Community

Average payer enrollment approval times

Some payers (i.e., Medicare, Medicaid, Blue Cross, Blue Shield) require providers to enroll before the provider can submit electronic claims and receive electronic payment reports from them. Processing time for these enrollments vary by payer and can take anywhere from 2 weeks to over 2 months.

The table below contains estimates (in weeks) for how long you can expect to wait for an enrollment to be approved. Although the data are based on actual enrollments, we cannot guarantee that your enrollment will approved in the same amount of time because it's up to the payers to approve enrollments.

Note: Until an enrollment has been accepted, we recommend that you continue to submit paper claims. Until your payment report enrollment has been accepted, we recommend that you continue to manually record your insurance payments. (This article explains how to manually add an insurance payment.)

Tips to expedite the process

If you hear from the payer, let us know

Some payers will notify you, the provider, that an enrollment has been accepted, but they won't notify the clearinghouse. If you receive confirmation from a payer that your enrollment has been approved, please do the following:

  1. If you get an email, get a screenshot of the email and share it with our support team.
  2. If you receive a letter, take a photo of the entire letter and share it with our support team.
  3. Submit a support ticket with the proof of acceptance.

We'll reach out to our clearinghouse to quickly process your enrollments from there.

Call the payer

You can also call the payer to check on the status of your enrollment. If the payer confirms that your enrollment has been accepted, please do the following:

  1. Ask for the representative’s name and a call reference number.
  2. Submit a support ticket with this information.

We'll reach out to our clearinghouse to quickly process your enrollments from there.

Tip: Interested in never having to worry about insurance again? Learn more about our in-house medical billing service, SmartBilling Pro here.

Additional resources:


Enrollment estimates table 
Last updated: June 11, 2018

Note: The table below is searchable by Payer ID number as well as Payer Name.

An asterisk (*) indicates that this payer is known for taking longer than average to approve enrollments. We recommend calling the payer if your enrollment has not been accepted after 60 days.

--- indicates that we do not have an exact estimate. However, this payer does require enrollment. 

