER PLUS 32481 X X
COMP OHIO (AUSTINTOWN) 34177 X X
COMPANION HEALTHCARE 401 X
COMPCARE 95192 X X
COMPDATA 98919 X
COMPDATA MEDICAID CDATM X
COMPDATA ONLY AETNA,
CIGNA, UHC98920 X Used for MT COMPdata only claims
COMPDATA ONLY
ALLEGIANCE00012 X Used for MT COMPdata only claims
COMPDATA ONLY BCBSMT 751 X Used for MT COMPdata only claims
COMPDATA ONLY CHAMPUS 98914 Used for MT COMPdata only claims
COMPDATA ONLY
COMMERCIAL98919 X Used for MT COMPdata only claims
COMPDATA ONLY
COMMERCIAL HMO98925 X Used for MT COMPdata only claims
COMPDATA ONLY EBMS 00010 X Used for MT COMPdata only claims
COMPDATA ONLY INDIAN
HEALTH SVCS98940 X Used for MT COMPdata only claims
COMPDATA ONLY
INTERMOUNTAIN ADMINIS00012 X Used for MT COMPdata only claims
COMPDATA ONLY
MAILHANDLERS00019 X Used for MT COMPdata only claims
COMPDATA ONLY MEDICAID 98916 X Used for MT COMPdata only claims
COMPDATA ONLY MEDICAID
MANAGED CARE98935 X Used for MT COMPdata only claims
COMPDATA ONLY MEDICARE 98910 X Used for MT COMPdata only claims
COMPDATA ONLY MEDICARE
MANAGED CARE98945 X Used for MT COMPdata only claims
COMPDATA ONLY MISC
COMMERCIAL98919 X
COMPDATA ONLY MUST 00012 X Used for MT COMPdata only claims
20 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
COMPDATA ONLY NEW WEST 00008 X Used for MT COMPdata only claims
COMPDATA ONLY SELFPAY 98918 X Used for MT COMPdata only claims
COMPDATA ONLY WORK
COMP98950 X Used for MT COMPdata only claims
COMPLEMENTARY
HEALTHCARE PLANS93101 X
COMPREHENSIVE
BEHAVIORAL CARE59314 X X
COMPREHENSVE BENEFITS
ADMIN03036 X X
COMPSYCH CHICAGO 37363 X
03/02/2016 CONCORDIA CARE INC 33632 X X
CONFEDERATION LIFE INS 80667 X X
CONNECTICARE INC 06105 X X
CONNECTICARE MEDICARE 78375 X X
CONNECTICUT BCBS 00060 X X XCONNECTICUT GENERAL
CIGNA62308 X X X X X See Cigna
CONNECTICUT GENERAL
MEDICAL CLAIMS62308 X X X X X See Cigna
CONNECTICUT GENERAL
MENTAL HEALTH02331 X
CONNECTICUT MEDICAID ET304 X X X
CONNECTICUT MEDICARE 13102 X X X XCONSOCIATE GROUP 37135 X X
CONSOLIDATED ASSOCIATES 75284 X X
CONSOLIDATED GROUP HPS 04274 X
CONSOLIDATED HEALTH
PLAN87843 X X
CONSUMER MUTUAL OF
MICHIGAN58112 X X
CONSUMERS CHOICE
HEALTH SC45321 X X
CONSUMERS LIFE
INSURANCE CO29076 X X X X X
See Medical Mutual of Ohio
CONTINENTAL GEN INS CO -
MEDICARE SUPPLEMENT13193 X X
CONTINENTAL GENERAL
INSURANCE CO71404 X X X X
CONTINUUM ABC MSO 13397 X
COOK CHILDRENS STAR
PLANCCHP1 X X
COOK CHILDRENS STAR
PLANCCHP9 X
21 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
COOK GROUP HEALTH PLAN 35149 X X
COOPERATIVE BENEFIT
ADMINISTRATOR52132 X X X X X
COORDINATED BENEFIT
PLAN14829 X X X
COORDINATED MEDICAL
SPECIALISTS58204 X X
CORE ADMINISTRATIVE
SERVICES58231 X
CORE MANAGEMENT
RESOURCES GROUP58231 X
CORESOURCE OF AZ & MN 35182 X X X XCORESOURCE OF NC 35180 X X
CORESOURCE OF OHIO 35183 X X X
CORESOURCE OF PA MD IL 35182 X X X X X
CORESOURCE, LITTLE ROCK 75136 X X X X
CORNERSTONE BENEFIT
ADMIN35202 X X X
CORPORATE BENEFIT
SERVICES OF AMERI41124 X X
CORPORATE BENEFITS SERV 56116 X
CORPORATE BENEFITS
SERVICE56116 X
CORPORATE SYSTEMS
ADMINISTRATION37246 X
CORRECTCARE INTEGRATED
HEALTHCCIH X X
The abbreviation for the institution should be entered
as the patient’s address in Loop
2010BA, N3 segment. Institution’s city, state
and zip should be entered in Loop 2010BA,
N4 segment. Obtain info from the following
link:
https://www.correctcare.com/portal/Institution%20Ab
breviation%20List.pdf
CORRECTION HEALTH
PARTNERSPHPMC X X
CORRECTIONAL MEDICAL
SERVICES, IN43160 X
CORSOLUTIONS 48146 X
COUNTRY LIFE INSURANCE 62553 X X
COUNTY CARE 60827 X X
COVENANT
ADMINISTRATORS58102 X X
COVENANT MGMT SYSTEMS CMSEB X X
22 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
COVENTRY HEALTH AND LIFE
(OK)25133 X X X X X
See Coventry Health Care
COVENTRY HEALTH CARE OF
CAROLINA25133 X X X X
See Coventry Health Care
COVENTRY HEALTH CARE OF
DELAWARE25133 X X X X X
See Coventry Health Care
COVENTRY HEALTH CARE OF
FLORIDA 25133 X X X X X
See Coventry Health Care
COVENTRY HEALTH CARE OF
GEORGIA25133 X X X X X
See Coventry Health Care
COVENTRY HEALTH CARE OF
IOWA25133 X X X X X
See Coventry Health Care
COVENTRY HEALTH CARE OF
KANSAS25133 X X X X X
See Coventry Health Care
COVENTRY HEALTH CARE OF
LOUISIANA25133 X X X X X
See Coventry Health Care
COVENTRY HEALTH CARE
WICHITA25133 X X X X X
See Coventry Health Care
COVENTRY HEALTH
NEBRASKA25133 X X X X X
See Coventry Health Care
COVENTRY HEALTH WICHITA 25134 X X
COX HEALTH PLAN COXHP X
CREATIVE MEDICAL
SYSTEMS64068 X X
CREATIVE PLAN
ADMINISTRATORS37320 X X
CRESCENT HEALTH
SOLUTIONS56213 X X X
CROWN LIFE 80705 X X X X See Great West Life & Annuity
CROY HALL MGMT 37266 X X
CT GENERAL CIGNA 62308 X X X X See Cigna
CTI ADMINISTRATORS 42141 X X X
CUSTODY MEDICAL
SERVICESCMS01 X
CUSTOM DESIGN BENEFITS
INC82056 X X
CUSTOMCARE 60054 X X X X X See Aetna
DAKOTACARE DAK01 X
DART MANAGEMENT CORP 06172 X X
DART MEMBER CARE CB987 X X
DC CHARTERED HEALTH
PLAN95748 X
DEAN HEALTH PLAN 39113 X X
DEFINITY HEALTH 64159 X X
DEFINITY SERVICES 64159 X X
DELAWARE BCBS
INSTITUTIONAL12B76 X X
DELAWARE BCBS
PROFESSIONAL00570 X X X
23 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
DELAWARE CARE 25137 X X
DELAWARE HEALTH PLAN
CONSORTIUM63081 X X
DELAWARE MEDICAID DEMCD X X
DELAWARE MEDICARE 12102 X X X XDELAWARE PHYSICIANS
CARE27009 X X
DELTA HEALTH 94235 X X
DELTA HEALTH SYSTEMS DHS01 X
DENVER HEALTH MEDICAL 84135 X X
DESERET MUTUAL UH105 X X01/12/2016 DESERT MEDICAL GROUP DESRT
DESERT VALLEY MEDICAL
GRPDVMC1 X
DESTINY HEALTH PLAN 36436 X X
DIRECTORS GUILD OF
AMERICA23706 X X
DIVERSIFIED
ADMINISTRATION06102 X
DIVERSIFIED GROUP
ADMINISTRATION25160 X X
DIVERSIFIED GROUP
ADMINISTRATION25160 X X
DIVISION OF SPECIALIZED
CARE FOR CH37600 X
DIVISION OF SPECIALIZED
CARE FOR CH37600 X
DMERC - ALL REGIONS 05655 X X X XDOWNEY SELECT IPA APP01 X
DRISCOLL CHILDRENS
HEALTH74284 X X
DRISCOLL CHILDRENS
HEALTH PLANDCHCH X X
DUNN AND ASSOCIATES
BENEFITS ADMINI35186 X X
E3 HEALTH INC 75232 X X
EAGLE CREEK MEDICAL
PLAZA61101 X X X X X
See Humana
EARLY INTERVENTION
CENTRAL BILLING36434 X
EATON BENEFITS OH 62308 X X X X XEBERLE VIVIAN EV001 X
EBMS 81039 X X X X Does not accept Secondary Institutional Claims
EBMS EBMS X X X Does not accept Secondary Claims
EDUCATORS MUTUAL (EMIA) SX110 X X See Comments Contact EMIA to enroll at 800-362-0533, Opt 2
EHS GROUP HEALTH PLAN 98006 X X
24 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
EIGHTH ELECTRICAL
DISTRICT74234 X
EL PASO FIRST - CHIP EPF03 X X
EL PASO FIRST GROUP
HEALTHEPF08 X X
EL PROYECTO DEL BARRIO
INCMPM04 X
ELDERPLAN 31625 X X X X
ELECTRONIC TRANSMISSION
CORPORATI75260 X
ELLIS CONSULTANTS INC ECISF X X
ELMCO 37253 X X
EMBLEM HEALTH 13551 X X X See GHI New York on FAQ 564 for ERA Enrollment
EMCOMPASS 37110 X X
EMERALD HEALTH NETWORK 34167 X X
EMERGENCY MED SRVCS
FUND - AMMEMS01 X
EMI KP AMBULANCE CLAIMS 59299 X
EMORYCARE 60054 X X X X X See Aetna
EMPHESYS 61101 X X X X X See Humana
EMPIRE BCBS NY 00803 X X X
EMPIRE NY MEDICARE 13202 X X X X
EMPLOYEE BENE MGT CORP 31074 X X X
EMPLOYEE BENEFIT ADMIN &
MGMT95288 X
EMPLOYEE BENEFIT
CONCEPTS INC38241 X X
EMPLOYEE BENEFIT
CONSULTANTS37257 X
EMPLOYEE BENEFIT MGMT
CORP31074 X X X
EMPLOYEE BENEFIT SERV
OF SANANTONIOEBSSA X
EMPLOYEE BENEFIT
SERVICES (SOUTH CA37216 X X X
EMPLOYEE BENEFITS PLAN
ADMIN03036 X X
EMPLOYEE CLAIM ADJ 75184 X X
EMPLOYEE PLANS LLC 35112 X X
EMPLOYEE SECURITY INC 54098 X X
EMPLOYER PLAN SERVICES 74212 X X X
EMPLOYERS COALITION ON
HEALTHMIDSC X
25 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
EMPLOYERS DIRECT HEALTH 75232 X X
EMPLOYERS DIRECT HEALTH
FI75235 X X
EMPLOYERS HEALTH 61101 X X X X X See Humana
EMPLOYERS HEALTH
COOPERATIVEMIDSC X
EMPLOYERS HEALTH
INSURANCE61101 X X X X X
See Humana
EMPLOYERS INS OF WAUSAU 39026 X X X X See UMREMPLOYERS INSURANCE OF
WAUSAU39026 X X X X See UMR
EMPLOYERS MUTUAL INC FL 59298 X X
ENCIRCLE PPO 35206 X X
ENCORE ENCORE GTPA1 X X
ENCORE HEALTH NETWORK 35206 X
ENH MEDICAL GROUP IPA 36364 X X
ENSTAT NATURAL GAS 91136 X X
EQUALITY CARE OF
WYOMING77046 X X X X X
EQUALITYCARE 77046 X X X X XEQUIFAX HEALTHCARE
ADMIN SERVICES75196 X X
EQUIOR 62308 X X X X X See Cigna
EQUITABLE CIGNA 62308 X X X X X See Cigna
EQUITABLE PLAN SERVICES 73126 X X
ERIN GROUP
ADMINISTRATORS, INC23250 X X
ESSENCE HEALTHCARE 20818 X X
EVERCARE 87726 X X X X X See United Healthcare
EVERGREEN HEALTH PLAN 58233 X X
EVOLUTIONS HEALTHCARE
SYSTEMS59313 X X
Payer id valid for only claims with a submission
address of PO Box 5001, Port Richey, FL 34656
EXCLUSICARE 71412 X X X X See Mutual of Omaha Insurance Co
EYE SPECIALISTS OF
ARIZONA75138 X X
F20199 51028 X X FOR MINNESOTA CLIENTS ONLY
FACEY MEDICAL
FOUNDATION95432 X
FACS GROUP 37300 X X
FALLON COMMUNITY HEALTH 22254 X X
FAMILY CARE 60995 X X
26 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
FAMILY CARE CCO PHD01 X X
FAMILY CARE MEDICAID FCD01 X X X
FAMILY CARE MEDICAID
MENTAL HEALTHFCM01 X X X
FAMILY CARE MEDICARE FCR01 X X X
FAMILY CHOICE MEDICAL IP080 X
FAMILY HEALTH PLAN 96865 X
FARA BENEFIT SERVICES 37289 X X
FARM FAMILY 14140 X X X
FBMC 59069 X X
FEDERATED MUTUAL
HEALTH INSURANCE41041 X X X X
FEP of SC BCBS 402 X
FIDELIS CARE NEW YORK 11315 X
FIDELIS SECURE CARE 77054 X X
FIRST ADMINISTRATORS INC FAMR1 X
FIRST CAROLINE CARE 56196 X X
FIRST CAROLINE CARE 56196 X X
FIRST CHOICE HEALTH
NETWORK91131 X X
FIRST CHOICE HEALTHPLANS
CT14163 X X
FIRST CHOICE MEDICAL
GROUPFCMG1 X
FIRST CHOICE OF MIDWEST 75138 X X
FIRST GREAT WEST LIFE &
ANNUITY80705 X X X X
FIRST HEALTH 25133 X X X X X See Coventry Health Care
FIRST OPTION HEALTH PLAN 22324 X
FIRST PRIORITY HEALTH 23241 X
FIRST PYRAMID LIFE 00520 X
FIRST SOURCE 00520 X
FIRSTCARE 94999 X X
FIRSTCARE TH003 X
FIRSTGUARD HEALTH PLAN 90060 X X
FIRSTGUARD HEALTH PLAN -
MISSOURI90061 X X
FISERV HEALTH -
KANSAS/TENNESSEE62061 X X
FITZHARRIS & COMPANY INC 11244 X
FLEXCARE 60054 X X X X X See Aetna
FLORIDA 1ST 59276 X X
FLORIDA BCBS 00590 X X XFLORIDA HEALTH CHOICE 81400 X
27 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
FLORIDA HOSPITAL HEALTH 59321 X X X
FLORIDA HOSPITAL
HEALTHCARE59321 X X X
FLORIDA HOSPITAL