Payer ID Payer Name Claim Filing enrollment (weeks) Payment Report enrollment (weeks)
00403 Blue Choice Medicaid (00403) Not needed *
00813 Beacon Health Options (formerly ValueOptions) (00813) 6 - 9 ---
00815 Value Options Colorado Medicaid (00815) * Not supported
00901 Medicare Part B of Maryland (00901) 6 - 9 6 - 9
00902 Medicare Part B of Delaware (00902) 4 - 6 4 - 6
01260 Magellan Behavioral Health (01260) Not needed *
03432 Arizona Physicians IPA (APIPA) (UnitedHealthcare Arizona Physicians IPA) (03432) Not needed *
04271 Harvard Pilgrim (04271) Not needed *
04298 Tufts Associated Health (04298) 4 - 8 *
06105 Connecticare Inc. (06105) Not needed *
06111 Oxford Health Plans (06111) Not needed *
10850 Metropolitan Health Plan (10850) Not needed 5 - 9
11315 Fidelis (CenterCare) (11315) Not needed *
12115 VA Fee Basis Programs (12115) Not needed 2 - 4
13162 1199 SEIU National Benefit Fund (13162) Not needed *
13265 Metro Plus Health Plan (13265) Not needed *
13334 Affinity Health Plans (Contact Affinity EDI Coordinator before submitting claims electronically at EDI@Affinityplan.org or call 718-794-7592.) (13334) Not needed 2 - 4
13350 ODS Health Plan (13350) Not needed *
13551 Group Health Incorporated (GHI) (New York) (13551) Not needed 2 - 4
14163 Wellcare HMO Inc. (14163) Not needed *
15460 Highmark Senior Health Company (15460) 2 - 4 3 - 8
16111 POMCO (16111) Not needed *
19991 Ucare of Minnesota (19991) Not needed 6 - 9
22099 Horizon Blue Cross Blue Shield of New Jersey (22099) 4 - 8 *
22248 AmeriHealth Mercy Health Plan (22248) Not needed 2 - 4
22254 Fallon Community Health (22254) Not needed 2 - 4
22326 Mercy Health Plan of New Jersey (Provider ID Required in Box33a - Contact (800) 682-9091 to obtain ID) (22326) Not needed 4 - 8
22521 EDS Healthchoice (22521) Not needed 6 - 8
22771 Managed Health Networks (MHN) (22771) Not needed 6 - 9
23037 AmeriHealth HMO New Jersey and Delaware (23037) * 4 - 8
23045 PA Capital Blue Cross (23045) 2 - 4 4 - 8
23228 Aetna Better Health - PA Medicaid (23228) Not needed 4 - 6
23281 UPMC Health Plan (23281) Not needed 6 - 9
23285 Select Health of South Carolina (Provider ID required in Box33a.) (23285) Not needed 2 - 4
23342 Qualcare (23342) Not needed 2 - 4
25133 Coventry Health Care (Coventry old Legacy Payer ID's are still accepted.) (25133) Not needed 4 - 8
25175 Americhoice Personal Care Plus PA (UnitedHealthcare Community Plan) (25175) Not needed *
25531 GHI HMO Select (25531) Not needed *
27357 AmeriHealth Caritas Louisiana (Formerly known as LA Care) (27357) Not needed 2 - 4
29076 Carolina Care Plan (Part of the Medical Mutual Family of companies. Former payerID was 57105.) (29076) Not needed 2 - 4
31114 CareSource (31114) Not needed *
34192 Antares Management Solutions (34192) Not needed 2 - 4
35145 Highmark - Key Family (35145) 6 - 9 ---
35187 CoreSource (35187) Not needed *
36273 AARP Hospital Indemnity Plans insured by UnitedHealthcare Insurance Company (36273) Not needed 6 - 9
36334 MacNeal Health Providers - CHS (Contact 708-783-7100 prior to first submission.) (36334) Not needed *
36406 Harmony Health Plan of Illinois (Wellcare Provider ID required call (800) 960-2530 opt. 2 then 5) (36406) Not needed *
37217 Key Benefit Administrators (37217) Not needed 2 - 4
37602 Golden Rule (UnitedHealthOne) (37602) Not needed 2 - 4
38217 Priority Health (Please contact Priority Health EDI Dept at 616-464-8686 or email EDISETUP@Priority-Health.com) (38217) Not needed 4 - 6
38335 Cofinity (formerly Sloans Lake) (38335) Not needed 2 - 4
38520 Tricare North (38520) Not needed *
38692 Aetna TX Medicaid & CHIP (38692) Not needed *
39026 UMR (formerly UMR Wausau) former payer ids 31107 33108 74223 75196 75243 (39026) Not needed 2 - 4
39045 Security Health Plan (39045) Not needed *
39113 Children's Community Health Plan (39113) Not needed 2 - 4
39144 Network Health Plan of Wisconsin Inc.(Prior to initial claims submission please contact Network Health Plan EDI specialist at 920-720-1506.) (39144) Not needed 2 - 4
39156 Physicians Plus Insurance Corp. (39156) Not needed *
39188 SUPERIOR HEALTH PLAN OF TEXAS (39188) Not needed *
41147 Preferred One (41147) Not needed 2 - 4
41154 Mayo Management Services Inc. (41154) Not needed 4 - 6
43307 ValueOptions/MBHP (For claim rejections please contact e-SupportServices@valueoptions.com or 888-247-9311) (43307) 2 - 6 Not supported
44054 GEHA (Government Employees Health Association) (44054) Not needed 2 - 4
46299 Molina Health Care of South Carolina (46299) Not needed *
47027 Physicians Mutual Insurance Company (47027) Not needed 4 - 8
48117 FMH Benefit Services (48117) Not needed *
48330 Hawaii Management Alliance Association (HMAA) (48330) Not needed *
51020 INTEGRA Administrative Group Inc. (51020) Not needed *
52123 Johns Hopkins (USFHP) (New submitter should send in their Billing NPI & Rendering servicing NPI) (52123) Not needed 2 - 4
52192 Bravo Health (Formerly known as Elder Health Inc. Serving members in PA MD DE TX and Washington DC.) (52192) Not needed 4 - 6
53589 SW Service Administrators (53589) Not needed 4 - 8
54154 Optima Health Plan (54154) Not needed *
54176 Virginia Premier Health Plan (54176) * ---
54704 Independent BLC of PA (Also known as Personal Choice PPO of Pennsylvania.) (54704) 6 - 8 6 - 9
54763 AmeriHealth Administrators (54763) 4 - 8 6 - 9
55247 HIP-Health Insurance Plan of Greater NY (55247) Not needed 6 - 9
55764 HealthPartners of Minnesota (55764) Not needed 6 - 9
57254 Government Employees Health Association Inc. (GEHA) (57254) Not needed *
58234 Alliant Health Plans of Georgia (58234) Not needed 4 - 6
60054 AETNA (60054) Not needed 6 - 9
61101 Group Health Insurance - DE (61101) Not needed *
61604 Prime West Health Plan (61604) Not needed 2 - 4
62308 Cigna (62308) Not needed 6 - 9
63114 Viva Health Plan (63114) Not needed *
64157 Meritain Health (North American Health Plan.) (64157) Not needed *
66705 Unity Health Insurance (66705) Not needed Not supported
68069 Bridgeway (68069) Not needed 6 - 9
71063 HealthSCOPE Benefits INC (71063) Not needed *
71412 Mutual of Omaha Insurance Company (71412) Not needed 2 - 4
72126 Peoples Health Network (Tenet) (Network ID must be on claim. Contact phn.provider@tenethealth.com) (72126) Not needed 2 - 4
72467 ACS Benefit Services inc. (72467) Not needed *
74238 Boon-Chapman Benefit Administrators Inc. (74238) Not needed 6 - 9
74284 Driscoll Childrens Health Plan (74284) Not needed 2 - 4
74289 Mental Health Network (Only claims for PO Box 209010 Austin TX 78720) (74289) Not needed 6 - 8
74323 Medical Benefits Mutual (74323) Not needed 2 - 4
75261 Community Health Electronic Claims/CHEC/webTPA (75261) Not needed 2 - 4
75273 Geisinger Health Plan (75273) Not needed *
76048 Texas Children's Health Plan (76048) Not needed 2 - 4
76342 Health Plan of Nevada (Encounter) (76342) Not needed 4 - 8
77002 Amerihealth District of Columbia (This Payer ID is effective for DOS after May 1 2013.) (For EDI Support please email edi.dc@amerihealthdc.com or call 1-888-6 (77002) Not needed *
77076 Network Health Insurance Corp - Medicare (77076) Not needed 2 - 4
77950 Health Alliance Medical Plans of Illinois (77950) Not needed 2 - 4
79480 UMR (formerly UMR Onalaska) former payer ids 74223 95266 (79480) Not needed *
80141 Healthfirst Inc. (NY) (80141) Not needed *
80314 Massachusetts Mutual also known as Mass Mutual (80314) Not needed *
81264 Nippon Life Insurance Company (81264) Not needed *
81400 All Savers Insurance (UnitedHealthOne) (81400) Not needed 6 - 9
82056 Custome Design Benefits Inc. (82056) Not needed *
84146 CHAMPVA-HAC (CHAMPVA-HAC is not associated with and does not process claims for TRICARE (formerly CHAMPUS.)) (84146) Not needed 2 - 4
86047 AmeriChoice NJ Medicaid NJ Family Care (UnitedHealthcare Community Plan) (86047) Not needed 8 - 9
87726 United HealthCare (87726) Not needed 6 - 9
87815 Acordia National (Now known as Wells Fargo TPA) (87815) Not needed 2 - 4
88023 Hometown Health Plan Nevada (88023) Not needed *
88030 Scott & White Health Care (88030) Not needed *
88067 Tall Trees Administrators (88067) Not needed *
91049 Lifewise Health Plan of Washington A Premier Health Plan (91049) Not needed 6 - 9
91051 kaiser permanente of WA (91051) Not needed *
91078 Trusteed Plans Service Corporation (91078) Not needed *
91184 Sanford Health Plan (91184) Not needed *
93029 PacificSource Health Plans (93029) Not needed 6 - 9
93093 Lifewise A Premier Health Plan (93093) Not needed 4 - 8
94265 MEDICA (94265) Not needed *
94320 Kaiser Foundation Health Plan PPO (94320) Not needed 4 - 8
94999 FirstCare (94999) Not needed 2 - 4
95308 Independent Health (Enrollment and Testing Required contact (716) 635-3911) (95308) 3 - 5 *
95378 AmeriChoice MS - CHIP (UnitedHealthcare Community Plan) (95378) Not needed *
95567 Health Net (of California) (95567) Not needed *
95959 Harris Methodist Health Plan (95959) Not needed *
96385 KanCare (UnitedHealthcare Community Plan - KS) (96385) Not needed 4 - 8
99026 University Health Alliance (99026) 6 - 9 6 - 9
99726 Tricare West (99726) 4 - 8 *
00014 SelectCare (00014) Not needed Not supported
00019 Cox Health Plan (Requires Provider ID in Box 33a. Contact Cox Health Plan for ID.) (00019) Not needed ---
00036 Preferred Health Professionals Kansas City (00036) Not needed Not supported
00130 Med-Pay (00130) Not needed Not supported
00143 J. F. Molloy and Associates Inc. (00143) Not needed ---
00164 COVENTRY HEALTH CARE OF THE CAROLINAS (00164) Not needed Not supported
00243 Helix Family Choice (00243) Not needed ---
00251 First Health Mail Handlers Benefit Plan (00251) Not needed Not supported
00290 Indian Health Services (00290) Not needed Not supported
00335 United Healthcare of River Valley (00335) Not needed Not supported
00507 Coventry Missouri (00507) Not needed Not supported
00530 Missouri Care (00530) Not needed Not supported
00661 Healthy Blue (00661) Not needed ---
00773 OptumHealth Vision (00773) Not needed Not supported
00816 Value Options Massachusetts Behavioral Health Partnership (00816) --- Not supported
00817 Value Options Pennsylvania Medicaid (00817) --- Not supported
00818 Value Options Texas Northstar (00818) --- Not supported
00903 Medicare Part B of DC (00903) --- ---
00922 Magellan Behavioral Health Services (00922) Not needed Not supported
00999 Benefit Management Services Inc of Lousiana (00999) Not needed Not supported
01041 Healthsource Maine - Claims must contain Healthsource specific Vendor ID & specific Rendering Provider ID (01041) Not needed ---
01066 American Healthcare Alliance (01066) Not needed Not supported
01250 Qual Choice of Ohio (01250) Not needed Not supported
01757 AM-First Insurance Morgan White (01757) Not needed Not supported
01758 Standard Life & Accident (01758) Not needed Not supported
01759 Monitor Life (01759) Not needed ---
02038 Healthsource New Hampshire (Claims must contain Healthsource specific Vendor ID & specific Rendering Provider ID) (02038) Not needed ---
02041 Healthsource Mass (02041) Not needed Not supported
03036 CBA Blue (03036) Not needed ---
03440 Phoenix Health Plan (03440) Not needed Not supported
03443 Abrazo Advantage Health Plan (03443) Not needed Not supported
04218 Pan American Life (04218) Not needed Not supported
04286 Health New England (04286) Not needed Not supported
04293 Neighborhood Plan (Boston MA) (04293) Not needed Not supported
04320 PrimeSource Health Network (04320) Not needed Not supported
04332 Network Health Massachusetts (04332) --- ---
04334 Practicare (04334) Not needed Not supported
04423 Molina Healcare of New Mexico - SCI (04423) Not needed Not supported
04911 Medicare J4 (WPS) Legacy (04911) Not needed Not supported
05003 Presbyterian(NM) (05003) Not needed Not supported
05047 Neighborhood Health Plan of Rhode Island (Contact NHPRI 401-459-6030 to verify provider and vendor number.) (05047) Not needed ---
05101 Medicare Part A of Iowa (835s returned under 05301) (05101) Not needed ---
05201 Medicare Part A of Kansas (835s returned under 05301) (05201) Not needed ---
05301 Medicare of Missouri J5 (05301) Not needed ---
05401 Medicare Part A of Nebraska (835s returned under 05301) (05401) Not needed ---
05901 Medicare of Mutual of Omaha (05901) Not needed ---
06089 Stirling & Stirling (06089) Not needed Not supported
06102 Diversified Group Brokerage (06102) Not needed Not supported
06108 Health Net of the North East Inc. (Health Net six digit ID REQUIRED in B0X33a; call 866-334-4638) (06108) Not needed ---
06119 Healthsource SC (claims) (06119) Not needed Not supported
06172 Dart Container Corporation (06172) Not needed Not supported
06201 Medicare Part A of Minnesota (06201) Not needed ---
06226 Novanet (06226) Not needed Not supported
06603 ASAGEHA (06603) Not needed Not supported
06607 Piedmont Behavioral Health (06607) Not needed Not supported
07205 360 Alliance PPO Gilsbar (07205) Not needed ---
07503 University Family Care - Healthcare Group (07503) Not needed ---
07689 Global Care Inc (07689) Not needed Not supported
08201 Medicare Part A of Michigan (08201) Not needed ---
09173 Physicians Health Plan (PHP-SC) (09173) Not needed Not supported
09302 Medicare of the Virgin Islands (09302) --- Not supported
09822 JMHP Medicaid (09822) Not needed Not supported
09824 Molina Healthcare of New Mexico Salud (09824) Not needed Not supported
09830 University Family Care (09830) Not needed ---
09908 University Family Care - Maricopa Health Plan (09908) Not needed ---
10002 Sheakley UniComp (OH BWC) (10002) Not needed Not supported
10003 HealthSmart Benefit Solutions (10003) Not needed ---
10005 CompManagement Health Systems Inc. (OH BWC) (10005) Not needed Not supported
10010 Careworks (10010) Not needed Not supported
10066 Coventry HealthCare of Florida (10066) Not needed Not supported
10207 Citrus Health Care (10207) Not needed Not supported
10253 Molina Healthcare of Washington (10253) Not needed Not supported
10262 Blue Cross Independence (Pennsylvania) (10262) Not needed Not supported
10337 Horizon New Jersey Health (10337) Not needed Not supported
10340 AmeriHealth Mercy Health Plan (10340) Not needed Not supported
10525 Patient Advocates LLC (10525) Not needed Not supported
10654 Allegiance Benefit Plan Management (10654) Not needed ---
10775 Physician United Plan (10775) --- Not supported
10988 Globe Life and Accident Insurance (10988) Not needed Not supported
11123 Liberty Mutual (11123) Not needed Not supported
11244 Fitzharris & Company (11244) Not needed Not supported
11303 MAGNACARE (11303) Not needed Not supported
11324 Health Plus PHSP (Payer requests providers to contact the EDI department at edi@healthplus-ny.org for 835/EFT enrollment.) (11324) Not needed ---
11325 Neighborhood Health Providers (Use this payer ID for Dates of Service prior to 6/1/13. For later claims use 80141) (11325) Not needed Not supported
11328 HealthCare Partners IPA (11328) Not needed Not supported
11334 New York Network Management (11334) Not needed Not supported
11345 CareCentrix (11345) --- ---
11440 Sendero Idealcare (11440) Not needed ---
11695 iCARE (Independent Care Health Plan) (11695) Not needed Not supported
11752 ClaimsBridge HPN (11752) Not needed Not supported
12005 Medicare of New Jersey (12005) Not needed Not supported
12021 Blue Cross of Arkansas (12021) Not needed Not supported
12022 Medicare Part A of Arkansas (12022) Not needed ---
12057 Medical Services Initiative (12057) Not needed Not supported
12399 Physicians Health Plan of Northern Indiana (12399) Not needed ---
12422 Medica portal | Medica Health Plans Portal (12422) Not needed Not supported
12611 Florida Healthcare Plus (12611) Not needed Not supported
13010 Smokey Mountain Center (13010) --- Not supported
13141 Partners Behavioral Health (13141) --- Not supported
13174 Montefiore Contract Management Organization (Provider ID required call 914-377-4400 for ID prior to first claims submissions.) (13174) Not needed Not supported
13185 TexasFirst Health Plan (13185) Not needed Not supported
13189 Meridian Health Plan (13189) Not needed Not supported
13193 Loyal American Life (Medicare Supplement) (13193) Not needed Not supported
13201 Medicare Part A of New York (13201) Not needed ---
13306 PHCS Savility (ONLY for Savility card members.) (13306) Not needed Not supported
13315 Insurance Design Administrators (13315) Not needed Not supported
13333 Affinity Health Plans (TMG Health) (Effective for Medicare claims with DOS on or after 01/01/2010) (13333) Not needed Not supported