WATERMAN EMPLOYE48116 X X
FLORIDA MEDICAID 77027 X X X
FLORIDA MEDICARE 09102 X X X X
FLORIDA POWER AND LIGHT 60054 X X X X XSee Aetna
FLORIDIANCARE BPN APBPN X X
FLORIDIANCARE SOUTH
FLORIDAAPSFL X X
FMH BENEFIT SERVICES INC 48117 X X X X
FORTIS BENEFITS 70408 X X X X
FORTIS INS CO 39065 X X X X See Assurant Health
FORTIS INS CO 39065 X X
FORTIS INSURANCE
COMPANY39065 X X X X See Assurant Health
FOUNDATION HEALTH PLAN 55248 X X X
FOX EVERETT INC 64069 X X
FOX EVERETT LITTON
INGALLS SHIPBL64067 X X
FOX VALLEY MEDICINE SITE
199FVMCH X
FOX VALLEY MEDICINE SITE
451FVMC1 X
FREEDOM BLUE (WV
Providers)71768 X
FREEDOM FIRST 31313 X X
FREEDOM HEALTH PLAN 41212 X X
FREEDOM LIFE INSURANCE
CO62324 X
FRESENIUS MEDICAL CARE
HEALTH PLANFMCHP X X
FRONTPATH 34171 X X
FUTURE CARE IPA FCI01 X
G E H A 44054 X X X XGALVESTON COUNTY
INDIGENT HEALTH30005 X X
GATEWAY HEALTH PLAN 25169 X X X XGATEWAY HEALTH PLAN
MEDICARE ASSURE60550 X X X X
GBA 37283 X X X
GE GROUP
ADMINISTRATORS75238 X X
28 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
GE GROUP LIFE ASSURANCE 67815 X X
GEHA 44054 X X X XGEHA PCIP 57254 X
GEICO INSURANCE GEICO X
GEISINGER HEALTH PLAN 75273 X X X XGEMCARE HEALTH PLAN MCS03 X X
GENERAL AMERICAN LIFE
INS. CO.63665 X X
GENESEE COUNTY MEDICAL
PLAN16112 X
GENESIS HEALTHCARE PROSP X X
GEORGE WASHINGTON
HEALTH PLAN52098 X
GEORGIA BCBS PROF 00601 X X X
GEORGIA BLUE CROSS INST 3537I X
GEORGIA MEDICAID INST 12K05 X X
GEORGIA MEDICAID PROF 77034 X X X
GEORGIA MEDICARE PART B 10202 X X X X
GEORGIA POWER MEDICAL
BENEFITS PL61271 X X X X
GETTYSBURG HEALTH 23274 X
GHC EASTERN WASHINGTON 91121 X X
GHC WESTERN
WASHINGTON91051 X X X
GHI HMO SELECT 25531 X X X
GHI INC PRIVATE INS 13551 X X XGHI MEDICARE PRIVATE FEE
FOR SERVIC22937 X X
GHI NEW YORK 13551 X X X X
GHI NY MEDICARE 13292 X X X X
GHP GROUP HEALTH PLAN 25133 X X X X XSee Coventry Health Care
GIC INDEMNITY PLAN 80314 X X X See Unicare
GILSBAR 07205 X X
GILSBAR, INC 07205 X X X XGLASSWORKERS HEALTH &
WELFARE FUND91136 X X
GLOBAL CARE INC 07689 X X X
GLOBAL CARE MED GRP IPA MPM05 X
GLOBAL EXCEL
MANAGEMENTGEM01 X X
GLOBAL HEALTH GHOKC X X
29 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
GOLDEN RULE INSURANCE
COMPANY37602 X X
GOLDEN TRIANGLE
PHYSICIAN ALLIANCEGTPA1 X X
GOOD SAMARITAN MED
PRACTICE ASSOCIP086 X X
GOVERNMENT EMPLOYEES
HOSP ASSOCIA44054 X X X X
GOVT EMPLOYEES HEALTH
ASSC45235 X X
GOVT EMPLOYEES HEALTH
ASSOC45275 X X
GRADY HEALTHCARE 58204 X X
GRANT PHYSICIANS
PRACTICE37234 X X
GREAT AMERICAN LIFE INS
CO13193 X X
GREAT LAKES HEALTH PLAN 95467 X X
GREAT WEST HEALTHCARE 80705 X X X X
GREAT WEST LIFE &
ANNUITY INSURANC80705 X X X X
GREAT WEST LIFE &
ANNUITY80705 X X X X
GREATER ORANGE CO MED
GRPNMM01 X
GREATER SAN GABRIEL MED
GRPNMM01 X
GREENTREE 78521 X X
GREENTREE
ADMINISTRATORS78521 X X
GROUP ADMINISTRATORS
LTD36338 X X
GROUP AND PENSION
ADMINISTRATORS48143 X
GROUP BENEFIT
ADMINISTRATORS72153 X X
GROUP BENEFITS -
LOUISIANA72087 X X X
GROUP HEALTH COOP EAU
CLAIRE95192 X X
GROUP HEALTH COOP
MADISON ENCOUNT39168 X X
GROUP HEALTH
COOPERATIVE EAST91121 X X
GROUP HEALTH
COOPERATIVE MADISON39167 X X
GROUP HEALTH
COOPERATIVE WEST91051 X X X
30 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
GROUP HEALTH MANAGERS 38194 X X
GROUP HEALTH
NORTHWEST91051 X X X
GROUP HLTH COOP WEST 91051 X X X
GROUP INSURANCE SERVICE 37276 X X
GUARDIAN HEALTHCARE 77010 X X
GUARDIAN LIFE INS COMP OF
AMERICA64246 X X X X
GUNDERSON LUTHERAN
HEALTH PLAN INC39180 X X
H.A.C., INC. 61101 X X X X X See Humana
HAMMERMAN & GAINER 97258 X
HARKEN HEALTH 43313 X X
HARMONY HEALTH PLAN OF
INDIANA36405 X X X
HARRINGTON BEN SRV OK 95266 X X X
HARRINGTON BENEFIT SERV 75196 X X
HARRINGTON BENEFIT
SERVICES95266 X X X
HARRINGTON BENEFIT
SERVICES, INC59142 X X
HARRINGTON BENEFIT SRV 95266 X X X
HARRINGTON EMPLOYEE
BENEFIT SERVICE41198 X X
HARVARD COMMUNITY 04271 X X
HARVARD PILGRIM HEALTH
CARE04271 X X
HAWAII BLUE SHIELD HIBLS X XHAWAII MANAGEMENT
ALLIANCE ASSOCIAT48330 X X X
HAWAII MEDICAID HIMCD X X
HAWAII MEDICAL
ASSURANCE ASSOC/HWMG99208 X X
HAWAII MEDICARE 01202 X X X XHCC LIFE INSURANCE HCCMI X
HCH ADMIN ILLINOIS 37111 X X
HCH ADMINISTRATION 37215 X X
HCHA ALBQ NM SELF
FUNDED37329 X X
HCS HEALTH CLAIMS
SERVICE82018 X X
HDM BENEFIT SOLUTIONS HDMCO X X
HEALTH 1-2-3 INC 23173 X X
HEALTH ADMINISTRATION
SERVICES IN34185 X
31 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
HEALTH ADVANTAGE 00520 X
HEALTH ALLIANCE
EXCLUSIVE & PLUS23172 X X
04/06/2016 HEALTH ALLIANCE MEDICAL 77950 X X X X
HEALTH ALLIANCE PLAN 38224 X X
HEALTH AMERICA, INC 25126 X X X
HEALTH AND WELFARE FUND
OHIO34564 X
HEALTH
ASSURANCE/HEALTH
AMERICA
25126 X X X
HEALTH CARE ALLIANCE 60054 X X X X X See Aetna
HEALTH CARE NETWORK OF
WISCONSIN42102 X
HEALTH CARE PARTNERS -
AZHCP02 X X
HEALTH CARE PAYERS
COALITION (HCP34193 X X
HEALTH CARE SOLUTIONS
GROUP73147 X X X
HEALTH CARE'S FINEST
NETWORK36335 X X
HEALTH CHOICE
GENERATIONS OF AZ62180 X X X X
HEALTH CHOICE
INTEGRATED CARE OF N. AZ22100 X X
HEALTH CHOICE OF AZ 62179 X X X XHEALTH CONNECTICUT 37263 X X
HEALTH CONNECTIONS MBHC X X
HEALTH COST SOLUTIONS 62111 X X
HEALTH DESIGN PLUS 34158 X X
HEALTH ECONOMIC
LIVELIHOOD PARTNERSHIP
(HELP)
66004 X X X X Enrollment for ERA only
HEALTH ECONOMICS CORP 75196 X X
HEALTH ECONOMICS GROUP 16112 X
02/23/2016 Health Edge 95213 X X
HEALTH FIRST - TYLER, TX 75234 X
HEALTH FIRST HEALTH
PLANS95019 X X
HEALTH FUTURE 30946 X X
HEALTH INFONET HINPAPER X X
HEALTH INSURANCE PLAN
OF NEW YORK55247 X X X X X
HEALTH MARKET CARE
ASSURED62295 X X
32 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
HEALTH MGMT ADMIN TH049 X
HEALTH NET - VA PATIENT
CENTERED COMMUNITY
CARE PROGRAM
68021 X X
The Payor ID 68021 facilitates claim submission to
Health Net Federal Services for services authorized
under the Veterans Affairs Patient-Centered
Community Care Program. Please include the VA
authorization number when submitting claims.
HEALTH NET CA
ENCOUNTERS95570 X
HEALTH NET CALIFORNIA &
OREGON95567 X X X X
See California or Oregon, which is applicable for your
state.
HEALTH NET OF ARIZONA 38309 X X
HEALTH NET PEARL SX185 X X
HEALTH NETWORK ONE 65062 X X X XHEALTH NEW ENGLAND 04286 X
HEALTH ONE BCBSPA 54720 X
HEALTH OPTIONS BCBSFL 00590 X X XHEALTH OPTIONS OF
ILLINOIS INCNAHOI X X
HEALTH PARTNERS - PA 80142 X X
HEALTH PARTNERS MN 00055 X X XHEALTH PARTNERS OF CT 06111 X X
HEALTH PARTNERS OF
KANSAS31478 X X
HEALTH PARTNERS,
JACKSON TN62157 X X
HEALTH PAYMENT SYSTEMS
INC20270 X X
HEALTH PLAN OF MICHIGAN 83253 X X
HEALTH PLAN OF NEVADA 76342 X X
HEALTH PLAN OF NEVADA
ENCOUNTERS76343 X X X
HEALTH PLAN OF SAN
JOAQUIN68035 X X
HEALTH PLAN OF SAN
MATEOSX174 X X
CONTACT PAYER FOR REGISTRATION : ENDRY
LO 650-616-2017 OR KEN COTTRELL 650-616-
2021
HEALTH PLAN SOLUTIONS OF
UTAH87068 X X
HEALTH PLANS INC 44273 X X
HEALTH PLEDGE HMO 95435 X
HEALTH PLUS MICHIGAN 38216 X
HEALTH PLUS PHSB
(BROOKLYN, NY)11324 X X X
HEALTH RISK MANAGEMENT
INC41170 X X
HEALTH SERVICES
MANAGEMENT (HSM)HSM01 X X
33 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
HEALTH SERVICES
PREFERRED HSP BY34167 X X
HEALTH SVCS FOR
CHILDREN SPECIAL NE37290 X X
HEALTH SYSTEMS
INTERNATIONAL ECOH27008 X X
HEALTH VALUE
MANAGEMENT61101 X X X X X See Humana
HEALTHCARE BENEFITS INC 84980 X X
HEALTHCARE DISTRICT
PALM BEACHHCDPB X
HEALTHCARE LA IPA MPM06 X
HEALTHCARE MANAGEMENT
ADMHMA01 X X
HEALTHCARE OPTIONS EPF37 X
HEALTHCARE PARTNERS HCP01 X X
HEALTHCARE PARTNERS IPA 11328 X X
HEALTHCARE RESOURCES
NW56731 X X
HEALTHCARE SOLUTIONS
GROUP73147 X X X
HEALTHCARE USA 128MO X X X X X See AETNA BETTER HEALTH OF MISSOURI
HEALTHCHOICE OF
CONNECTICUT/YALE95376 X X
HEALTHCHOICE OF MEMPHIS 95376 X X
HEALTHCOMP, INC 85729 X X
HEALTHEASE 14163 X X XTaxonomy codes required at both the Billing and
Rendering Provider loops
HEALTHEASE TAMPA 59608 X X X
HEALTHFIRST INC NEW
YORK80141 X X X X X
HEALTHGUARD OF
LANCASTER23226 X X
HEALTHHELP NETWORK INC 59087 X X
HEALTHLINK HMO 96475 X X
HEALTHLINK PPO 90001 X X X
HEALTHNET CA
ENCOUNTERS95568 X
HEALTHNET EMPIRE BCBS 00803 X X XHEALTHNET OF ARIZONA 38309 X X
HEALTHNET OF THE
NORTHEAST06108 X X X X
HEALTHNOW NEW YORK,
INC.55204 X
HEALTHPARTNERS ADMIN 00055 X X X
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Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
HEALTHPLAN SERVICES
OKLAHOMA59142 X X
HEALTHPLAN SERVICES
TAMPA59140 X
HEALTHPLUS OF LOUISIANA 95009 X X
HEALTHPLUS OF MICHIGAN 38216 X
HEALTHPOWER HMO 31106 X X
HEALTHSCOPE BENEFITS
INC71063 X X
HEALTHSMART ACCEL 75237 X X X
HEALTHSMART PREFERRED
CARE HSPC75250 X X X
HEALTHSOURCE AR 71074 X X
HEALTHSOURCE AR
MEDICARE HMO71075 X X X
HEALTHSOURCE CMHC 02041 X X X
HEALTHSOURCE GA 58210 X X X
HEALTHSOURCE KY 61127 X X X
HEALTHSOURCE
MASSACHUSETTS INC02041 X X X
HEALTHSOURCE ME 01041 X X
HEALTHSOURCE NC 56147 X X X
HEALTHSOURCE NH 02038 X X X
HEALTHSOURCE NORTH
TEXAS75255 X X X
HEALTHSOURCE OH 31141 X X X
HEALTHSOURCE PROVIDENT 68195 X X X
HEALTHSOURCE SC 06119 X X X
HEALTHSOURCE TN 62129 X X X
HEALTHSOUTH MEDICAL
PLAN ADMINIST63086 X
HEALTHSPAN 34092 X X X X See Kaiser Foundation
HEALTHSPAN INC 31434 X X
HEALTHSPRING HMO 25193 X X
HEALTHSPRING HMO
MEDICARE CHOICE63092 X X
HEALTHSTAR INC 36332 X X X
HEALTHWAVE 31472 X X
HEALTHY CT INC 77180 X X
HEALTHY EQUATION HLTHQ X X
HEALTHY PALM BEACH 95827 X
HELP 66004 X X X X Enrollment for ERA only
HEREIU WELFARE PENSION
FUNDS37114 X X
HERITAGE CONSULTANTS 59230 X
HERITAGE IPA HER01 X
35 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
HERITAGE NEW YORK
MEDICAL GROUP11328 X X
HERITAGE PHYSICIAN
NETWORKTH011 X
HERITAGE PHYSICIAN
NETWORK (HOUSTONHPN11 X X
HERITAGE PROVIDER
NETWORKREGAL X
HFN, INC 36335 X X
HIGHMARK BCBSD HEALTH
OPTIONS INC47181 X X
HIGHMARK COMMERCIAL 37323 X X
HIGHMARK-KEY FAMILY 35145 X X
HILL PHYSICIANS 00046 X
HILLCREST BENEFIT
ADMINISTRATORS59347 X X
HIN HINPAPER X X
HIN AMERICAN TRUST
ADMINISTRATORS IHINPAPER X X
HIN BENEFIT CONCEPTS HIN51037 X X
HIN BENEFITS
ADMINISTRATION AND INSHINPAPER X X
HIN BENESIGHT HIN87265 X X
HIN CNIC HEALTH
SOLUTIONSHINPAPER X X
HIN COASTAL
ADMINISTRATIVE SERVICESHINPAPER X X
HIN CORPORATE BENEFIT