13335 Hudson Health Plan (Provider must be located in Duchess Orange Rockland Sullivan or Westchester County NY) (13335) Not needed ---
13337 Boston Medical Center Healthnet (13337) Not needed ---
13343 Amalgamated Life - PA/Alicare (13343) Not needed Not supported
13346 AFTRA Health Fund (13346) Not needed Not supported
13357 CenterCare (13357) Not needed Not supported
13360 CenterLight Healthcare (13360) Not needed Not supported
13374 Community Premier Plus (13374) Not needed ---
13375 Medical Select Management (13375) Not needed Not supported
13381 Orthonet Corporation (13381) Not needed Not supported
13383 Orthonet - AETNA (13383) Not needed Not supported
13402 Touchstone Health/Health Net Smart (13402) Not needed Not supported
13407 Uniformed Service Family Health Plan (13407) Not needed Not supported
13413 WIN Healthcare (Woman's Integrated Network Inc.) (13413) Not needed Not supported
13522 Perfect Health Insurance/Benefit Assistance (13522) Not needed Not supported
13550 Amalgamated Life Insurance Co. (13550) Not needed Not supported
13853 Atlantis Health Plan (13853) Not needed Not supported
14140 Farm Family (14140) Not needed Not supported
14142 NYS DOH UCP (14142) Not needed ---
14145 MERIDIAN HEALTH PLAN OF IOWA (14145) Not needed Not supported
14164 Wellcare of CT (14164) Not needed ---
14165 MVP Health Plan of NY (14165) Not needed ---
14179 CareCore National LLC (Aetna Radiology Claims) (14179) Not needed Not supported
14180 CareCore National LLC (Radiology charges for Oxford) (14180) Not needed Not supported
14182 Care Core National (14182) Not needed Not supported
14184 CareCore - Healthnet (14184) Not needed Not supported
14185 CareCore National LLC - Health Net New Jersey (14185) Not needed Not supported
14188 Carecore National Wellcare (14188) Not needed Not supported
14315 Commonwealth Care Alliance (14315) Not needed Not supported
14829 Coordinated Benefit Plan (14829) Not needed Not supported
15688 Insurance Management Services (Amarillo TX)(This payerID is only valid for claims submission address of PO Box 15688 Amarillo TX 79105) (15688) Not needed ---
15752 Stones River Regional IPA - Windsor (15752) Not needed Not supported
15754 Blue Grass Family Health (SRRIPA) (15754) Not needed Not supported
16107 Univera Healthcare WNY (837P) (16107) Not needed ---
16114 Nova Casualty Company (16114) Not needed Not supported
16117 RMSCO Inc. (16117) Not needed Not supported
16120 America's PPO (Formerly known as ARAZ.) (16120) Not needed Not supported
16146 SCHC Total Care (16146) Not needed Not supported
16158 International Educational Exchange Services Inc. (IEES) (16158) Not needed Not supported
16600 Chautauqua County Health Plan (Mayville NY) (16600) Not needed Not supported
16644 Nova Healthcare Administrators Inc. (Grand Island NY) (16644) Not needed Not supported
17902 Community Care Associates (17902) Not needed Not supported
17965 American Sentinel Insurance Company (17965) Not needed Not supported
19305 Cuatro LLC (19305) --- ---
20029 America's Choice NMA (20029) Not needed Not supported
20039 Mediture (20039) Not needed Not supported
20050 Integrated Medical Solutions (20050) Not needed Not supported
20081 Today's Health Wisconsin (20081) Not needed Not supported
20133 Optimum Healthcare Inc. (20133) Not needed ---
20149 Molina Healthcare of Ohio (20149) Not needed Not supported
20172 Pennsylvania Pace (20172) Not needed Not supported
20197 Summit Healthplan I Par Plus (20197) Not needed Not supported
20212 Tethys Health Ventures (20212) Not needed Not supported
20257 HDPC Alliance Physicians (20257) Not needed Not supported
20270 Health Payment Systems (20270) Not needed Not supported
20333 Worksite Benefit Services (20333) Not needed Not supported
20356 The Health Exchange (Cerner Corporation) (20356) Not needed Not supported
20377 Pacificsource Medicare (20377) Not needed Not supported
20398 Physicians Health Collaborative (20398) Not needed Not supported
20413 3P ADMIN (20413) Not needed Not supported
20435 INTGRITAS Benefit Group (20435) Not needed Not supported
20460 SCAN Long Term Care (20460) Not needed Not supported
20472 Pediatric Associates of Broward (20472) Not needed Not supported
20481 Resolve Health Plan Administrators (Authorization number required: begins with the number 5 and is 13 characters in length.) (20481) Not needed Not supported
20488 Better Health Plan of Florida (For claims rejections contact payer at 800-514-4561 and select provider services option.) (20488) Not needed Not supported
20501 HCP Nevada (20501) Not needed Not supported
20553 Americas 1st Choice Health Plans of South Carolina (20553) Not needed ---
20554 Molina Healthcare of Texas (20554) Not needed ---
20805 Marrick Medical Finance LLC (20805) Not needed ---
20807 Transchoice - First Administrator's (20807) Not needed Not supported
21810 America's Health Choice (21810) Not needed Not supported
22149 Kern Health Care Network (22149) Not needed Not supported
22175 I. E. Shaffer (22175) Not needed Not supported
22195 Maksin Management Corporation (22195) Not needed Not supported
22240 St. Barnabas System Health Plan (22240) Not needed Not supported
22264 VYTRA Healthcare (Provider ID number required. Please call 1-631-420-4100 opt 4 opt 4 for payer set-up and payer assigned provider ID number.) (22264) Not needed Not supported
22284 Colonial Medical (22284) Not needed Not supported
22285 Atlantic Medical (22285) Not needed Not supported
22286 BritCay (22286) Not needed Not supported
22312 QualCare Alliance Networks Inc. (22312) Not needed Not supported
22321 One Call Medical (22321) Not needed Not supported
22340 Health Net Oregon (22340) Not needed Not supported
22348 Maryland Physicians Care (22348) Not needed ---
22355 AmeriHealth VIP Care (22355) Not needed Not supported
22384 Adminstrative Concepts Inc. (22384) Not needed Not supported
22603 NJ Carpenters Health Fund (22603) Not needed Not supported
22823 Mid-American Benefits (22823) Not needed ---
23130 Pennsylvania Life Insurance (23130) Not needed Not supported
23171 CHA - Commonwealth Health Alliance (23171) Not needed ---
23172 Health Alliance Exclusive & Plus (23172) Not needed Not supported
23212 American Medical & Life (23212) Not needed Not supported
23218 Superior Administrators Inc. (23218) Not needed Not supported
23223 The Loomis Company (Call Provider Relations at 610-374-4040 ext. 2438 for procedures prior to submitting electronically.) (23223) Not needed Not supported
23226 HealthGuard of Lancaster (23226) Not needed Not supported
23229 Integral Quality Care (23229) Not needed Not supported
23241 First Priority Health (23241) --- ---
23243 Berkshire Health Partners (23243) Not needed Not supported
23249 Sentinel Management Services (23249) Not needed Not supported
23250 Erin Group Administrators (Now known as Significa Benefit Services Inc.) (23250) Not needed ---
23252 Inter-County Health Plan (23252) Not needed Not supported
23253 Spectrum Administrators (23253) Not needed Not supported
23253 Populytics (23253) Not needed Not supported
23274 Core Value (Part of Gettysburg Health.) (23274) Not needed Not supported
23282 Community Care BHO (For Dates of Service after October 1 2007) (23282) Not needed Not supported
23284 Keystone Mercy Health Plan (23284) Not needed ---
23287 Intergroup Services Corporation (23287) Not needed Not supported
23296 CompFirst LLC (23296) Not needed Not supported
23550 Midland Management/MFC (23550) Not needed Not supported
23708 C & O Employees Hospital Association (23708) Not needed Not supported
23856 Touchstone Health PSO (23856) Not needed ---
24077 Santa Clara Family Health Plans (24077) Not needed Not supported
24735 Western Grower's Assurance Trust (24735) Not needed Not supported
24770 Easy Choice Health Plan of NY (24770) Not needed Not supported
24818 Amida Care (Formerly Vida Care.) (24818) Not needed Not supported
24819 New York Presbyterian System Select Health (24819) Not needed Not supported
25137 DelawareCare Inc. (25137) Not needed Not supported
25140 Carelink Medicaid (25140) Not needed Not supported
25141 GHP (Group Health Plan) (25141) Not needed Not supported
25142 Carenet of Virginia (Prepare to use consolidated Coventry payerID of 25133.) (25142) Not needed Not supported
25145 Benefit Coordinators Corporation (25145) Not needed Not supported
25147 Southcare / Healthcare Preferred (25147) Not needed Not supported
25150 OmniCare (For claims with Dates of Service after 10/01/04) (25150) Not needed ---
25152 Advantra Freedom (25152) Not needed ---
25160 DGA - Diversified Group Administrators (25160) Not needed ---
25169 Gateway Health Plan (25169) Not needed ---
25172 D. H. Evans and Associates (Call Jessica Picarde @ 410-349-3222 before sending this payerID.) (25172) Not needed Not supported
25179 Community Care Behavioral Health Org. (For Dates of Service prior to October 1 2007) (25179) Not needed Not supported
25351 Columbia Cornell Care (25351) Not needed Not supported
25404 Seven Corners (25404) Not needed Not supported
25681 Orthonet-HealthNet (25681) Not needed Not supported
26054 ICARE Health Options TPA (26054) Not needed Not supported
26078 America 1st Choice Plans of North Carolina (26078) Not needed ---
26335 PATIENTPAY (26335) Not needed Not supported
26337 Aetna Better Health Medicaid IL (26337) Not needed Not supported
26372 Majesta Care (26372) Not needed ---
26374 Amerikids-Dallas/Ft. Worth (26374) Not needed Not supported
26492 Florida True Health (26492) Not needed Not supported
26545 VillageCareMAX (26545) Not needed Not supported
27004 Care Wisconsin Health Plan (Trizetto) (27004) Not needed Not supported
27005 Medova Healthcare (27005) Not needed Not supported
27008 Employers Coalition On Health (ECOH) (27008) Not needed Not supported
27009 Delaware Physicians Care Inc. (27009) Not needed ---
27094 Simply HealthCare Plans (27094) Not needed Not supported
27136 CSI OF MICHIGAN (27136) Not needed Not supported
27154 Arizona Priority Care Plus (27154) Not needed Not supported
27215 Kentucky Health Administrators Inc. (27215) Not needed Not supported
27320 Max Specialty Benefits (27320) Not needed Not supported
27327 WinHealth Partners/Wyoming Health Solutions (27327) Not needed Not supported
27515 Americaid Community Care (Houston) (27515) Not needed Not supported
27516 Americaid Community Care (New Jersey) (27516) Not needed Not supported
27517 Americaid Community Care (Maryland) (27517) Not needed Not supported
27518 Amerigroup of Illinois (27518) Not needed Not supported
28021 Kern County CDCR (28021) Not needed Not supported
28530 Secure Health of Georgia (28530) Not needed Not supported
28804 Amerigroup / Americaid - Ft. Worth New Mexico (28804) Not needed Not supported
28805 Amerigroup / Americaid - Houston (28805) Not needed Not supported
28806 Amerigroup - New Jersey (28806) Not needed Not supported
28807 Amerigroup - Maryland and District of Columbia (28807) Not needed Not supported
28809 Amerigroup of Florida (28809) Not needed Not supported
28943 Stones River IPA (28943) Not needed Not supported
30005 GALVESTON COUNTY INDIGENT HEALTHCARE (30005) Not needed Not supported
30757 Hometown Health Plan of Ohio (Now known as The Health Plan) (30757) Not needed Not supported
31048 Western Southern Financial Group (31048) Not needed Not supported
31053 State Farm Group Medical & Ind Health Ins Co (Note that payer requires Insured's ID of 11 or 12 digits and exact structure. Otherwise claims will reject.) (31053) Not needed ---
31059 State Farm (Casualty and Property) (31059) Not needed ---
31074 Employee Benefit Management Corp. (31074) Not needed Not supported
31106 HealthPower HMO (31106) Not needed Not supported
31112 InHealth Inc. (31112) Not needed ---
31118 Central Benefit National (31118) Not needed ---
31121 Stoner & Associates (31121) Not needed Not supported
31127 Integra Group (Also known as Rehab Provider Network but not the same as Colorado payer of same name.) (31127) Not needed Not supported
31129 Integra Group - CHA (31129) Not needed Not supported
31138 AHPO (Cleveland OH) (31138) Not needed Not supported
31140 Mid-Valley CareNet Inc. (31140) Not needed Not supported
31141 Healthsource OH (31141) Not needed ---
31144 TriHealth Physician Solutions (31144) --- Not supported
31147 OH Worker's COMP (31147) Not needed Not supported
31172 Innovante Benefit Administrators (31172) Not needed Not supported
31182 Total Community Care (31182) Not needed ---
31313 Freedom First (31313) Not needed Not supported
31354 MDwise Health Indiana Plan (For DOS on or after 1-01-2017) (31354) Not needed Not supported
31417 Nationwide Group (31417) Not needed ---
31441 S & S Healthcare Strategies (31441) Not needed Not supported
31472 Healthwave of Kansas (31472) Not needed ---
31478 Preferred Health Professionals (31478) Not needed Not supported
31625 ElderPlan Inc. (Elderplan Provider ID necessary on all claims. Contact (718)921-7979 for Provider ID.) (31625) Not needed ---
32004 Buckeye Community Health (837P & 837I) (Remits returned under 68069) (32004) Not needed ---
32680 POLY AMERICA MEDICAL (32680) Not needed Not supported
33001 Universal Care - California (ProviderID required.) (33001) Not needed Not supported
33033 FCE Benefit Administrators (33033) Not needed Not supported
33053 PacifiCare Behavioral Health (33053) Not needed Not supported
33065 CHOC - Childrens Hospital of Orange County Health Alliance (33065) Not needed Not supported
33069 High Desert Primary Care (33069) Not needed Not supported
33072 San Luis Obispo Select IPA (33072) Not needed Not supported
34080 Multiplan Wisconsin Preferred Provider Network (34080) Not needed Not supported
34097 Central Reserve Life (34097) Not needed ---
34108 E.S. Beveridge and Associates (34108) Not needed Not supported
34131 Self-Funded Plans (IL PA OH) (34131) Not needed Not supported
34134 Professional Risk Management Inc. (34134) Not needed Not supported
34136 JP Farley Corporation (34136) Not needed Not supported
34145 Klais and Company (34145) Not needed Not supported
34150 The Health Plan (Upper Ohio Valley) (34150) Not needed Not supported
34154 The Chesterfield Companies (34154) Not needed Not supported
34158 Health Design Plus (34158) Not needed Not supported
34159 North American Benefits Network (NABN) (34159) Not needed Not supported
34167 Emerald Health Network (34167) Not needed Not supported
34171 FrontPath Health Coalition (34171) Not needed Not supported
34177 COMP - Ohio (Austintown OH) (34177) Not needed Not supported
34181 Commerce Benefits Group (34181) Not needed Not supported
34185 Health Administration Services Inc (34185) Not needed Not supported
34189 Ohio Health Choice PPO (34189) Not needed Not supported
34196 Apex Benefit Services (Claims must contain the rendering provider ID or the claim will reject.) (34196) Not needed Not supported
34444 AFL - CIO Food & Beverage Dealers Trust Fund (Toledo OH) (34444) Not needed Not supported
34638 Unified Physicians Network (For Claims rejections please contact Unified Physicians claim department at 847-763-1700) (34638) Not needed ---
34734 Aetna Better Health NY (34734) Not needed Not supported
35092 Morris Associates aka HealthScope Benefits (35092) Not needed Not supported
35107 Indiana Teamsters Health Benefits Fund (Formerly known as Local 135 Health Benefits Fund) (35107) Not needed Not supported
35112 Employee Plans LLC (35112) Not needed Not supported
35149 Cook Group Health Plan (35149) Not needed Not supported
35161 Indiana ProHealth Network (35161) Not needed Not supported
35162 Managed Care Services LLC (35162) Not needed Not supported
35164 Sagamore Health Network Inc. (35164) Not needed Not supported
35167 Healthsource Indiana (Claims must contain Healthsource specific Vendor ID & specific Rendering Provider ID) (35167) Not needed ---
35174 Qual Choice of Arkansas (35174) Not needed Not supported
35180 CoreSource of North Carolina (Start using new PayerID of 35182. Old payerID will start rejecting soon.) (35180) Not needed Not supported
35182 CoreSource of Illinois (35182) Not needed Not supported
35183 Coresource of OH (35183) Not needed Not supported
35186 Dunn and Associates Benefits Administrators Inc. (35186) Not needed Not supported
35191 MDwise Hoosier Healthwise (For DOS on or after 1-01-2017) (35191) Not needed Not supported
35193 Community Health Alliance (35193) Not needed ---
35198 Unified Group Services (35198) Not needed Not supported
35199 SUBURBAN HEALTH ORG. CONNECTION (35199) Not needed Not supported
35202 Cornerstone Benefit Administrators (35202) Not needed Not supported