SERVICES OF AHIN41124 X X
HIN ECOM PPO HINPAPER X X
HIN INSURANCE
ADMINISTRATOR OF AMERHINPAPER X X
HIN JF MOLLOY &
ASSOCIATESHIN61271 X X
HIN KIPP COMPANY
ADMINISTRATORSHINPAPER X X
HIN MARSH ADVANTAGE
AMERICAHINPAPER X X
HIN MBA OF WY HINPAPER X X
HIN NATIONAL FOUNDATION
LIFE INSHINPAPER X X
HIN ODS HEALTH PLAN HIN13350 X X
HIN P5 E HEALTH SERVICES HINPAPER X X
HIN PEAK HEALTH PLAN HINALLEG X X
HIN PERFORMAX HIN51037 X X
HIN PRINCIPAL HIN61271 X X
HIN REGIONAL CARE INC HIN47076 X X
HIN WMI TPA HINPAPER X X
HIN WORLD INSURANCE HIN75276 X X
36 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
HIP HEALTH INSURANCE
PLAN OF GREA55247 X X X X X
HISPANIC PHYSICIANS IPA HPFFS X
HISPANIC PHYSICIANS IPA HPIPA X
HMA HAWAII 86066 X
HMC HEALTHWORKS/HEALTH
MANAGEMENT CO75318 X X
HMO OREGON 00851 X X
HMPK, INC. 61101 X X X X X See Humana
HMSO - MOLINA 91164
HMSO - PSHP 91161 X X
HN1 THERAPY NETWORK 65062 X X X XHOMETOWN HEALTH
NETWORK34150 X X
HOMETOWN HEALTH PLAN
NEVADA88023 X X
HORIZON BCBSNJ 22099 X X X X X
HORIZON MERCY 22326 X X X X XHOTEL & RESTAURANT
EMPLOYEES HEALTH91136 X X
HPLAN, INC. 61101 X X X X X See Humana
HPS PARADIGM 58227 X X
HRM INC 41170 X X
HS1 MEDICAL MGMT 65062 X X
HSHS MEDICAL GROUP IPA 37137 X X
HUDSON HEALTH PLAN 13335 X X
HUMANA GOLD CHOICE 61101 X X X X XHUMANA HEALTH OHIO 95348 X
HUMANA HEALTH PLANS 61101 X X X X X
HUMANA INS CO 61101 X X X X X
HUMANA INS CO MSD 61101 X X X X X
HUMANA MEDICARE 61101 X X X X XHUMANA VETERANS
HEALTHCARE SERVICES61120 X X
HUMANA VETERANS
HEALTHCARE SERVICES61160 X X X
HUMCO, INC. 61101 X X X X X See Humana
HUMREALTY, INC. 61101 X X X X X See Humana
HUNT INSURANCE GROUP 37260 X X
HVHS VA HERO 61160 X X X
I E SHAFFER 22175 X X
IBA HEALTH AND LIFE
ASSURANCE, IN38234 X X
IBC PERSONAL CHOICE 12X26 X
IBC PERSONAL CHOICE BCBS
PASX083 X
37 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
IBI 41124 X X
IBM MEDICAL PLANS 60054 X X X X X See Aetna
ICARE (INDEPENDENT CARE
HP)11695 X
ICARE HEALTH OPTIONS TPA 26054 X X
ICM 37296 X
ID MEDICAID AIDID X X X X
IDAHO BLUE CROSS BLUEC X X X XIDAHO BLUE SHIELD 00611 X X X
IDAHO BLUE SHIELD
REGENCE00611 X X X
IDAHO MEDICAID AIDID X X X
IDAHO MEDICARE PART A 02001 X X X X
IDAHO MEDICARE PART B 02202 X X X XIHC HEALTH SOLUTIONS IAC01 X X
ILLINOIS BLUE SHIELD 00621 X X XILLINOIS CENTRAL HOSPITAL
ASSOCIATI36600 X
ILLINOIS MEDICAID IL621 X
ILLINOIS MEDICARE 00952 X X X XIMA OF LOUISIANA INC 72091 X
IMCARE 41600 X X
INDECS CORPORATION 40585 X X
INDEPENDENCE BCBS PA 95044 X X XINDEPENDENCE CARE
SYSTEMS13396 X X
INDEPENDENCE MEDICAL
GROUPMHM01 X
INDEPENDENT HEALTH 95308 X X X Contact 716-635-3911 prior to sending claims
INDIAN HEALTH SERVICES 00290 X X
INDIANA BCBS 00630 X X X X
INDIANA HEALTH NETWORK 35204 X X X
INDIANA MEDICAID IHCP X
INDIANA MEDICARE ET116 X X X XINDIANA PROHEALTH
NETWORK35161 X
INETICO, INC 43471 X X
INFORMED UHC 50946 X X
INFORMED, LLC/SELF
FUNDING ADMINI52196 X X
INLAND EMPIRE HEALTH
PLANIEHP1 X
INLAND VALLEYS IPA 75299 X X
INNOVATION HEALTH 40025 X X
INNOVATIVE HEALTHWARE
SOLUTIONS04320 X X
38 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
INS HEALTH SERVICES
(IMMIGRATION HEVAICE X X
INSTITUTES OF QUALITY 60054 X X X X X See Aetna
INSURANCE
ADMINISTRATORS OF
AMERICA
37279 X X
INSURANCE DESIGN
ADMINISTRATORS13315 X X
INSURANCE MANAGEMENT
SERVICES (TX)IMSMS X X
INSURANCE MANAGEMENT
SERVICES OF TEXASIMSMS X X
INSURANCE MANAGEMENT
SVCS AMARILLO15688 X X
Payer id is only valid for claims with submission
address of P.O. Box 15688, Amarillo, TX 79105
INSURANCE SVCS OF
LUBBOCKTH012 X
INSURANCE TPA.COM 39182 X X
INSURERS ADMINISTRATIVE
CORP86304 X X
INTEGRA ADMINISTRATIVE
GROUP51020 X X
INTEGRA GROUP 31127 X X
INTEGRA GROUP-CHA 31129 X
INTEGRANET INET1 X X
INTEGRATED CARE
NETWORK BY EMERAL34167 X X
INTEGRATED MENTAL
HEALTH SVCS68053 X X X
Prior to submitting claims, please call Provider
Relations Dept at 1-800-716-5650 to verify your
provider info is on file in the claim system. This
will prevent rejections and allow payments to be
made in a timely manner.
Payer requires Billing Provider Taxonomy on all
claims.
INTEGRITY BENEFIT
NETWORK58200 X X
INTERCARE HEALTH PLAN
INC37227 X X
INTERCOUNTY HEALTH PLAN 54763 X X X
INTERFACE EAP 60280 X X X
INTERGROUP AZ 38309 X X
INTERGROUP SERVICES PPO 23287 X
INTERMOUNTAIN
ADMINISTRATORS81040 X X X Does not accept Secondary Institutional Claims
INTERMOUNTAIN HEALTH
CAREUH107 X X Contact Payer before sending at 801-442-5442
39 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
INTERNATIONAL MEDICAL
GROUPIMGIN X X
INTERNATIONAL UNION
LOCAL 437241 X
INTERNATL UNION OPER
ENGINEERS37269 X X
INTERWEST 84137 X X
IOWA BCBS 88848 X X X XIOWA BENEFITS INC 41124 X X
IOWA BLUE CROSS
INSTITUTIONAL12B10 X X
IOWA MEDICAID
INSTITUTIONAL18049 X X X
IOWA MEDICAID
PROFESSIONAL18049 X X X
IOWA MEDICARE PART A 05101 X X
IOWA MEDICARE PART B 05102 X X X XIW ADVANCED BENEFIT
RESOURCES CORP84137 X X
IW AMERICAN COUNSEL OF
ENGINEERING84137 X X
IW OUTSOURCEONE
BENEFITS84137 X X
IW STARMARK 84137 X X
IW THE BENEFIT GROUP 84137 X X
IW TRUSTMARK 84137 X X
JACKSON MEMORIAL HEALTH
PLAN COMMERCIAL HMO05014 X X X
JACKSON MHP COMMERCIAL
HMO05014 X X X
JF MOLLOY 61271 X X X X See Principal Financial Group
JI SPECIALTIES TH033 X
JI SPECIALTY SERVICES JISSP X X
JI SPECIALTY SERVICES
WORKERS COMPWK006 X
JMH HP MEDICAID HMO 16001 X X
JMH MEDICARE ADVANTAGE 59171 X X
JMH SFCCN PHT 09822 X X
JOHN ALDEN LIFE
INSURANCE CO41099 X X X X
JOHN DEERE HEALTH CARE 95378 X X X X See UnitedHealthcare Community Plan MS - CAN
JOHN HANCOCK 80314 X X X X X See Unicare
JOHN MORREL CO. - AHPBA 38310 X X
JOHN MUIR JMH01 X
40 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
JOHN P PEARL &
ASSOCIATES, LTD37215 X X
JOHNS HOPKINS
HEALTHCARE EHP PP52189 X X
JOHNS HOPKINS MEDICAL
SERVICES52123 X X X
JOPLIN CLAIMS 43178 X X
JP FARLEY CORPORATION 34136 X X
JSL ADMINISTRATORS 37272 X X X XKAISER CSI - CALIF SELECT
FOR INDIVIDUALS94320 X X
KAISER FOUNDATION
HEALTH PLAN NO CA94135 X X X X
KAISER FOUNDATION
HEALTH PLAN OF CO91617 X X
KAISER FOUNDATION
HEALTH PLAN SO CA94134 X X
KAISER FOUNDATION OF THE
NORTHWEST93079 X X
This payer ID can only be used to submit claims for
Oregon and Washington Kaiser Permanante
members.
KAISER OF GEORGIA 21313 X X X XKAISER OF MIDATLANTIC
STATES52095 X X X X
KAISER OHIO REGION KS005 X
KAISER PERMANENTE
COLORADO SPRINGSKSRCS X
KAISER PERMANENTE HP
HAWAII94123 X X
KAISER PERMANENTE
NORTHWESTKS007 X
KAISER PPO 94320 X X
KANAWHA INSURANCE CO 57038 X X
KANCARE 96385 X X X X
KANSAS BCBS 47163 X X
KANSAS BLUE CROSS INST KSBLS X X
KANSAS CITY BCBS 47171 X X XKANSAS CITY BLUE CROSS
INSTKCBLS X X
KANSAS MEDICAID ET024 X X X X
KANSAS MEDICARE PART A 05201 X X
KANSAS MEDICARE PART B 05202 X X X X
KELSEY SEYBOLD
INSTITUTIONALKELSI X
KELSEY SEYBOLD
PROFESSIONALKELSE X
KEMPTON COMPANY 73100 X X
KENTUCKY BCBS 00660 X X X
41 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
KENTUCKY HEALTH
COOPERATIVE77894 X X
KENTUCKY HEALTH SELECT 63077 X X
KENTUCKY KARE 61101 X X X X X See Humana
KENTUCKY MEDICAID KYMCD X X
KENTUCKY MEDICARE ET217 X X X XKENTUCKY SPIRIT HEALTH
PLAN68067 X X
KERN HEALTH PLAN KERNS X X
KEY BENEFIT
ADMINISTRATORS37217 X X X
KEY MEDICAL GROUP IP082 X
KEY SELECT 37321 X X X
KEYSTONE CONNECT 77050 X X
KEYSTONE EAST HP SX055 X
KEYSTONE HEALTH PLAN 23239 X X
KEYSTONE HP EAST 12X25 X
KEYSTONE MERCY HEALTH
PLAN23284 X X X X X
KITSAP CTY BS of WA KPS01 X
KITSAP PHYSICIANS SERVICE KPS01 X
KLAIS & COMPANY 34145 X X
02/23/2016 KPIC CA KPIC1 X
02/23/2016 KPIC CO KPIC1 X
02/23/2016 KPIC DC KPIC1 X
02/23/2016 KPIC GA KPIC1 X
02/23/2016 KPIC HI KPIC1 X
02/23/2016 KPIC MD KPIC1 X
02/23/2016 KPIC OH KPIC1 X
02/23/2016 KPIC OR KPIC1 X
KPS HEALTH PLANS KPS01 X
KY MEDICARE ET217 X X X XLA CARE HEALTH PLAN LACAR X
LA MEDICARE 07202 X X X X01/12/2016 LA SALLE MEDICAL GROUP NMM02 X X
LABORERS AG TRUST ZNTHW X X
LAKE FOREST MANAGED
CARE37112 X
LAKESIDE HEALTH SERVICES 95415 X X
LAKESIDE IPA 95416 X
LAKESIDE MEDICAL GROUP 66125 X X
LAND OF LINCOLN HEALTH 90096 X X X X
LANDMARK HEALTHCARE LNDMK X
LBA HEALTH PLANS 52193 X X
42 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
LEON MEDICAL CENTER
HEALTH PLAN65055 X X
LHP CLAIMS UNIT 37248 X X
LIFE INVESTORS INS CO LIIC2 X X
LIFE INVESTORS INS CO OF
AMERICALIIC3 X X
LIFE INVESTORS INS CO OF
AMERICALIICA X X
LIFE TRAC 41136 X X
LIFEPRINT LIFE1 X X
LIFEWISE HEALTH PLAN OF
WA91049 X X
LIFEWISE HEALTH PLAN OR 93093 X X X X
LINCOLN NATIONAL 61101 X X X X X See Humana
LINN COUNTY 75283 X X
LOCAL 135 HEALTH BENEFITS
IN35107 X X
LOMA LINDA UNIV EMPLOYEE
HEALTH PLA37267 X X
LOMA LINDA UNIVERSITY
ADVENT37267 X X
LONE STAR TPA 45289 X X
LOOMIS COMPANY - TPA
WYOMISSING PA23223 X X X X
Call Provider Relations at 610-374-4040 x2438
before submitting first electronic claims
LOS ALAMOS TOTAL CARE 60054 X X X X X See Aetna
LOUISIANA BCBS 53120 X X XLOUISIANA HEALTHCARE
CONNECTIONS68069 X X X
LOUISIANA MEDICAID DME ET036 X XLOUISIANA MEDICAID
PROFESSIONALET399 X X
LOUISIANA MEDICARE 07202 X X X XLOVELACE HEALTH PLAN 90328 X X X
LOVELACE SALUD SX159 X X
LOVELACE SANDIA HEALTH 90328 X X X
LOVELACE SENIOR PLANS 90328 X X X
LOYAL AMERICAN LIFE INS
CO13193 X X
LUMENOS 54195 X X
MA BEHAV HLTH PRTNR ET394 X
MACNEAL HEALTH
PROVIDERS - CHS36334 X X
MACO HEALTHCARE TRUST 81040 X X X Does not accept Secondary Institutional Claims
MAGELLAN BEHAVIORAL
HEALTH01260 X X X X X
43 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
MAGELLAN HEALTH
SERVICES01260 X X X X X
MAGESTACARE VIRGINIA 26372 X X
MAGNACARE 11303 X X
MAGNOLIA 68062 X X X
MAHCP QCCMT X X
MAIL HANDLERS 25133 X X X X X See Coventry Health Care
MAINE BCBS 00680 X X X
MAINE MEDICAID MEMCD X X
MAINE MEDICARE 14102 X X X XMAKSIN MANAGEMENT
CORPORATION22195 X X X
MAMSI LIFE AND HEALTH
INSURANCE C52148 X X X X X See United Healthcare 87726
MANAGED CARE INDEMNITY 61101 X X X X X See Humana
MANAGED CARE SERVICES 35162 X X
MANAGED HEALTH
NETWORKS (MHN)22771 X
MANAGED HEALTH SERVICES
INDIANA68069 X X X X X
Prior to sending claims, contact payer to verify your
provider info is in their system.