35206 Encore Health Network (Note: Group Policy Number in HCFA Box 11 is required.) (35206) Not needed Not supported
35209 Advantage Health Solutions Inc. (35209) Not needed Not supported
35212 North Texas Healthcare Network (35212) Not needed Not supported
35245 Continental Benefits (35245) Not needed Not supported
35315 Continental Key Family (35315) Not needed Not supported
35600 Indiana Department of Health Children's Health (35600) --- Not supported
35605 Everence (35605) Not needed Not supported
36149 Benefit Administrative Systems (36149) Not needed ---
36215 Central States Southeast and Southwest Areas Health and Welfare and Pensions Funds (36215) Not needed Not supported
36320 Advocate Health Centers (AHC) (36320) Not needed ---
36326 Associates for Healthcare (36326) Not needed Not supported
36331 Professional Benefit Administrators Inc. (Oak Brook IL) (36331) Not needed Not supported
36333 Lawndale Christian Health Center (36333) Not needed Not supported
36335 HFN Inc. (36335) Not needed Not supported
36337 Weiss Health Providers (36337) Not needed Not supported
36338 Group Administrators Ltd. (36338) Not needed Not supported
36342 Benefit Systems and Services Inc. (36342) Not needed Not supported
36345 Physicians Care Network (Rockford IL Only) PayerID valid only for claims with billing submission name city and state of Physicians Care Network Rockford IL. (36345) Not needed Not supported
36346 Northwest Suburban IPA (IL) (36346) Not needed Not supported
36347 Northern Illinois Health Plan (36347) Not needed Not supported
36356 Argus Health Systems (36356) Not needed Not supported
36364 ENH Medical Group IPA (36364) Not needed Not supported
36369 American Imaging Management Inc. (Assigned Group Policy Plan ID required. To obtain call AIM at 800-252-2021) (36369) Not needed Not supported
36373 Prairie States Enterprises Inc. (36373) Not needed Not supported
36387 Silver Care Managed Care Organization (36387) Not needed Not supported
36389 Rush Prudential Health Plans (HMO Only) (36389) Not needed Not supported
36392 North Suburban Associated Physicians (36392) Not needed Not supported
36393 CENTURYPHO (36393) Not needed Not supported
36396 Family Medical Network (36396) Not needed ---
36401 Preferred Network Access (36401) Not needed Not supported
36404 Self Insured Plans LLC (36404) Not needed Not supported
36405 Harmony Health Plan of Indiana (Only claims for Indiana Hoosier Healthwise members can be sent to this payer electronically.) (36405) Not needed ---
36426 Sendero Health (36426) Not needed ---
36434 Early Intervention Central Billing (36434) Not needed Not supported
36439 DiaTri LLC (36439) Not needed Not supported
36609 Boilermakers national Health & Welfare Fund (36609) Not needed Not supported
37060 Caterpillar Inc. (37060) Not needed Not supported
37105 Sage Technologies (Formerly CCMSI) (Claims for payer address of Rockford IL ONLY.) (37105) Not needed Not supported
37111 HCH Administration (37111) Not needed Not supported
37112 Lake Forest Managed Care Associates (37112) Not needed Not supported
37114 H.E.R.E.I.U. Welfare Pension Funds (37114) Not needed Not supported
37116 St. Therese Physician Association (37116) Not needed Not supported
37118 Benefit Plan Administrators Inc (For DOS prior to 10-1-12. Use 57080 for DOS after 10-1-12) (37118) Not needed ---
37119 Premier Health Network (37119) Not needed Not supported
37120 NTL (37120) Not needed Not supported
37121 Bluebonnet Administrators (37121) Not needed Not supported
37123 Colonial Healthcare (37123) Not needed Not supported
37125 BeneFirst (37125) Not needed Not supported
37127 OSG-Michael Reese (37127) Not needed Not supported
37135 Consociate Group (37135) Not needed Not supported
37136 Physicians Health Association of Illinois (37136) Not needed Not supported
37137 Sage Technologies - PBS (37137) Not needed Not supported
37212 Benefit Management Systems Inc of Mississippi (37212) Not needed Not supported
37215 Employee Benefit Corporation (37215) Not needed Not supported
37216 Employee Benefit Systems (37216) Not needed ---
37224 Pittman and Associates (37224) Not needed ---
37225 Third Party Administrators Inc. (37225) Not needed Not supported
37228 Care N' Care (37228) Not needed Not supported
37230 TR Paul Inc. (37230) Not needed Not supported
37233 MPE Employee Benefit Services (37233) Not needed Not supported
37242 Professional Claims Management (37242) Not needed Not supported
37247 Western Mutual Insurance (37247) Not needed Not supported
37253 Elmco (37253) Not needed Not supported
37255 Nesika Health Group (37255) Not needed Not supported
37256 Mutual Assurance Administrators (37256) Not needed ---
37264 St. John's Claims Administration (37264) Not needed Not supported
37266 Southwest Service Life (37266) Not needed Not supported
37267 Loma Linda University Adventist (37267) Not needed Not supported
37268 Palladian Muscular Skeletal Health (Formerly Prism Health Networks) (37268) Not needed Not supported
37269 International Union Operating Engineers (37269) Not needed Not supported
37272 JSL Administrators AKA Wells Fargo Third Party Administrators (37272) Not needed ---
37275 Missoula County Medical Benefits (37275) Not needed Not supported
37276 Group Insurance Service Center INC (37276) Not needed Not supported
37278 Adminone (37278) Not needed Not supported
37279 Insurance Administrator of America (37279) Not needed Not supported
37280 Automated Group Administration Inc. (37280) Not needed Not supported
37281 Mid-America Associates (37281) Not needed Not supported
37282 Select Benefit Administrators of America (37282) Not needed Not supported
37283 American Administrative Group (formerly Gallagher Benefit) (37283) Not needed Not supported
37284 Transchoice - Key Benefit Admin (37284) Not needed Not supported
37286 Benefit Plan Administrators INC (37286) Not needed Not supported
37287 Planned Administrators Inc. (PAI) (37287) Not needed Not supported
37290 Health Services for Children with Special Needs (HSCSN) (37290) Not needed ---
37297 CompBenefits Corporation (37297) Not needed Not supported
37298 MBA of MD Inc. (37298) Not needed Not supported
37299 Nyhart (37299) Not needed Not supported
37300 FACS Group (37300) Not needed Not supported
37301 Summit America Insurance Services Inc. (Student Accident and Sickness College Sports and NASCC claims only.) (37301) Not needed ---
37305 The Ford Meter Box Company INC (37305) Not needed Not supported
37307 Connecticut Carpenters Health Fund (37307) Not needed Not supported
37308 Allied Benefit Systems (37308) Not needed ---
37309 Protective Life Insurance Company (37309) Not needed Not supported
37313 Assurant Health Self Fund (Verify that claims should go to Ft. Mill SC) (37313) Not needed Not supported
37314 North Broward Hospital District (37314) Not needed Not supported
37315 Prism Univera (37315) Not needed Not supported
37316 Leon Medical Center Health Plan (37316) Not needed Not supported
37318 Southern Benefit Services (37318) Not needed Not supported
37320 Creative Plan Administrators (37320) Not needed Not supported
37321 Key Select (37321) Not needed Not supported
37322 American Worker Health Plan (37322) Not needed Not supported
37329 HCHA Albq - Self Funded (37329) Not needed Not supported
37330 Physicians Health Plan (37330) Not needed ---
37331 RightChoice Benefits Administrators (37331) Not needed Not supported
37363 ComPsych (37363) Not needed Not supported
37510 First Choice VIP Care (37510) Not needed Not supported
38201 Total Healthcare Inc. (38201) Not needed Not supported
38216 Health Plus of Michigan (38216) Not needed Not supported
38219 AmeraPlan (Claims are printed and mailed to the payer.) (38219) Not needed ---
38224 Health Alliance Plan of Michigan (38224) Not needed ---
38225 NGS American Inc. (38225) Not needed ---
38232 Weyco Inc. (38232) Not needed Not supported
38234 IBA Self Funded Group (38234) Not needed Not supported
38238 BeneSys Inc. (Located in Troy MI) (Now known as Sheet Metal Workers Local 104) (38238) Not needed Not supported
38241 Employee Benefit Concepts (38241) Not needed Not supported
38254 Activa Benefits Services LLC (Formerly Amway Corporation) (38254) Not needed Not supported
38259 Automated Benefit Services (ABS) (38259) Not needed Not supported
38264 Mcare of Michigan (Payer no longer accepting electronic claims. Claim will be printed and mailed to payer.) (38264) Not needed Not supported
38265 ASR Corporation (38265) Not needed Not supported
38269 Carechoices Michigan - Mercy Healthplans (Enrollment required; please contact Noreen at (248) 489-5281.) (38269) Not needed Not supported
38308 Christian Brothers Services (38308) Not needed Not supported
38309 Healthnet of AZ (38309) Not needed ---
38310 John Morrell Company - AHPBA (38310) Not needed Not supported
38329 Pro Care Health Plan Inc. (Valid for PO Box 3160 and 3590 Detroit MI only.) (38329) Not needed Not supported
38333 Molina Healthcare of California (Rendering provider must use Medi-Cal ID number or State License Number. Billing provider should use Federal TaxID only.) (38333) Not needed Not supported
38334 Molina Healthcare of Michigan (38334) Not needed Not supported
38336 Molina Healthcare of Washington (Rendering providers use DSHS Medicaid ID or State Licence Number.) (38336) Not needed Not supported
38337 Upper Peninsula Health Plan (38337) Not needed Not supported
38338 McLaren Health Plan (38338) Not needed Not supported
39033 Sentry Insurance Co. (Sentry LIfe Insurance Co. Group and Subscriber numbers 800-426-7234) (39033) Not needed ---
39065 Assurant Employee Benefits (Formerly Fortis Insurance) (39065) Not needed ---
39081 Benefit Plan Administrators Co. (Payer ID valid only for claims with a billing submission address of PO Box 1128 Eau Claire WI 54702-1128) (39081) Not needed Not supported
39112 CHP/RPU (FABOH) (Facility physical address required on claim.) (39112) Not needed Not supported
39126 Community Care Organization (39126) Not needed Not supported
39151 WEA Insurance Group (39151) Not needed Not supported
39167 Group Health Cooperative of South Central Wisconsin Claims (39167) Not needed Not supported
39168 Group Health Cooperative of South Central Wisconsin Encounters (39168) Not needed Not supported
39180 Gunderson Lutheran Health Plan (39180) Not needed Not supported
39181 Triad Healthcare Inc (39181) Not needed Not supported
39182 International Funding Inc. (39182) Not needed Not supported
39185 Prevea Health Insurance Plan (39185) Not needed Not supported
39186 Managed Health Services Indiana (837P) (Remits returned under 68069) (39186) Not needed ---
39187 Managed Health Services of Wisconsin (39187) Not needed ---
39197 QuadMed (West Allis WI) (39197) Not needed Not supported
39200 Wisconsin Auto & Truck Dealers Insurance Corporation (39200) Not needed Not supported
40585 INDECS Corporation (40585) Not needed Not supported
41041 Federated Mutual Insurance (41041) Not needed ---
41045 CoreStar AZ MN (Start using new PayerID of 35182. Old payerID will start rejecting soon.) (41045) Not needed Not supported
41095 Wilson-McShane (41095) Not needed Not supported
41099 John Alden Life Ins. (41099) Not needed ---
41124 CBSA (Corporation Benefit Services of America) (41124) Not needed Not supported
41136 Life Trac (41136) Not needed Not supported
41161 Optum Health - Physical Health (Includes Oxford) (formerly ACN former payerIDs 41159 41160 ACN01) (41161) Not needed Not supported
41163 PROCLAIM DBA PROFESSIONAL CLAIM ADMIN (41163) Not needed Not supported
41170 CBCA (Formerly know as Health Risk Management) (41170) Not needed Not supported
41178 HealthEZ (41178) Not needed Not supported
41194 OptumHealth (OptumHealth Care Solutions) formerly United Resources Networks former payerID 52190 (41194) Not needed Not supported
41205 Benefit Administration Services (41205) Not needed Not supported
41206 Ultra Benfits Inc. (41206) Not needed Not supported
41212 Freedom Health Plan (41212) Not needed ---
41600 IMCARE (41600) Not needed Not supported
42011 American Republic Insurance Company (42011) Not needed ---
42102 Health Care Network of Wisconsin (HCN) (42102) Not needed Not supported
42130 Aetna Better Health of Nebraska (42130) Not needed Not supported
42137 Select Benefit Administrators (PayerID valid for claims submission address of PO Box 8339 Des Moines IA 50301) (42137) Not needed Not supported
42138 County Care Behavioral ( CountyCare Provider help desk: 312-864-8200 or toll-free 855-444-1661) (42138) Not needed ---
42140 CENTURION (42140) Not needed Not supported
42141 CTI Administrators Inc (42141) Not needed Not supported
42149 Employee Benefit System (42149) Not needed Not supported
42150 Butler Benefits (42150) Not needed Not supported
42172 Puget Sound Health Partners Inc. (42172) Not needed Not supported
42406 South Carolina Solutions (42406) Not needed Not supported
43141 Coastal Care (43141) --- Not supported
43160 Correctional Medical Services (43160) Not needed Not supported
43172 Care Partners (43172) Not needed Not supported
43173 Family Health Partners/MC+ Missouri (43173) Not needed Not supported
43178 Joplin Claims (43178) Not needed Not supported
43179 Missouri Care (Valid thru 4/30/2013 DOS 5/1/13 and after should be sent to Wellcare PID 14163) (43179) Not needed ---
43313 Harken Health (43313) Not needed Not supported
43324 beacon health strategies (43324) Not needed ---
43471 INETICO Inc. (43471) Not needed Not supported
44030 Kansas City Life Insurance Company (44030) Not needed Not supported
44219 BHP-Unity (44219) Not needed Not supported
44273 Health Plans Inc. (44273) Not needed Not supported
44444 American Postal Workers Union Health Plan (44444) Not needed Not supported
45048 Independent Living Systems (45048) Not needed Not supported
45056 Prestige Health Choice (45056) Not needed Not supported
45129 New Mexico Health Connections (45129) Not needed ---
45275 PHCS GEHA (45275) Not needed Not supported
45281 Riverside Health Inc (45281) Not needed Not supported
45289 Lone Star TPA (45289) Not needed Not supported
45332 Oregon Health Co-op (45332) Not needed Not supported
45341 Maine Community Health (45341) Not needed Not supported
45399 Health Choice Utah (45399) Not needed Not supported
46045 Avera Health Plans (46045) Not needed ---
46050 Generations Health (46050) Not needed Not supported
46156 Aspire Health Plan (46156) Not needed ---
46227 LIJ CareConnect Insurance Company (46227) Not needed ---
46320 Aetna Better Health of New Jersey (46320) Not needed Not supported
46594 AFFINITY MEDICAL GROUP (46594) Not needed Not supported
46871 Cinncinnati Financial Corporation (46871) Not needed Not supported
47046 Contractors Laborers Teamsters & Engineers (47046) Not needed Not supported
47076 Regional Care Inc. (47076) Not needed Not supported
47080 Midlands Choice (47080) Not needed Not supported
47083 GMS Inc. (47083) Not needed Not supported
47181 Highmark BCBSD Health Options (47181) Not needed Not supported
48026 NorthShore Physicians Associates (48026) Not needed Not supported
48055 Todays Option (American Progressive and Pyramid Life) (48055) Not needed ---
48100 ProviDRs Care Network (48100) Not needed Not supported
48116 Florida Hospital Waterman (48116) Not needed Not supported
48120 Century Health Solutions (48120) Not needed Not supported
48143 Group and Pension Administrators (48143) Not needed Not supported
48145 Community Health Choice (Please include TPI Number (Texas Medicaid Number) in Field FA0-23) (48145) Not needed ---
48153 CNA Health Partners Repricing - AR (48153) Not needed Not supported
48603 International Brotherhood of Boilermakers Employee Health Care Plan (IBBEHC) (48603) Not needed Not supported
48611 Benefit Management Inc. of KS (Only accepts claims for these groups BMI187 BMI219 BMI234 BMI236 BMI214 BMI241 BMI617 BMI246 BMI246.) (48611) Not needed Not supported
48964 BPS Inc (48964) Not needed Not supported
49153 BCI Administrators Inc (49153) Not needed Not supported
50383 US Imaging (50383) Not needed ---
50946 Informed UHC Compass Rose (50946) Not needed Not supported
51028 21st Century Insurance and Financial Services (51028) Not needed Not supported
51037 Benefit Concepts (51037) Not needed Not supported
51052 Psychcare LLC (51052) Not needed Not supported
51062 Molina Healthcare of Florida (51062) Not needed Not supported
51909 Neighborhood Doctors Organization (51909) Not needed Not supported
52103 National Telecommunications Cooperative Association (NTCA) (52103) Not needed Not supported