MANAGED HEALTH SERVICES
WISCONSIN39187 X X X X X
MANAGED PHYSICAL
NETWORK87726 X X X See United Healthcare
MANAGED PHYSICIAN
NETWORK93900 X
MANAGED PRESCRIPTION
SERVICES, IN61101 X X X X X See Humana
MANATEE SERVICE CENTER 41555 X X
MAPCO, INC 75258 X X
MARCH VISION HEALTH PLAN 5246M X
MARICOPA FOUNDATION ET352 X
MARIN IPA IP097 X
MARION PARK COMM HP 33711 X
MARQUETTE LIFE INS CO 48055 X X
MARRIOTT 60054 X X X X X See Aetna
MARTINS POINT
HEALTHCAREMPHC2 X
MARYLAND BCBS SB690 X XMARYLAND BCBS CARE
FIRST12011 X
MARYLAND MEDICAID MDMCD X X
MARYLAND MEDICARE 12302 X X X XMARYLAND PHYS CARE 22348 X X
44 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
MASHANTUCKET PEQUOT
TRIBAL NATION37121 X X
MASSACHUSETTS BCBS SB700 X X X
MASSACHUSETTS MEDICAID DMA7384 X X
MASSACHUSETTS MEDICARE 14202 X X X X
MASSACHUSETTS MUTUAL 65935 X X
MASTERS MATES PILOTS
PLANMMPHB X X
MASTERS MATES PILOTS
PROGRAM12T52 X
MATTHEW THORNTON
HEALTH PLAN02030 X X
MAYO MANAGEMENT
SERVICES, INC41154 X X X X X
MBA BENEFIT
ADMINISTRATORS83028 X X
MBA OF MD INC 37298 X X
MBA OF WYOMING 87065 X X
MBHP VALUE OPTIONS ET394 X
MCARE 38264 X X
MCARE OF COLORADO
SPRINGSCSMED X
MCC BEHAVIORAL CARE 02331 X
MCCREARY CORPORATION 59331 X
MCLAREN ADVANTAGE HMO
SNP3833R X X
MCLAREN HEALTH
ADVANTAGE3833A X X
MCLAREN HEALTH PLAN 38338 X X
MCLAREN MEDICAID 3833C X X
MCLAREN NORTHERN
HEALTH PLANS3833N X X
MCLAREN TENCON HEALTH
PLAN3833T X X
MD HAWAII MDXHI X X
MD HEALTH PLAN 06118 X
MDNY HEALTHCARE 11338 X X
MDWISE HOOSIER ALLIANCE 20475 X X X X X
MDWISE INC SX172 X X
MED3000 EM216 X X
MED3000 CMS EARLY STEPS EM350 X X
MED3000 CMS MMA
SPECIALTY PLANEM843 X X
MED3000 CMS SAFETY NET EM284 X X
45 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
MED3000 CMS TITLE 21 EM205 X X
MED3000 COVENTRY HEALTH
KIDSEM521 X X
MED3000 PEDICARE TITLE 19 EM039
MEDADMIN SOLUTIONS 58202 X X
MEDADMIN SOLUTIONS 58204 X X
MEDBEN NEWARK OH 74323 X X
MEDBENEFIXX, INC. 61101 X X X X X See Humana
MEDCONNECTION 60054 X X X X X See Aetna
MEDCOST BENEFITS
SERVICE56205 X X X
MEDCOST INC 56162 X X X
For questions on claim submission,
please contact Payer Customer Service
800-824-7406
MEDFOCUS 95321 X
MEDICA 94265 X X X X X
MEDICA CHOICE 94265 X X X X XMEDICA HEALTH CARE PLAN
INC MIAMI F78857 X
MEDICA2 12422 x x x X X
MEDICAID ACS ADDED FEE 77039 X X X X X
MEDICAID ACS WYOMING 77046 X X X x X
MEDICAID AK ET344 X X X
MEDICAID AL ET033 X X
MEDICAID AR ARMCD X X
MEDICAID AZ AZMCD X X
MEDICAID CA 610442 X X X X
MEDICAID CO 77016 X X X
MEDICAID CT ET304 X X X
MEDICAID DE DEMCD X X X
MEDICAID FL 77027 X X X
MEDICAID GA INSTITUTIONAL 12K05 X X
MEDICAID GA
PROFESSIONAL77034 X X X
MEDICAID HI HIMCD X X
MEDICAID IA INSTITUTIONAL 18049 X X X
MEDICAID IA PROFESSIONAL 18049 X X X
MEDICAID IL IL621 X
MEDICAID IN IHCP X
MEDICAID KS ET024 X X X X
MEDICAID KY KYMCD X X
46 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
MEDICAID LA DME ET036 X X
MEDICAID LA PROFESSIONAL ET399 X X
MEDICAID MA DMA7384 X X
MEDICAID MD MDMCD X X
MEDICAID ME MEMCD X X
MEDICAID MN INSTITUTIONAL 12K16 X X
MEDICAID MN
PROFESSIONALET025 X X X
MEDICAID MO ET028 X X X X
MEDICAID MS 77032 X X X
MEDICAID MT 77039 X X X X X
MEDICAID NC DNC00 X X X
MEDICAID NE INSTITUTIONAL 1520I X X
MEDICAID NE PROFESSIONAL ET194 X X
MEDICAID NH SKNH0 X X X
MEDICAID NJ INSTITUTIONAL 12006 X X
MEDICAID NJ PROFESSIONAL 610515 X X X
MEDICAID NM NMMCD X
MEDICAID NV DHCFP X X X
MEDICAID NY INSTITUTIONAL 12K35 X X
MEDICAID NY PROFESSIONAL ET044 X X
MEDICAID OH ET045 X X XMEDICAID OK OKMCD X
MEDICAID OR ORDHS X X XMEDICAID PA ET213 X
MEDICAID RI RIMCD X X X
MEDICAID SC 619 X X X
MEDICAID SD (INST) 12K36 X X
MEDICAID SD (PROF) SDMCD X X XMEDICAID TN XANTUS SKTN2 X
MEDICAID TX 86916 X X
MEDICAID UT UTMCD X X
MEDICAID VA ET042 X X X X
MEDICAID VT SKVT0 X X X
MEDICAID WA HCFA ONLY ET043 X X X
MEDICAID WA UB ONLY 12K27 X X
47 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
MEDICAID WASHINGTON DC 77033 X X X
MEDICAID WI WIMCD X X
MEDICAID WV INSTIUTIONAL 12K28 X X
MEDICAID WV
PROFESSIONALWVMCD X
MEDI-CAL 610442 X X X XMEDICAL BENEFITS
ADMINISTRATORS74323 X X
MEDICAL BENEFITS
ADMINISTRATORS OF37298 X X
MEDI-CAL BY MEDPOINT MPM18 X
MEDICAL CLAIMS SERVICE 04258 X X
MEDICAL DEVELOPMENT
INTERNATIONAL52181 X X
MEDI-CAL MANAGED CARE 47198 X
MEDICAL MUTUAL OF OHIO 29076 X X X X XMEDICAL PATHWAYS 33029 X
MEDICAL PLAN OF KANSAS
CITY MO61101 X X X X X See Humana
MEDICAL RESOURCE
NETWORK58203 X X
MEDICAL SELECT
MANAGEMENT13375 X
MEDICAL SERVICES
INITIATIVE12057 X X
MEDICAL SVCS FOR
INDIGENTS12057 X X
MEDICAL VALUE PLAN OHIO 38224 X X
MEDICARE AK 00831 X X X X X
MEDICARE AL 10102 X X X
MEDICARE AR 07102 X X X X
MEDICARE AZ 03102 X X X X
MEDICARE CA NORTH 01102 X X X X
MEDICARE CA SOUTH 01192 X X X X
MEDICARE CO PART A 04111 X X
MEDICARE CO PART B 04102 X X X X
MEDICARE CT 13102 X X X X
MEDICARE DE 12102 X X X X
MEDICARE FL 09102 X X X X
MEDICARE GA PART B 10202 X X X X
MEDICARE HI 01202 X X X X
MEDICARE IA PART A 05101 X X
MEDICARE IA PART B 05102 X X X X
48 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
MEDICARE ID PART A 02001 X X X X
MEDICARE ID PART B 02202 X X X X
MEDICARE IL 00952 X X X X
MEDICARE IN ET116 X X X X
MEDICARE KS PART A 05201 X X
MEDICARE KS PART B 05202 X X X X
MEDICARE MA 14202 X X X X
MEDICARE MD 12302 X X X X
MEDICARE ME 14102 X X X X
MEDICARE MI PART A 08201 X X X X
MEDICARE MI PART B 08202 X X X X
MEDICARE MN 00954 X X X X
MEDICARE MO PART A 05301 X X
MEDICARE MO PART B 05302 X X X X
MEDICARE MS 00512 X X X X
MEDICARE MT MCARE X X X X X
MEDICARE NC 11502 X X X X
MEDICARE ND PART A 03301 X X X X
MEDICARE ND PART B 03302 X X X X
MEDICARE NE PART A 05401 X X
MEDICARE NE PART B 05402 X X X X
MEDICARE NH 14302 X X X X
MEDICARE NJ 12402 X X X X
MEDICARE NM 04202 X X X X
MEDICARE NV 01302 X X X X
MEDICARE NY EMPIRE 13202 X X X X
MEDICARE NY GHI 13292 X X X X
MEDICARE NY WEST 13282 X X X X
MEDICARE NY WEST 13282 X X X X
MEDICARE OH 15202 X X X X
MEDICARE OK 04302 X X X X
MEDICARE OR 00835 X X X X
MEDICARE PA 12502 X X X X
MEDICARE RI 14402 X X X X
MEDICARE SC PART A 12M55 X X
MEDICARE SC PART B 11202 X X X X
MEDICARE SD PART A 03401 X X X X
MEDICARE TN PART A 10301 X X
MEDICARE TN PART B 10302 X X X X
MEDICARE TODAYS OPTION 48055 X X
49 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
MEDICARE TX PART A 00400 X X X
MEDICARE TX PART B 04402 X X X X
MEDICARE UT PART B 03502 X X X XMEDICARE VA PART A 11003
MEDICARE VA PART B 11302 X X X X
MEDICARE VT 14512 X X X X
MEDICARE WA 00836 X X X X
MEDICARE WI PART A 12M29 X X
MEDICARE WI PART B 06302 X X X X
MEDICARE WV PART A 11003 X X
MEDICARE WV PART B 11402 X X X XMEDIGOLD 95655 X X
01/01/2016 MEDITURE 20039 X X
MEDIVERSAL 37304 X X
MEDPARTNERS
ADMINISTRATIVE SRVCS35205 X X
Payer ID is only for claims with mailing address of:
PO Box 2602, Fort Wayne, IN 46801
MEDPLAN PPO 58216 X
MEDSOLUTIONS INC OF
GEORGIA62160 X X
MEDSPAN INC 82160 X
MEDSTAR FAMILY CHOICE 39190 X X
MEDSTAR PHYSICIAN
PARTNERS00243 X
MEGA LIFE & HLTH STUDENT 74227 X X X
MEGA LIFE AND HEALTH INS 59227 X X X X
MEMIC 01047 X X
MEMORIAL HERMANN
HEALTH SOLUTIONSMHHNP X X
MEMORIAL INTEGRATED
HEALTHCARE59064 X X
MEMPHIS MANAGED CARE 36193 X X
MENNONITE MUTUAL AID
ASSOC35605 X X
MERCY CARE AZ 86052 X X
MERCY CARE PLAN 86052 X X
MERCY HEALTHPLAN OF NJ 22326 X X X X X
MERCY HEALTHPLANS 43166 X
MERCY MARICOPA
INTEGRATED CARE33628 X X
MERIDIAN HEALTH PLAN 13189 X X
MERITAIN HEALTH 64157 X X
MERITAIN HEALTH
MINNEAPOLIS41124 X X
50 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
MERITAIN HEALTH W N
AMERICAN AD64157 X X
MERTIAN HEALTH W FIRST
HEALTH41124 X X
MESA MENTAL HEALTH 85035 X
METCARE HEALTH PLANS 65113 X X
METHODIST ASSOCIATES 62168 X X
METHODIST CARE, INC 80314 X X X X X See Unicare
METRAHEALTH 65978 X
METRO ALLIANCE 82135 X
METROPLUS HEALTH PLAN 13265 X X
METROPOLITAN HEALTH
PLAN10850 X X X X
METROPOLITAN LIFE 87726 X X X X X See United Healthcare
METROPOLITIAN LIFE INS 87726 X X X X X See United Healthcare
METROWEST HEALTH PLAN MWP01 X
MHBP 25133 X X X X X See Coventry Health Care
MHN 22771 X
MHNET 74289 X X X X
MI BCBS 00710 X X X XMI BCBS BCN 00710H X X X
MI BCBS FEP 00710F X X X
MI BCBS INSTITUTIONAL 00210 X X X XMI BCBS MEDICARE
ADVANTAGE00710A X X X
MI MEDICAID D00111 X X X
MICHAEL REESE HMO 61101 X X X X X See Humana
MICHAEL REESE PHYSICIANS
GROUP37127 X X
MICHIGAN BCBS 00710 X X X X
MICHIGAN BCBS BCN 00710H X X X
MICHIGAN BCBS FEP 00710F X X XMICHIGAN BCBS
INSTITUTIONAL00210 X X X X
MICHIGAN BCBS MEDICARE
ADVANTAGE00710A X X X
MICHIGAN MEDICAID D00111 X X X
MICHIGAN MEDICARE PART A 08201 X X X X
MICHIGAN MEDICARE PART B 08202 X X X X
MID AMERICA ASSOCIATES 37281 X X
MID ATLANTIC HEALTH
SYSTEM63079 X X
51 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
MID ROGUE OREGON
HEALTH PLAN26161 X
MID VALLEY CARENET INC 31140 X X
MID WEST NATL LIFE AND
HEALTH INS59227 X X X X
MID WEST UNITED LIFE 74227 X X X
MID-AMERICAN BENEFITS 22823 X X
MIDLANDS CHOICE 47080 X X
MIDWEST GROUP BENEFITS 61146 X X
MIDWEST HEALTH PLAN MHP77 X X
MIDWEST HEALTH PLANS TH074 X
MIDWEST PREFERRED MIDSC X
MIDWEST SECURITIES MIDSC X
MIDWEST SECURITY 79480 X X X
MILLS PENINSULA MEDICAL
GROUPMPMG1 X
MILLS PENINSULA MEDICAL
GRP (SPS)94115 X
MINNEAPOLIS PRUDENTIAL 60054 X X X X XSee Aetna
MINNESOTA BCBS INST
CLAIMS00220 X X X X
MINNESOTA BCBS PROF
CLAIMS00720 X X X
MINNESOTA MEDICAID
INSTITUTIONAL12K16 X X
MINNESOTA MEDICAID
PROFESSIONALET025 X X X
MINNESOTA MEDICARE 00954 X X X X
MISSISSIPPI BCBS 00230 X X
MISSISSIPPI MEDICAID 77032 X X X
MISSISSIPPI MEDICARE 00512 X X X XMISSISSIPPI PHYSICIAN
CARE NETWORK64084 X
MISSISSIPPI SELECT
HEALTHCARE64088 X X
MISSOULA COUNTY MEDICAL
BENEFITS37275 X X
MISSOURI BCBS 00241 X X X XMISSOURI CARE MC 14163 X X
MISSOURI DEPT OF MENTAL
HEALTHMODMH X
MISSOURI HOME STATE
HEALTH CARE68069 X X X
MISSOURI MEDICAID ET028 X X X X
MISSOURI MEDICARE PART A 05301 X X X
52 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
MISSOURI MEDICARE PART B 05302 X X X X
MMA 35316 X X X
MMBP MBHC X X
MMS LLC 62178 X
MN DEPT OF HEALTH MNDH1 X X X X
03/02/2016 MODA HEALTH PLAN 13350 X X X X X See ODS for ERA enrollment
MOLINA HC OF NEW MEXICO 09824 X X X
MOLINA HC OF NM 09824 X X X
MOLINA HEALTHCARE OF
CALIFORNIA38333 X X X
MOLINA HEALTHCARE OF
FLORIDA51062 X X X
MOLINA HEALTHCARE OF
INDIANA00076 X
MOLINA HEALTHCARE OF
MICHIGAN38334 X X X
MOLINA HEALTHCARE OF
OHIO20149 X X X
MOLINA HEALTHCARE OF TX 20554 X X X
MOLINA HEALTHCARE OF
WASHINGTON38336 X X X
MOLINA HEALTHCARE SOUTH
CAROLINA46299 X X
MOLINA HEALTHCARE UTAH SX109 X X
MOMENTUM HEALTH
SERVICES72135 X
MONARCH HEALTHCARE IPA IP095 X
MONTANA ASSOC OF
COUNTIES81040 X X X Does not accept Secondary Institutional Claims
MONTANA BCBS BCBS X X X X X XMONTANA HEALTH CO-OP A
COVENTRY HP25133 X X X X X
See Coventry Health Care
MONTANA MED BENEFIT
PLANMBHC X X
MONTANA MEDICAID 77039 X X X X X
MONTANA MEDICARE MCARE X X X X XMONTANA RETAIL STORE
EMPLOYEES TRUSZNTHW X X
MONTANA UNIFIED 91131 X X Does not accept Secondary Claims
MONTANA UNIFIED SCHOOL
TRUST91131 X X Does not accept Secondary Claims
MONTEFIORE CONTRACT
MANAGEMENT13174 X X X
MONUMENTAL LIFE INS CO MMLI2 X X LOUISVILLE, KY
53 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
MONUMENTAL LIFE INS CO MMLI3 X X HURST, TX
MONUMENTAL LIFE INS CO MMLIC X X LITTLE ROCK, AR
MOSAIC IPA MEDICAL GROUP IP083 X
MOTION PICTURE HEALTH
PLAN99282 X
MOTOROLA INC 36111 X
MOUNTAIN MEDICAL COMMA X
MOUNTAIN STATES
ADMINISTRATION AZ86040 X X
MPE EMPLOYEE BENEFIT
SERV37233 X X
MPLAN 95444 X X
MPM PROSPECT MPM16 X
MT ASSOC OF COUNTIES 81040 X X X Does not accept Secondary Institutional Claims
MT BCBS BCBS X X X X X XMT BENEFITS AND HEALTH
CONNECTIONSMBHC X X
MT CARMEL HEALTH PLAN 95655 X X
MT LABORERS AG TRUST ZNTHW X X
MT MEDICAID 77039 X X X X XMT RETAIL STORE
EMPLOYEES TRUSTZNTHW X X
MT UNIFIED SCHOOL TRUST 91131 X X Does not accept Secondary Claims
MT. DIABLO JMH01 X
MULTIPLAN WISCONSIN
PREFERRED34080 X
MUNICIPAL HEALTH BENEFIT
FUND81883 X X
MUST 91131 X X Does not accept Secondary Claims
MUTUAL ASSURANCE
ADMINISTRATION37256 X X
MUTUAL BENEFIT LIFE MBL 70408 X X X X See Fortis Benefits
MUTUAL BENEFIT WESTERN
LIFE39065 X X X X See Assurant Health
MUTUAL OF OMAHA 71412 X X X X
MUTUALLY PREFERRED 71412 X X X XMVP HEALTH PLAN OF NY 14165 X X X
N TEXAS HEALTHCARE
SYSTEMS35212 X X X
N.W. IRONWORKERS HEALTH
& SECURIT91136 X X
Please Enter Group Number (F15) when
Submitting Claims
N.W. ROOFERS &
EMPLOYERS HEALTH91136 X X
N.W. TEXTILE PROCESSORS 91136 X X
NACL AFFORDABLE 53011 X X X
54 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
NAMM - ILLIINOIS 36398 X
NAPHCARE INC 58182 X X X
NATIONAL ASSOC OF LETTER
CARRIERS53011 X X X
NATIONAL BENEFIT LIFE 00243 X
NATIONAL CLAIM
ADMINISTRATION37126 X X
NATIONAL FINANCIAL LIFE
INS CO NFIC90956 X
NATIONAL HEALTH
INSURANCE COMPANY75275 X X
NATIONAL RURAL ELEC
COOP52132 X X X X X See Cooperative Benefit Administrator
NATIONAL RURAL ELECTRIC
COOP52132 X X X X X See Cooperative Benefit Administrator
NATIONAL RURAL ELECTRIC
COOPERATI52132 X X X X X See Cooperative Benefit Administrator
NATIONAL RURAL LETTER
CARRIER ASSOC71412 X X X X See Mutual of Omaha Insurance Co
NATIONAL TELEPHONE COOP 52103 X X
NATIONAL TELEPHONE COOP
ASSOC STAFF52104 X X
NATIONAL TRAVELERS 65978 X
NATIONAL TRAVELERS LIFE
CO37120 X X
NATIONWIDE GROUP 31417 X X X X XNATIONWIDE HEALTH PLANS
HMO PPO31112 X
NATIONWIDE INSURANCE 31417 X X X X XNATIONWIDE LIFE AND
HEALTH31417 X X X X X
NATL BENEFIT ADMIN NC 56176 X X
NATL BENEFIT ADMIN NJ 56175 X
NCAS 75190 X X
NCAS - OWINGS MILL, MD 75190 X X
NCAS CHARLOTTE NC 75191 X X
NCAS FAIRFAX 75190 X X
NCAS VIRGINIA 75190 X X
NCAS-CHARLOTTE 75191 X X
ND BS 00820 X X X XND MEDICAID NDDHSMED X X
NE NEW YORK BLUE SHIELD 00800 X X X
NEBRASKA BCBS
PROFESSIONAL00760 X X X
NEBRASKA BLUE CROSS
INST00260 X X
NEBRASKA MEDICAID INST 1520I X X
55 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
NEBRASKA MEDICAID PROF ET194 X X
NEBRASKA MEDICARE PART
A05401 X X
NEBRASKA MEDICARE PART
B05402 X X X X
NEIGHBORHOOD HEALTH
PARTNERSHIP OF FL96107 X X
Payer ID is valid for claims submission for address
PO Box 02568, Miami FL 33102-5680. Any
questions should be directed to 305-715-4334
NEIGHBORHOOD HEALTH
PLAN - BOSTON04293 X X
NEIGHBORHOOD HEALTH
PLAN OF RHODE I05047 X X
NEIGHBORHOOD HEALTH
PROVIDERS11325 X X X
NESIKA HEALTH GROUP 37255 X X
NETCARE LIFE AND HEALTH 66055 X X
NETWORK HEALTH 04332 X X
NETWORK HEALTH INS CORP
MEDICARE77076 X X
NETWORK HEALTH
SOLUTIONS39144 X
NETWORK MEDICAL MGMT NMM01 X
NETWORK PLAN OF
WISCONSIN39111 X
NETWORK TPA LLC 58204 X X
NEVADA BCBS 00265 X X X XNEVADA HEALTH COOP 90091 X X
NEVADA MEDICAID DHCFP X X X
NEVADA MEDICARE 01302 X X X XNEW AVENUES INC 95998 X X
NEW ENGLAND FINANCIAL 80705 X X X X See Great West Life & Annuity
NEW ENGLAND MUTUAL LIFE
INSURANCE66893 X
NEW ERA LIFE 75281 X X
NEW HAMPSHIRE BCBS 00770 X X X
NEW HAMPSHIRE MEDICAID SKNH0 X X X
NEW HAMPSHIRE MEDICARE 14302 X X X X
NEW JERSEY BCBS 22099 X X X X XNEW JERSEY MEDICAID
(INST)12006 X X
NEW JERSEY MEDICAID
(PROF)610515 X X X
NEW JERSEY MEDICARE 12402 X X X X
NEW MEXICO BCBS 00790 X X X
56 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
NEW MEXICO HEALTH
CONNECTIONS45129 X X X X X
NEW MEXICO MEDICAID NMMCD X
NEW MEXICO MEDICARE 04202 X X X X
NEW WEST HEALTH 84141 X X X X Does not accept Secondary Claims
NEW WEST MEDICARE 84141 X X X X Does not accept Secondary ClaimsNEW WEST MEDICARE
ADVANTAGE84141 X X X X Does not accept Secondary Claims
NEW YORK LIFE - LTC NYL11 X X
NEW YORK MEDICAID
INSTITUTIONALET044 X X
NEW YORK MEDICAID
PROFESSIONALET044 X X
NEW YORK MEDICAL
IMAGING14179 X
NEW YORK MEDICARE
EMPIRE13202 X X X X
NEW YORK MEDICARE GHI 13292 X X X X
NEW YORK MEDICARE WEST 13282 X X X X
NEW YORK NETWORK
MANAGEMENT11334 X
NEW YORK PRESBYTERIAN
COMMUNITY48186 X X
NEW YORK STATE
EMPLOYEES65978 X
NEWMARKET DIMENSIONS 65056 X X
NGS AMERICAN 38225 X X X XNHBCAUX 88050 X X
NHC HEALTH BENEFIT PLAN 62124 X X
NHP/SHP (NEIGHBOORHOOD
HEALTH PRO11325 X X X
NIPPON LIFE INSURANCE
COMPANY OF81264 X X X X
NJ CARPENTERS HEALTH
FUND22603 X X X
NORTH AMERICA
ADMINISTRATORS65085 X X
NORTH AMERICAN
ADMINISTRATORS64157 X X
NORTH AMERICAN BENEFITS
NETWORK34159 X X
NORTH AMERICAN MEDICAL
CAE3510 X
NORTH AMERICAN MEDICAL
IL36398 X
57 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
NORTH AMERICAN MEDICAL
ILLINOIS36398 X
NORTH BROWARD HOSPITAL
DISTRICT37314 X X
NORTH CAROLINA BCBS ET095 X X X
NORTH CAROLINA MEDICAID DNC00 X X X
NORTH CAROLINA MEDICARE 11502 X X X X
NORTH DAKOTA BCBS 00820 X X X XNORTH DAKOTA MEDICAID NDDHSMED X X
NORTH DAKOTA MEDICARE
PART A03301 X X X X
NORTH DAKOTA MEDICARE
PART B03302 X X X X
NORTH SHORE LIJ
CARECONNECT INS46227 X X X
NORTH TEXAS HEALTHCARE
NETWORK75250 X X X
NORTH WEST LIFE PH018 X
NORTHERN CA SHEET METAL
WORKERS INS38238 X
NORTHERN ILLINOIS HEALTH
PLAN36347 X X
NORTHERN NEVADA TRUST
FUND88027 X X
NORTHERN REG TRICARE 57106 X X X X X See your specific state for enrollment forms
NORTHWEST ENERGY 81040 X X X Does not accept Secondary Institutional Claims
NORTHWEST ENERGY PLAN 81040 X X X Does not accept Secondary Institutional Claims
NORTHWEST SUBURBAN IPA
(ILLINOIS)36346 X X
NORTHWESTERN ENERGY
BENEFIT PLAN81040 X X X Does not accept Secondary Institutional Claims
NORTHWESTERN NATIONAL
LIFE INSURA41045 X X
NOVA CASUALTY COMPANY 16114 X X X
NOVA HEALTHCARE
ADMINISTRATION16644 X X
NOVASYS 75080 X X
NOVASYS HEALTH NETWORK 71080 X X
NTCA STAFF MEMBERS 52104 X X
NTHC NTX11 X X
NW ADMINISTRATORS NWADM X X
NYHART 37299 X X
NYLCARE ETHIX
NORTHWEST91135 X
58 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
NYLCARE HEALTH PLANS NW 91166 X
NYMI OXFORD 14180 X
OCCUPATIONAL HEALTH
MGMT 31147 X X
OCHSNER HEALTH PLANS OCH01 X X
ODS HEALTH 13350 X X X X X
OHANA HEALTH PLAN 14163 X XTaxonomy codes required at both the Billing and
Rendering Provider loops
OHIO BCBS 00834 X X X XOHIO HEALTH CHOICE 34189 X X
OHIO MEDICAID ET045 X X X
OHIO MEDICARE 15202 X X X XOHIO PPO CONNECT 74431 X X
OHIO WORK COMP 31147 X X
OK STATE EMPLY AND
EDUCATORS22521 X X X
OKLAHOMA BCBS 00840 X X
OKLAHOMA MEDICAID OKMCD X
OKLAHOMA MEDICARE 04302 X X X XOLYMPIC HEALTH MGMT
SYSTEMS91150 X X
OLYMPUS MANAGED CARE 65074 X X
OMNI/MEDICORE HP 68037 X X
OMNICARE A COVENTRY
HLTH25150 X X X X X See Coventry Health Care
OMNICARE HEALTH PLAN OF
MICHIGAN38252 X X
ONE CALL MEDICAL 22321 X X
ONE HEALTH PLAN OF CA
INC95379 X
ONE HEALTH PLAN OF GA 95569 X
ONE HEALTH PLAN OF IL INC 95388 X
ONE HEALTH PLAN, INC 80705 X X X X See Great West Life & Annuity
OPERATING ENG LOCAL 234 OBAOE X X
OPERATING ENGINEERS
LOCAL 302 & 61291136 X X
OPTICARE EYE HEALTH
NETWORK56190 X
OPTIMUM CHOICE OF
CAROLINA52152 X X X
OPTIMUM CHOICE, INC. (OCI) 52148 X X X
OPTIMUM HEALTHCARE 20133 X X
03/23/2016OPTUM BEHAVIORAL HEALTH
SLCOU6885 X X X X
OPTUM HEALTH 41161 X
59 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
OPTUMHEALTH BEHAVIORAL
SOLUTIONS87726 X X X X X See United Healthcare
OREGON BCBS 00851 X X
OREGON HEALTH CO-OP 21455 X X
OREGON HEALTH CO-OP 45332 X X
OREGON HEALTH PLAN 00851 X X
OREGON MEDICAID ORDHS X X X
OREGON MEDICARE 00835 X X X XORTHONET AETNA 13383 X X X
ORTHONET CORPORATION -
CIGNA13381 X X
ORTHONET HEALTHNET 25681 X
ORTHONET UNIFORMED
SVCS FHP13382 X
OSF CARE ADVANTAGE OSFMC X
OSF HEALTH PLAN OSFIL X
OSF HEALTH PLANS 62171 X X
OSMA HEALTH CLFR2 X
OXFORD HEALTH PLANS 06111 X X X XP5 HEALTH PLAN SOLUTIONS
OF UTAH87068 X X
PACE EPF29 X
PACIFIC GAS AND ELECTRIC 60054 X X X X XSee Aetna
PACIFIC HEALTHCARE IPA PHI01 X
PACIFIC MUTUAL 67466 X X
PACIFICARE 87726 X X X X See United Healthcare
PACIFICARE BEHAVIORAL
HEALTH87726 X X X See United Healthcare
PACIFICARE OF ARIZONA 87726 X X X X See United Healthcare
PACIFICARE OF COLORADO 87726 X X X X See United Healthcare
PACIFICARE PPO 95999 X X
PACIFICSOURCE
ADMINISTRATORS93031 X X
PACIFICSOURCE HEALTH
PLANS93029 X X X X
PACIFICSOURCE MEDICARE 23077 X X
PACIFICSOURCE OHP COIHS X
PALMETTO GBA 00882 X X X XPALMETTO GBA RAILROAD
MEDICARE00882 X X X X
PAN AMERICAN LIFE INS GRP 04218 X X
PAPER PIPELINE BENEFIT
FUND73074 X
PARAMOUNT HEALTH SX158 X X
60 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
PARKLAND COMMUNITY
HEALTH PLAN66917 X X
PARKLAND HEALTHFIRST 66917 X X
PARTNERS BEHAVIORAL
HEALTH MGMT52613 X X X
PARTNERS NATIONAL
HEALTH56152 X X
PARTNERSHIP HEALTH PLAN PHP02 X X X X
PASSPORT HEALTH PLAN 61129 X X X X XPATIENT ADVOCATES LLC 10525 X X
PATIENT CHOICE 39026 X X X X See UMR
PATIENT PHYSICIAN
NETWORKPPN11 X
PAYER FUSION 27048 X X
PAYNET INC 37210 X X
PCA HEALTH PLAN OF
FLORIDA65018 X
PCA OF TEXAS HUMANA 61101 X X X X X See Humana
PCA STAR MEDICAID 61101 X X X X X See Humana
PCMC/ICSL CHIROPRACTIC 65007 X
PCMC/ICSL DERMATOLOGY 65001 X
PCMC/ICSL
GASTROENTEROLOGY65003 X
PCMC/ICSL PODIATRY 65002 X
PCMC/ISCL ALLERGY 65000 X
PEACH STATE HEALTH PLAN 68069 X X X X X
PENNSYLVANIA BLUE CROSS 23045 X X
PENNSYLVANIA BLUE SHIELD 54771 X
PENNSYLVANIA MEDICAID ET213 X
PENNSYLVANIA MEDICARE 12502 X X X X
PEOPLES BENEFIT LIFE INS PBLIC X X
PEOPLES HEALTH NETWORK 72126 X X X
PERFORMAX 41124 X X
PERSONAL CARE 25133 X X X X X See Coventry Health Care
PERSONAL INSURANCE
ADMINISTRATORS95397 X X
PERSONAL PHYSICIAN CARE 34173 X
PG&E 60054 X X X X X See Aetna
PHA ADMIN SERIVCES 95183 X X
PHCS 60054 X X X X X See Aetna
61 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
PHCS SAVILITY PAYERS 13306 X X
PHIFER WIRE PRODUCTS INC PHIF4 X X
PHOENIX GROUP SERVICE 75238 X X
PHOENIX GROUP SERVICES,
INC06143 X X
PHOENIX HEALTH PLAN 03440 X X X
PHOENIX HEALTHCARE 62153 X X
PHOENIX HOME LIFE 67814 X
PHOENIX MUTUAL 67814 X
PHP OF MICHIGAN 87726 X X X X X See United Healthcare
PHP TENNCARE 62155 X X
PHX HEALTH PLAN 03440 X X X
PHYS ASSOC GRTR SAN
GABRIEL VALLEYPA513 X X
PHYSICIAN ASSOC OF
LOUISIANA58204 X X
PHYSICIAN CARE NETWORK
LLC58204 X X
PHYSICIAN HEALTH
PARTNERS MEDICAREPHPMD X X
PHYSICIAN HEALTH PLAN
PHP37330 X X X X
PHYSICIANS CARE NETWORK
ILLINOIS36345 X X
PHYSICIANS CARE NETWORK
MICHIGAN38265 X X
PHYSICIANS CARE NETWORK
MISSISSIPPI64084 X
PHYSICIANS CARE
NETWORK/ THE POLYCLINICPCN12 X
PHYSICIANS HEALTH
ASSOCIATION37136 X X
PHYSICIANS HEALTH CHOICE
- CLAIMSPHCS1 X X
PHYSICIANS HEALTH CHOICE
- ENCOUNTEPHCEN X X
PHYSICIANS HEALTHCARE
PLANS65031 X X
PHYSICIANS HEALTHWAYS
IPAPHIPA X X
PHYSICIANS HP OF N
INDIANA12399 X X X X
PHYSICIANS MUTUAL INS 47027 X X X XPHYSICIANS MUTUAL
INSURANCE COMPANY47027 X X X
PHYSICIANS OF SW
WASHINGTON91171 X X
62 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
PHYSICIANS PLUS
INSURANCE CORPORA39156 X X
PHYSICIANS UNITED PLAN 10775 X X
PIEDMONT BEHAVIORAL
HEALTH06607 X X X X
PIMA HEALTH SYSTEM PMA86 X XPINNACLE CLAIMS
MANAGEMENT, INC24735 X X
PINNACOL ASSURANCE 84109 X X
PIPEFITTERS LOCAL 597 59700 X
PIPELINE INDUSTRY BENEFIT
FUND73074 X X
PITTMAN & ASSOCIATES 37224 X X X XPITTSBURGH CARE
PARTNERSHIP INC23283 X X
PLANNED ADMIN SC 886 X
PLANNED ADMINISTRATORS
INC37287 X X
PM GROUP 67466 X X
PODI CARE MANAGED CARE 58204 X X
POLY AMERICA MEDICAL
BENEFITS32680 X X
POMCO 16111 X X X
PPO OKLAHOMA 73159 X X X
PPO PLUS LLC 72148 X X X
PPOM 38335 X X
PPOM COFINITY 38335 X X
PRACTICARE, INC 04334 X
PRAIRIE STATES
ENTERPRISE36373 X X
PREF ONE 41147 X X X X See Payer ID 00015
PREFERRED
ADMINISTRATORSEPF10 X X
PREFERRED BENEFITS
ADMIN WICHITA KS61665 X X
PREFERRED CARE
PARTNERS65088 X X
PREFERRED CARE ROCH,NY 14165 X
PREFERRED COMMUNITY
CHOICE/PCC SE73145 X X X
PREFERRED HEALTH PLAN 61106 X X
PREFERRED HEALTH
PROFESSIONALS31478 X X
PREFERRED HEALTH
SYSTEMS60110 X X X X X
PREFERRED HEALTH
SYSTEMS INS60110 X X X X X
63 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
PREFERRED IPA PFIPA X
PREFERRED NETWORK
ACCESS36401 X X
PREFERRED ONE 41147 X X X X X See Payer ID 00015
PREFERRED ONE OF MN 00015 X X XPREFERRED PLUS OF
KANSAS60110 X X X X X
PREFERRED PLUS OF
KANSAS PPK60110 X X X X X
PREFERRED PLUS OF KS 47163 X X
PREMERA BCBS 00430 X X XPREMIER BENEFITS 43166 X
PREMIER CARE IPA PCI01 X
PREMIER EYE CARE 65054
PREMIER HEALTH 90440
PREMIER HEALTH
EXCHANGE88056 X X
PREMIER HEALTH PLAN 251PR X X X X XPREMIER HEALTH PLANS 43166 X X
PREMIER HEALTH PLANS 251PR X X
PREMIER HEALTH SYSTEMS 29076 X X X X XSee Medical Mutual of Ohio on FAQ 641 for ERA
Enrollment
PREMIER HEALTHCARE
EXCHANGE INC PHX88051 X X
PREMIER PHYSICIANS
NETWORKCAPMN X
03/23/2016PRESBYTERIAN HEALTH
PLAN05003 X X X X X
PRESBYTERIAN HEALTH
PLAN COMMERCIALPREHP X
PRESCRIPTION BENEFITS,
INC.61101 X X X X X See Humana
PRESTIGE HEALTH CHOICE 77003 X X Formerly under payer ID 45056
PREVEA HEALTH INSURANCE
PLAN39185 X X
PRIMARY CARE ASSOCIATES
OF CAPCACZ X
PRIMARY HEALTH PLAN PRIME X X
PRIMARY PHYSICIAN CARE
INC56144 X X
PRIME BENEFITS SYSTEMS 61101 X X X X X See Humana
PRIME CARE HEALTH PLAN IP079 X
PRIME HEALTH 61101 X X X X X See Humana
PRIME VISION HEALTH PLAN 56190 X
PRIME WEST HEALTH PLAN 61604 X X X X X
64 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
PRIMESOURCE HEALTH
NETWORK04320 X X
PRINCIPAL FINANCIAL
GROUP61271 X X X X
PRINCIPAL LIFE INSURANCE
CO61271 X X X X
PRIORITY HEALTH 38217 X X X
PRISM - UNIVERA 37315 X X
PRISM FIRST HEALTH 37303 X
PRISM NETWORK 37296 X X
PRO CARE HEALTH PLAN,
INC38329 X X
PROCLAIM 41163 X X
PROF BENEFIT ADMIN
OAKBROOK IL36331 X X
PROFESSIONAL BENEFIT
ADMINISTRATORS36331 X X
PROFESSIONAL CLAIMS
MANAGEMENT37242 X X
PROFESSIONAL RISK
MANAGEMENT34134 X X
PROMINA 58226 X X
PROMINENCE HEALTH PLAN 93082 X
PROSPECT HEALTH
NETWORKPROSP X
PROSPECT MEDICAL GROUP PROSP X
PROVIDENCE CHOICE
OPTIONPHP01 X X X
For 2310A only the NPI is required; Loop 2310B the
NPI + tax ID is required
PROVIDENCE GOOD HEALTH
PLANPHP01 X X X
For 2310A only the NPI is required; Loop 2310B the
NPI + tax ID is required
PROVIDENCE HEALTH PLAN
PPOPHP00 X
PROVIDENCE OREGON
HEALTH PLANSX133 X X X X
PROVIDENCE PPO SX187 X
PROVIDENCE PREFERRED
OF WASHINGTO91131 X X
PROVIDENT AMERICAN LIFE
& HEALTH IN71404 X X X X
proviDRs CARE NETWORK 48100 X X X
PRU NET 60054 X X X X X See Aetna
PRU PLUS 60054 X X X X X See Aetna
PRUCARE 60054 X X X X X See Aetna
PRUCHOICE 60054 X X X X X See Aetna
PRUDENTIAL 60054 X X X X X See Aetna
PRUNET 60054 X X X X X See Aetna
65 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
PRUPSYCH 60054 X X X X X See Aetna
PSYCHCARE LLC 51052 X X
PUGET SOUND BENEFITS
TRUST91136 X X
PUGET SOUND ELECTRICAL
WORKERS TR91136 X X
PUGET SOUND HEALTH
PARTNERS INC42172 X
PYRAMID HEALTH 48055 X X
PYRAMID LIFE INSURANCE
CO48055 X X
QUADMED (WEST ALLIS, WI) 39197 X X
QUAL CHOICE OF ARKANSAS 35174 X X X X
QUAL CHOICE OF NORTH
CAROLINA35172 X
QUAL CHOICE OF OHIO 01250 X
QUAL CHOICE OF VIRGINIA 35171 X X
QUALCARE INC 23342 X X
QUALITY CARE PARTNERS 89461
QUIKTRIP 73067 X X
Payer does not return a Claim Status or Report for
Inst claims. Providers will need to call QuikTrip 918-
615-7972 for Claim Status questions.
QUINCY HEALTH CARE
MANAGEMENT37129 X X
QVI RISK SOLUTIONS INC 57117 X
RAILROAD MEDICARE 00882 X X X X
RANDMARK, INC. 61101 X X X X X See Humana
RBMS LLC 91176 X X
RE HARRINGTON 95266 X X X
READING HOSPITAL
EMPLOYER GROUP44219 X X X
REDLANDS IPA (SYNERMED) SYMED X
REGAL MEDICAL GROUP REGAL X
REGENCE BLUE SHIELD of
IDAHO00611 X X X
REGENCE BLUE SHIELD
WASHINGTON00932 X X
REGENCE BLUECROSS
BLUESHIELD OREGON00851 X X
REGENCY EMPLOYEE
BENEFITS38221 X X
REGION A DMERC 05655 X X X
REGION B DMERC 05655 X X X
Region C DMERC 05655 X X X X
66 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
REGIONAL CARE INC 47076 X X
REGIONAL HOME HEALTH
HOSPICE INTERMEDIARY12M55 X X
RESERVE NATIONAL INS CO 73066 X X X
RETIREES WELFARE TRUST NWADMIN X X
REUNION INDUSTRIES CHAT1 X X
RHODE ISLAND BCBS RIBLS X X X
RHODE ISLAND MEDICAID RIMCD X X X
RHODE ISLAND MEDICARE 14402 X X X XRIO GRANDE HMO 84980 X X
RIVER QUEST NETWORK, INC 37129 X X
RIVERSIDE FAMILY HEALTH
MED GRP IPAMPM08 X
RMSCO INC RMSCO X
ROCKWELL INTERNATIONAL 75196 X X
ROONEY LIFE INC 37602 X X
ROSEMONT OF DES PLAINES
IL36215 X X
RR MEDICARE 00882 X X X X
RUSH HEALTH ASSOCIATION 36339 X X
RUSH PRUDENTIAL HEALTH 60054 X X X X XSee Aetna
RUSH PRUDENTIAL HMO 36389 X X
S & S HEALTHCARE
STRATEGIES31441 X
S ATLANTIC MEDICAL GROUP SAMG1 X X
SAGAMORE HEALTH
NETWORK35164 X X
SAGE PROGRAM MNDH1 X X X XSAINT BARNABAS SYSTEM
HEALTH PLAN22240 X X
SAMARITAN HEALTH PLANS CP001 X X
SAMBA 62308 X X X X X See Cigna
SAN FRANCISCO
ELECTRICAL WORKERS37236 X
SANDIA TRIPLE OPTION 60054 X X X X X See Aetna
SANFORD HEALTH PLAN 91184 X X
SANTA BARBARA COTTAGE
HOSPITAL35182 X X X X X See CoreSource
SANTA CLARA FAMILY
HEALTH PLAN24077 X X
67 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
SANTE HEALTH SYSTEM AND
AFFILIATES77038 X X X
SANUS PPO - ST. LOUIS 63665 X X
SC PLANNED
ADMINISTRATORS INC886 X
SCAN HEALTHPLAN 72261 X X
SCAN HEALTHPLAN AZ 73172 X X
SCAN LONG TERM CARE 20460 X X
SCOTT & WHITE 88030 X X X
Enrollment required. Contracted providers please
call 254-298-3278. Noncontracted providers please
call 254-298-3274.
SCOTT AND WHITE TH002 X
SEABURY AND SMITH 13310 X X
SEASIDE HEALTHPLAN 46187 X X
SECURE CARE OF IOWA 42142 X X
SECURE HEALTH PLAN OF
GA28530 X X
SECURE HORIZONS - UHC 87726 X X X X X See United Healthcare
SECURE HORIZONS -
WELLMEDWELM2 X X
SECURECARE OF IOWA 42142 X X
SECURITY HEALTH PLAN 39045 X X
SELECT ADMINISTRATIVE
SERVICES64088 X X
SELECT BENEFIT ADMIN OF
WI37282 X X
SELECT BENEFIT
ADMINISTRATORS IA42137 X X
SELECT BENEFIT
ADMINISTRATORS INC93031 X X
SELECT HEALTH OF SOUTH
CAROLINA23285 X X X X X
SELECTCARE 00014 X X X
SELECTCARE COCA COLA 60054 X X X X X See Aetna
SELECTCARE OF OKLAHOMA SCOK1 X X
SELECTCARE OF TX
(INTEGRANET)INET1 X X
SELECTCARE OF TX KELSEY
SEYBOLDKLSY1 X X
SELECTHEALTH UH107 X X Contact Payer before sending at 801-442-5442
SELF FUNDED PLANS IL PA
OH34131 X X
SELF INSURED BENEFIT ADM 59111 X X
SELF INSURED PLAN LLC 36404 X X
SENIOR CARE 60054 X X X X X See Aetna
SENIOR WHOLE HEALTH 83035 X X
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UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
SENTARA HEALTH
MANAGEMENT54154 X X
SENTINEL MANAGEMENT
SERVICES23249 X X
SENTRY INSURANCE 39033 X X X XSEOUL MEDICAL GROUP SMG01 X
SETON EMPLOYEE PLAN SHEBP X X
SETON HEALTH PLAN EPNSH X X
SETON HEALTH PLAN CHIP SHPCH X X
SETON HEALTH PLAN MAP
PRGSHMAP X
SFCCN COMMERCIAL 59064 X X X XThis payer has no Paper EOB option. ERA
enrollment is required
SFCCN MEDICAID 59065 X X X XThis payer has no Paper EOB option. ERA
enrollment is required
SHARE HEALTH PLAN ILL
HMOUH005 X
SHARE HEALTH PLAN ILL PPO UH006 X
SHASTA ADMINISTRATIVE
SERVICES75280 X X
SHEFFIELD OLSON &
MCQUEEN, INC41143 X X
SIERRA HEALTH SERVICES 76342 X X X X
SIERRA HEALTH SERVICES
ENCOUNTERS76343 X X
SIGNATURE HEALTH
ALLIANCE (SHA)62159 X
SILVER CROSS MANAGED
CARE ORG36387 X X
SIMPLY HEALTHCARE 27094 X X X
SINCLAIR HEALTH PLAN 84076 X X
SISCO SISCO X X
SLOAN'S LAKE MANAGED
CARE84096 X X
SMITH ADMINISTRATORS 02057 X X X
SOONER HEALTH NETWORK
WI81400 X
SOUND HEALTH SISTERS OF
PROVIDENCE91131 X X
SOUTH CAROLINA BCBS 401 X
SOUTH CAROLINA BCBS FEP 402 X
SOUTH CAROLINA MEDICAID 619 X X X
SOUTH CAROLINA MEDICARE
PART A12M55 X X
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UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
SOUTH CAROLINA MEDICARE
PART B11202 X X X X
SOUTH DAKOTA BCBS ET099 X X X XSOUTH DAKOTA MEDICAID
(INST)12K36 X X
SOUTH DAKOTA MEDICAID
(PROF)SDMCD X X
SOUTH DAKOTA MEDICARE
PART A03401 X X X X
SOUTH FLORIDA COMMUNITY
CARE NETWORK59065 X X X
SOUTHCARE/HEALTHCARE
PREFERRED25147 X X X
SOUTHEASTERN INDIANA
HEALTH77153 X X
SOUTHERN BENEFIT
SERVICES LLC37318 X X
SOUTHERN CALIFORNIA
MEDICAL COALITIONSCMC0 X
SOUTHERN DESERT HEALTH
WI81400 X
SOUTHERN GROUP
ADMINISTRATORS56131 X X
SOUTHERN HEALTH
SERVICES25133 X X X X X
See Coventry Health Care
SOUTHWEST SERVICE LIFE 37266 X X
SOUTHWESTERN BELL 60054 X X X X X See Aetna
SPECIAL RISK
INTERNATIONAL (SRI)52190 X X
SPECTRUM
ADMINISTRATORS INC23253 X X X
SPOHN HEALTH SPOHN X X
ST ANTHONY MEMORIAL
MDWISE35199
ST BARNABAS SYSTEM
HEALTH PLAN22240 X X
ST CATHERINE HOSPITAL
MDWISE35199
ST FRANCIS IPA APP01 X
ST JOHNS CLAIMS ADMIN 37264 X X
ST JOSEPH 74128 X X
ST JOSEPH HERITAGE HC STJOE X X
ST THERESE PHYSICIANS
ASSOCIATES37116 X X
ST VINCENT CATHOLIC
MEDICAL13407 X X
STAR HEALTH PLAN COMMF X X
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UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
STARBRIDGE STAR/HRG 59225 X X X
Payer ID valid only if the address on the Health ID
card matches one of the following PO Boxes: PO
Box 55270, 30870, 30888, 54150, 30069, 55400;
Phoenix AZ 85270
STARMARK 61425 X X X XSTATE FARM (CASUALTY
AND PROPERTY)31059 X
STATE FARM INSURANCE 31053 X X X X
STATE MERIT GA BCBS 00601 X X XSTATES GENERAL LIFE
INSURANCE75087 X
STAYWELL 14163 X X XTaxonomy codes required at both the Billing and
Rendering Provider loops
STAYWELL
HEALTH/WELLCARE14163 X X X
Taxonomy codes required at both the Billing and
Rendering Provider loops
STERLING MEDICARE
ADVANTAGE67829 X X
STERLING OPTION 1 91151 X X
STIRLING AND STIRLING 06089 X X
STONER AND ASSOCIATES 31121 X X
STOWE ASSOCIATES 58128 X X
STUDENT INSURANCE
DIVISION74227 X X X
SUFFOLK HEALTH PLAN 88331 X X
SUMMACARE HEALTH PLAN 95202 X X X
SUMMIT AMERICA
INSURANCE SERVICES37301 X X
SUN TRUST BANK, INC. 60054 X X X X X See Aetna
SUNSHINE STATE HEALTH
PLAN68057 X X X
SUPERIOR BENEFITS 23218 X X
SUPERIOR HEALTH PLAN 68069 X X X
Prior to submitting claims, contact your Health Plan
Provider Relations Department to verify your provider
information is on file in the Health Plans claim
system. This will prevent claim rejections and allow
payments to be made in a timely manner. You may
reach Provider Relations at 800.218.7453 or by
visiting www.superiorhealthplan.com.
SUPERIOR HEALTH PLAN OF
TEXAS39188 X X X X X
SURBURBAN HEALTH ORG 35199 X
SUTTER MEDICAL GROUP
REDWOODS77304 X X
Sutter Connect requires the providers to complete an
application & get approval prior to sending claims to
a clearinghouse. Contact Sutter Connect EDI Dept @
(800)611-5191
SYRACUSE COMMUNITY
HEALTH CENTER16146 X
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UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
TALL TREE ADMINISTRATORS 88067 X X
TARRANT HEALTH SERVICES 37228 X
TBG ADMINISTRATIVE
SERVICE39157 X X
TEAM CHOICE ALPHA ADSL1 X X
TEAM CHOICE GOLD 75139 X X
TEAM CHOICE PPO 75133 X X
TEAM CHOICE UMC 75134 X X
TEAMCARE 36215 X X
TEAMSTERS (UT/ID/MT) - GRP
BENEFIT ADMIN88054 X X X
TEAMSTERS BENEFIT TRUST 94304 X X
TEAMSTERS CONSTRUCTION
INDUSTRY TRUNWADMIN X X
TEAMSTERS LOCAL UNION
30136612 X X
TENNCARE 36193 X X
TENNESSEE BCBS 00390 X X XTENNESSEE MEDICARE PART
A10301 X X X
TENNESSEE MEDICARE PART
B10302 X X X X
TEXAN PLUS (INTEGRANET) INET1 X X
TEXAN PLUS KELSEY BOLD KLSY1 X X
TEXAS BCBS 84980 X X
TEXAS CHILDRENS HEALTH
PLAN76048 X X
TEXAS CHILDRENS STAR TXCSM X
TEXAS FIRST HEALTH PLANS 76046 X X
TEXAS MEDICAID 86916 X X
TEXAS MEDICARE PART A 00400 X X X
TEXAS MEDICARE PART B 04402 X X X XTEXAS MUNICIPAL LEAGUE
GROUP74214 X X
TEXAS PLAN
ADMINISTRATORTXP11 X
TEXAS TRUE CHOICE TH055 X
03/09/2016 THE BENFIT GROUP TGBNE X X
THE BOON GROUP BOONG X X
THE CARE NETWORK /
SAVANNAH BUSINESS GRP68423 X X
THE CHESTERFIELD
COMPANIESCRI01 X
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UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
THE EMPIRE PLAN 87726 X X X X X See United Healthcare
THE EPOCH GROUP LC 28777 X X
THE EYE PA EYEPA X
THE FORD METER BOX CO 37305 X X
THE HEALTH EXCHANGE
CERNER CORP20356 X X
THE HEALTH PLAN 34150 X X
THE HEALTHCARE GROUP 35206 X X
THE INTEGRITY BENEFIT
NETWORK58200 X X
THE LOOMIS COMPANY 23223 X X
THE MUTUAL GROUP 70491 X X
THE OATH - HEALTH
PARTNERS FOR AL63092 X
THE PERFECT HEALTH INS
CO13522 X X X
THE PRUDENTIAL 60054 X X X X X See Aetna
THE SANDHILLS CENTER SHC303 X X X
THE WELLNESS PLAN 38200 X X
THE WILLAIM EARHART CO 93050 X X
THERAPHYSICS THERA X
THERAPHYSICS COLORADO COTHE X
THIRD PARTY
ADMINISTRATORS37225 X X
THIRD PARTY CLAIMS
MANAGE95266 X X X
THIRD PARTY CLAIMS
MANAGEMENT06131 X X
THOMAS H COOPER SX160 X X
THREE RIVERS HEALTH PLAN 25175 X X X X See Unison Health Plan
THREE RIVERS PREFERRED MP340 X
TIME INSURANCE CO 39065 X X X X See Assurant Health
TIME INSURANCE COMPANY 39065 X X X X See Assurant Health
TIOPA (TEXAS FIRST HEALTH
PLANS)76046 X X
TLC ADVANTAGE - SIOUX
FALLSTLC01 X X
TMG LIFE INSURANCE
COMPANY70491 X X
TODAYS OPTION 48055 X X
TODAYS OPTION MEDICARE 48055 X X
TONGASS TIMBER TRUST 92620 X X X
TORRANCE HOSPITAL IPA THIPA X X
TOTAL CARE (NEW YORK) TCARE X
TOTAL CARE CAROLINA 68055 X X X
73 www.hewedi.com | 877.565.5457
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UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
TOTAL COMMUNITY CARE 31182 X X
TOTAL HEALTH CARE INC 38201 X X
TOUCHSTONE HEALTH 11328 X X
TOUCHSTONE HEALTH PSO
PARTNERSHIP23856 X X
TOWER LIFE INSURANCE
COMPANY69493 X X
TPA TEXAS PLAN
ADMINISTRATORSTXP11 X
TPM 81040 X X X Does not accept Secondary Institutional Claims
TR PAUL INC 37230 X X
TRANSAMERICA 59222 X XPayer ID only valid if the patient ID card matches
P.O. Box 982009, North Richland Hills, TX 76182
TRANSAMERICA ASSURANCE
COMPANYTSAAC X X
TRANSAMERICA FINANCIAL TFLIC X X
TRANSAMERICA LIFE INS AR TLINS X X
TRANSAMERICA LIFE INS KY TLIN3 X X
TRANSAMERICA LIFE INS TX TLIN2 X X
TRANSAMERICA
OCCIDENTALTOLI2 X X
TRANSAMERICA
OCCIDENTAL LIFE INS COTOLIC X X
TRANSCHOICE KEY BENEFIT
ADMIN37284 X X X
TRICARE 99726 X X X X X See your specific state for enrollment forms
TRICARE FOR LIFE TDDIR X X X X See your specific state for enrollment forms
TRICARE WEST 99726 X X X X X See your specific state for enrollment forms
TRIHEALTH PHYSICIAN
SOLUTIONS31144 X X X X
TRUE CHOICE USA 54210 X X
TRUE CHOICE USA
CHRISTUSTCUCH X X
TRUE CHOICE USA
CHRISTUS HEALTH PLATCUCH X X
TRUSTED HEALTH PLAN L0230 X X
TRUSTED PLANS SERVICE 91078 X X
TRUSTMARK 61425 X X X X
TRUSTMARK INS CO 61425 X X X XTTPA CHIP 76055 X X
TTPA COMM VIA MEDIVEW 76054 X X
TUFTS HEALTH PLAN 04298 X XTUFTS HP MEDICARE
PREFERRED04298 X X
74 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
TX CHILDRENS HEALTH PLAN 76048 X X
TXEN ALTPROS 75206 X
UBH-RIOS 87726 X X X X X See United Healthcare
UC CARE 60054 X X X X X See Aetna
UCARE 52629 X X
UCARE OF MINNESOTA 19991 X X X
Please make sure that UCARE has your billing
provider NPI registered or they will reject your
enrollment.UCS MASONRY INDUSTRY
TRUST60230 X X
UCSF/CSL PULMONARY 65006 X
UFCW LOCAL 400-5205 ET059 X
UGS UGS X
UHC COMMUNITY PLAN
KANSAS96385 X X X X
UHIS - UNITED HLTH
INTEGRATED SRVCS39026 X X X X
UICI - ADMINISTRATORS NV 74223 X X X
UICI ADMINISTRATORS 75240 X X
ULTRA BENEFITS INC 41206 X X
UMR HARRINGTON 95266 X X X
UMR LEXINGTON 37237 X X XFormerly known as Common Wealth Administrative
Group
UMR LEXINGTON
COMMONWEALTH ADMIN
GROUP
37237 X XFormerly known as Common Wealth Administrative
Group
UMR ONALASKA 79480 X X
UMR WAUSAU 39026 X X X X See UMR
UMR WAUSAU UHIS 39026 X X X X See UMR
UMWA HEALTH AND
RETIREMENT FUNDS52180 X X X
UNICARE 80314 X X X X X
UNICARE INDIVIDUAL 80314 X X X X X See Unicare
UNICARE MAJOR ACCOUNTS 80314 X X X X X See Unicare
UNICARE OF CA 47198 X X X
UNIFIED GROUP SERVICES 35198 X X
UNIFIED HEALTH SERVICES 62170 X X
UNIFORM MEDICAL PLAN 75243 X X X
UNIFORM MEDICAL
SERVICES75243 X X X
UNIFORMED SERVICES
FAMILY13407 X X
UNION LABOR LIFE INS CO 13142 X X
75 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
UNION LABOR LIFE
INSURANCE13142 X X
UNION PACIFIC RAILROAD
EMPLOYEES87042 X X X
UNITED AGRICULTURAL
BENEFITSUAGBT X
UNITED BEHAVIORAL
HEALTH87726 X X X X X See United Healthcare
UNITED BEHAVIORAL
HEALTH EMPLOYERUBHRI X
UNITED BEHAVIORAL
HEALTH NON HMOUBHRI X
UNITED FOOD COMM
WORKERS MIDWEST UN36659 X
UNITED FURNITURE
WORKERS INSURANCEUFWIF X X
UNITED GOVERNMENT
SERVICESUGS X
UNITED GROUP PROGRAMS UGP19 X X
UNITED HEALTH CARE 87726 X X X X XUNITED HEALTHCARE OF
RIVER VALLEY95378 X X X X See UnitedHealthcare Community Plan MS - CAN
UNITED HEALTHCARE VISION 00773 X X X
UNITED MEDICAL ALLIANCE 84132 X X
UNITED OF OMAHA 71412 X X X X See Mutual of Omaha Insurance Co
UNITED PHYSICIANS
INTERNATIONAL IPAMPM15 X
UNITED PHYSICIANS OF
NORTHER84132 X
UNITED RESOURCES GROUP 41194 X X X
UNITED RESOURCES
NETWORK41194 X X X
UNITED SECURITY LIFE AND
HEALTH36362 X X X
UNITED STATES LIFE
INSURANCE CO13545 X
UNITEDHEALTHCARE 87726 X X X X X See United Healthcare
UNITEDHEALTHCARE METRA 65978 X
UNITY HEALTH INSURANCE 66705 X
Before submitting claims, please go to
http://www.unityhealth.com/Providers/AdminResourc
es/EDI/index.htm and complete EDI Sign Up Form
and NPI Appendix A documents.
UNITY SECURITY LIFE &
HEALTH81108 X
76 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
UNITY/PRECISION HEALTH
PLANS81400 X
UNIVERA HEALTHCARE
SOUTHERN TIER16108 X X
UNIVERA MANAGED CARE 16107 X
UNIVERA PPO UNINE X
UNIVERA PPO UNINW X
UNIVERSAL CARE OF
CALIFORNIA33001 X X
UNIVERSAL CARE OF
TENNESSEE33002 X X
UNIVERSITY FAMILY CARE
#983009830 X X X X
UNIVERSITY FAMILY CARE,
MARICOPA HP09908 X X
UNIVERSITY HEALTH
ALLIANCE99026 X X X X
UNIVERSITY HEALTH PLAN
MEDICAID58247 X X
UNIVERSITY HEALTH PLAN
NJ59000 X X
UNIVERSITY OF MIAMI
BEHAVIORAL HEALTH92579 X
UNIVERSITY OF UTAH
HEALTH PLANSSX155 X X
UNIVERSITY OF
WASHINGTON STUDENTS91136 X X
UNIVERSITY PHYSICIANS HC
GRP07503 X X
UNIVITA ATEND X X
UPMC HEALTH PLAN 23281 X X X XUPPER PENINSULA HEALTH
PLAN38337 X X
US BENEFITS 93092 X X X
US DEPARTMENT OF LABOR 77044 X X X
US FAMILY HEALTH PLAN TH103 X
US HEALTHCARE 23222 X X
US HEALTHCARE 60054 X X X X X See Aetna
US. DEPT OF LABOR 77044 X X XUSAA UNITED STATES AUTO
ASSOCIATI74095 X X
USC HEALTH SERVICES TH021 X
USFHP TH103 X
USFHP TEXAS AND
LOUISIANASHMAP X
UTAH BLUE CROSS 12B42 X X
UTAH BLUE SHIELD 00910 X X X
UTAH MEDICAID UTMCD X X X
77 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
UTAH MEDICARE PART B 03502 X X X XUTAH PUBLIC EMPLOYEE
HEALTH PLANSX106 X X Call Provider Relations before sending 801-352-7270
UTMB 76049 X X
UTMB CHOICEONE CHIP UHSCH X X
VA - HAC 84146 X X X X X
VA FEE BASIS PROGRAMS 12115 X X X X XVA ROCKY MOUNTAIN
NETWORK PAYMENT12115 X X X X X
VA ROCKY MOUNTAIN NPC 12115 X X X X X
VA ROCKY MTN NMC CENTER 12115 X X X X X
VA VETERAN
ADMINISTRATION12115 X X X X X
VALLEY BAPTIST HEALTH
PLAN94999 X X
VALLEY BAPTIST HEALTH
PLANTH022 X
VALLEY PHYSICIANS INC 77004 X
VALUE OPTIONS - PROF ET308 X XVALUE OPTIONS -INST 12X56 X
VALUE OPTIONS MBHP ET394
VALUE OPTIONS MD MHA VALMD X X
VALUE OPTIONS PA
MEDICAIDET371 X
VANTAGE HEALTH PLAN, INC 72128 X
VANTAGE MEDICAL GROUP PPM01 X
VAPCCC REGION 3 VAPCCC3 X X X X See your specific state for enrollment forms
VAPCCC REGION 5A VAPCCC5A X X X X See your specific state for enrollment forms
VAPCCC REGION 5B VAPCCC5B X X X X See your specific state for enrollment forms
VAPCCC REGION 6 VAPCCC6 X X X X See your specific state for enrollment forms
VARIAN HEALTH CARE 60054 X X X X X See Aetna
VENTURENET HEALTHCARE 86062 X X X
VERITY NATIONAL GROUP
INCGASA1 X X
VERMONT BCBS BCBSVT X X X
VERMONT MEDICAID SKVT0 X X X
VERMONT MEDICARE 14512 X X X XVESTACARE VESTA X X
VHP COMMUNITY CARE 23173 X X
VICARE ADMINISTRATIVE
SERVICES54182 X
VICARE ADMINISTRATIVE
SERVICES54182 X
VILLAGECARE MAX 26545 X X
78 www.hewedi.com | 877.565.5457
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UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
VIPA BVVP1 X
VIPA BVVP1 X
VIRGINIA BCBS ET103 X X X X
VIRGINIA HEALTH NETWORK 54138 X
VIRGINIA MEDICAID ET042 X X X X
VIRGINIA MEDICARE 11302 X X X X
VIRGINIA PREMIER HEALTH 54176 X
VIRGINIA PREMIERE
COMPLETECAREVPCCP X X X
VISION CARE
INCORPORATED37297 X
VISITING NURSES SERVICE 77073 X X
VISTA HEALTH PLAN 55248 X X X
VIVA HEALTH PLAN 63114 X XVIVA Health requires complete member id including
suffix on all claims submissions
VNS CHOICE MEDICARE 77073 X X
VYTRA HEALTHCARE 22264 X X X
W NEW YORK COMM BLUE 00301 X
WASHINGTON BLUE SHIELD 00932 X X
WASHINGTON DC BCBS INST 12000 X
WASHINGTON DC BCBS
PROFSB580 X X X
WASHINGTON DC MEDICAID 77033 X X X
WASHINGTON DC MEDICARE 12202 X X X X
WASHINGTON DC MEDICARE 12202 X X X X
WASHINGTON L&I ET080 X XWASHINGTON MEDICAID
HCFA ONLYET043 X X X
WASHINGTON MEDICAID UB
ONLY12K27 X X
WASHINGTON MEDICARE 00836 X X X XWASHINGTON REGENCY 00932 X X
WASHINGTON TEAMSTERS
WELFARE TRUSTNWADMIN X X
WATERSTONE BENEFIT
ADMINISTRATORS73155 X X
WATKINS ASSOCIATED
INDUSTRIES58082 X X
WATTS HEALTH CARE CORP
IPAMPM09 X
WAUSAU 39026 X X X X See UMR
79 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
WC BEELER & COMPANY 62111 X
WC EARHART 93050 X X
WEA INSURANCE GROUP 39151 X X
WEB TPA 75261 X X
WEISS HEALTH PROVIDERS 36337 X
WELLCARE CT 14163 X X XTaxonomy codes required at both the Billing and
Rendering Provider loops
WELLCARE HMO 14163 X X XTaxonomy codes required at both the Billing and
Rendering Provider loops
WELLCARE HP, INC
(ENCOUNTERS ONLY)59354 X X
WELLCARE OF CT INC 14164 X X X
WELLCARE OF FL 59608 X X X
WELLCARE OF GA 14163 X X XTaxonomy codes required at both the Billing and
Rendering Provider loops
WELLCARE OF GEORGIA 14163 X X XTaxonomy codes required at both the Billing and
Rendering Provider loops
WELLCARE OF LOUISIANA 14163 X X XTaxonomy codes required at both the Billing and
Rendering Provider loops
WELLCARE OF NEW YORK 14163 X X XTaxonomy codes required at both the Billing and
Rendering Provider loops
WELLMED TH023 X
WELLMED MEDICAL WELM2 X X
WELLPATH OF CAROLINA 25133 X X X X See Coventry Health Care
WELLS FARGO TPA 87815 X X X X X
WELS BENEFIT PLAN OFFICE 22925 X X
WENATCHEE VALLEY
MEDICAL CENTER91064 X X
WEST COAST STATIONARY
ENGINEERS91136 X X
WEST VIRGINIA BCBS 54828 X X
WEST VIRGINIA BLUE CROSS 12B28 X X
WEST VIRGINIA MEDICAID -
PROFWVMCD X
WEST VIRGINIA MEDICAID UB 12K28 X X
WEST VIRGINIA MEDICARE
PART A12M28 X X
WESTERN CARE 70408 X X X XWESTERN GROWERS
INSURANCE CO24735 X X
WESTERN HEALTH INC 37306 X X
WESTERN LIFE INS CO 70408 X X X XWESTERN MUTUAL 91131 X X
WESTERN MUTUAL INS
NONPAR PROVIDERS37247 X X
80 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
WESTERN MUTUAL
INSURANCE91131 X X
WESTERN SOUTHERN
FINANCIAL GROUP31048 X X
WESTERN TEAMSTERS
WELFARE TRUSTNWADMIN X X
WESTLAKE FINANCIAL
GROUPWESTL X X
WEYCO INC 38232 X X
WILLIAM C EARHART 93050 X X
WILLIAM J SUTTON & CO 98010 X X
WILLIAMS AND COUNTY MAP WCMAP X X
WINDSOR MEDICARE EXTRA 62153 X X
WINHEALTH PARTNERS 27327 X X
WINTERBROOK HEALTHCARE 73159 X X X
WISCONSIN AUTO & TRUCK
DEALERS39200 X X
WISCONSIN BCBS 00950 X
WISCONSIN DEPT OF
CORRECTIONS74101 X X
WISCONSIN EMPLOYERS
GROUP61101 X X X X X See Humana
WISCONSIN MEDICAID WIMCD X X
WISCONSIN MEDICARE PART
A12M29 X X
WISCONSIN MEDICARE PART
B06302 X X X X
WISCONSIN PHYSICIANS
SERVICE GROUPSX022 X X
WM C EARHART 93050 X X
WM EARHART 93050 X X
WMI 91131 X X
WORKSITE BENEFIT
SERVICES, LLC20333 X X
WORKSITE BENEFIT
SERVICES, LLC20333 X X
WORLD INSURANCE 75276 X X
WORLD INSURANCE
COMPANY75276 X X
WPS CHAMPUS 99726 X X X X X See your specific state for enrollment forms
WPS HEALTH INSURANCE of
WISCONSINWPS X X X
WPS J5 NATIONAL MEDICARE
INSTITUTIONAL 05901 X X
WPS PREVEA HEALTH PLAN 10159 X X
WPS TRICARE 99726 X X X X X See your specific state for enrollment forms
81 www.hewedi.com | 877.565.5457
Health-e-Web Payer ListUpdated: 4/6/2016
UPDATED PAYER NAME PAYER ID CODE MEDICAL HOSPITAL DENTAL COB ERA ENROLLMENT REQ
PASS
THROUGH
FEE APPLIES
COMMENTS
COB = Coordination of Benefits: HeW has been informed that any carriers marked with an X in this column will accept secondary electronic claims.
ERA = Electronic Remittance Advice: HeW can receive ERAs on behalf of your organization from any carriers marked with an X in this column.
Enrollment Required = Any carrier with an X marked in this column has an enrollment process, whether for claims and ERAs, or ERAs only.
Updated = Indicates that the recent date the payer was added or updated.
WRITERS GUILD 25133 X X X X X See Coventry Health Care
WV MEDICARE 11402 X X X X
WY BLUE CROSS 00460 X X X X
WY BLUE SHIELD 00960 X X X X X
WY MEDICAID 77046 X X X x X
WY MEDICARE PART A 03601 X X X X
WY MEDICARE PART B 00320 X X X X
WYOMING BLUE CROSS 00460 X X X X
WYOMING BLUE SHIELD 00960 X X XWYOMING MEDICAID 77046 X X
WYOMING MEDICARE PART A 03601 X X X X
WYOMING MEDICARE PART B 00320 X X X X
XANTUS HEALTHPLAN OF
TENNESSEE62153 X X
82 www.hewedi.com | 877.565.5457
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