52104 National Telecommunications Cooperative Association (NTCS Staff) (52104) Not needed Not supported
52132 CBA Inc. (Cooperative Benefits Administrators Inc.) (52132) Not needed ---
52133 Dental Benefit Providers (52133) Not needed Not supported
52149 Alliance PPO Inc.(Now known as OneNet PPO LLC.) (52149) Not needed Not supported
52152 Optimum Choice of the Carolina's (MAMSI) (52152) Not needed Not supported
52180 UMWA Health & Retirement Funds (52180) Not needed Not supported
52181 Medical Development International (52181) Not needed Not supported
52189 John Hopkins Healthcare (EHP/PP) (Submit Billing NPI and Rendering/Servicing NPI) (52189) Not needed Not supported
52193 LBA HealthPlans (52193) Not needed Not supported
52196 InforMed LLC (52196) Not needed Not supported
52312 Arbor Health (52312) Not needed ---
53011 National Association of Letter Carriers (53011) Not needed Not supported
53085 Anchor Benefit Consulting (53085) Not needed Not supported
53476 Preferred Benefit Administrators (53476) Not needed Not supported
54098 Employee Security Inc. (54098) Not needed Not supported
54160 APS Healthcare Inc. (54160) Not needed Not supported
55204 HealthNow New York, Inc (55204) Not needed Not supported
55438 CBCA Administrators of Ft. Worth TX (55438) Not needed Not supported
56071 American Family (administered by American Republic) (56071) Not needed ---
56089 EAST CAROLINA BEHAVIORAL HEALTH (56089) Not needed ---
56116 Corporate Benefits Service Inc. (NC) (Only valid for payer address of PO Box 12953 Charlotte NC 28220) (56116) Not needed Not supported
56122 CenterPoint Human Services (56122) Not needed ---
56132 Interactive Medical Systems (56132) Not needed Not supported
56139 Benefit Management Administrators/Services (56139) Not needed ---
56142 Health Care Savings (56142) Not needed Not supported
56144 Primary PhysicianCare Inc. (56144) Not needed Not supported
56147 Healthsource North Carolina - Claims must contain Healthsource specific Vendor ID & specific Rendering Provider ID (56147) Not needed Not supported
56151 Piedmont Administrators (56151) Not needed Not supported
56152 Partners National Health Plans of North Carolina Inc (Contracted providers only. Call 888-296-9790) (56152) Not needed Not supported
56162 MedCost (56162) Not needed Not supported
56175 National Benefit Administrators - New Jersey (56175) Not needed Not supported
56176 National Benefits Administrators - North Carolina (56176) Not needed Not supported
56190 Opticare Eye Health Network (56190) Not needed Not supported
56195 Carolina Summit Healthcare Inc (56195) Not needed Not supported
56196 First Carolina Care (56196) Not needed Not supported
56205 MedCost Benefit Services (56205) Not needed Not supported
56213 Crescent Health Solutions (56213) Not needed Not supported
56215 CBHA Carolina Behavioral Health Alliance (56215) Not needed Not supported
56240 Detroit Medical Center (56240) Not needed Not supported
56731 Healthcare Resources NW (56731) Not needed Not supported
57038 Kanawha Healthcare Solutions (57038) Not needed ---
57080 ClaimsWare Inc. DBA ManageMed (57080) Not needed Not supported
57082 Essence Healthcare (57082) Not needed Not supported
57115 Care 1st Health Plan of CA (57115) Not needed Not supported
57116 Care 1st Health Plan of Arizona (57116) Not needed Not supported
57117 QVI Risk Solutions Inc. (57117) Not needed Not supported
57492 Stones River IPA Amerivantage (57492) Not needed Not supported
57604 Aetna Affordable Health Choices (SM) - SRC (57604) Not needed Not supported
58086 Great American Life Insurance Company (837P) (58086) Not needed ---
58102 Covenant Administrators Inc. (58102) Not needed ---
58174 Paragon Benefits Inc. (58174) Not needed ---
58182 Naphcare Inc (58182) Not needed Not supported
58200 The Integrity Benefit Network Inc. (58200) Not needed Not supported
58202 Advanced Data Solutions (58202) Not needed Not supported
58203 Medical Resource Network (MRN INC) (58203) Not needed Not supported
58204 AVMED-Parity Healthcare (OB/GYN only) (58204) Not needed Not supported
58210 Healthsource GA (CIGNA) (58210) Not needed Not supported
58213 Healthways WholeHealth Networks (58213) Not needed ---
58226 Promina (58226) Not needed Not supported
58227 HPS Paradigm Inc. (58227) Not needed Not supported
58231 Core Administrative Services (58231) Not needed Not supported
58730 Aetna ASA PPO/Assurant Health (Signature Admin) (58730) Not needed Not supported
59069 Brown & Brown Benefits (59069) Not needed Not supported
59087 Health Help Networks Inc. (59087) Not needed Not supported
59140 American Benefits Plan Administrators (Las Vegas NV) (59140) Not needed Not supported
59141 Administrative Services Inc. (59141) Not needed Not supported
59143 Harrington Health BPO (59143) Not needed Not supported
59171 JMH Medicare Advantage (59171) Not needed Not supported
59204 Fringe Benefit Coordinators (59204) Not needed Not supported
59221 Mega Life & Health Insurance Company (SSN is not a valid Insured ID. Must be similar to 01234567899 or AA1234567) (59221) Not needed ---
59222 TransAmerica Life Insurance Company (Valid for PO Box 982009 North Richland Hills TX 76182) (59222) Not needed Not supported
59224 Mid-West National Life Insurance Co. of Tennessee (ID valid only for following: PO Box 982017 North Richland Hills TX 76182) (59224) Not needed ---
59225 CT General Life Insurance (Formerly STAR HRG.) (59225) Not needed Not supported
59227 The MEGA Life and Health Insurance Company-OKC (Valid if PO BOX 548801 Oklahoma City OK 73154.) (59227) Not needed Not supported
59230 Heritage Consultants (Must use 9-digit subscriber ID on all claims) (59230) Not needed Not supported
59231 MedCom (59231) Not needed Not supported
59266 Volusia Health Network (59266) Not needed Not supported
59274 AvMed (59274) Not needed ---
59275 AVMED ENCOUNTERS (59275) Not needed Not supported
59276 First Service Administrators (59276) Not needed Not supported
59279 BayCare Life Management (59279) Not needed Not supported
59296 Professional Benefits Administrators (Winter Park FL) (59296) Not needed Not supported
59298 Employers Mutual Inc. (Florida Providers only) (59298) Not needed Not supported
59313 Evolutions Healthcare (59313) Not needed Not supported
59314 Comprehensive Behavioral Care (59314) Not needed Not supported
59322 Florida Health Plan (59322) Not needed ---
59324 Podiatry Network FL (59324) Not needed Not supported
59331 McCreary Corporation (59331) Not needed Not supported
59347 Hillcrest Benefits Administrators (59347) Not needed Not supported
59354 Wellcare Health Plan Inc. (Encounters only) (59354) Not needed Not supported
59355 Christian Care Ministries (Medishare) (59355) Not needed Not supported
59374 Advantica Benefits (59374) Not needed Not supported
59608 HealthEase (59608) Not needed ---
59698 Florida League of Cities Inc. (59698) Not needed Not supported
59700 Pipefitters Local 597 (59700) Not needed Not supported
60110 Preferred Health Systems Inc. (60110) Not needed ---
60280 Interface EAP (60280) Not needed Not supported
60305 American Community Mutual Insurance (60305) Not needed ---
60495 Community Health Choice Marketplace (60495) Not needed ---
60550 Gateway Health Plan ((Yellow Card). Check the ID card to verify the Payer ID before submitting) (60550) Not needed ---
60646 Yale University Health Plan (60646) Not needed Not supported
60801 Fidelity Assurance Company (60801) Not needed ---
60827 County Care Medical ( CountyCare Provider help desk: 312-864-8200 or toll-free 855-444-1661) (60827) Not needed ---
60995 Family Care - Milwaukee WI (60995) Not needed ---
61102 HUMANA Encounters Only (61102) Not needed Not supported
61104 LIFESYNCH (61104) Not needed Not supported
61106 Preferred Health Plan (Louisville KY) (61106) Not needed Not supported
61120 Humana Veterans Healthcare Services (61120) Not needed Not supported
61124 Bluegrass Family Health (61124) Not needed ---
61127 Healthsource Kentucky - Claims must contain Healthsource specific Vendor ID & specific Rendering Provider ID (61127) Not needed ---
61129 Passport Health Plan (61129) Not needed ---
61146 Midwest Group Benefits (61146) Not needed Not supported
61425 Benefit Trust Life Insurance Company (61425) Not needed Not supported
61665 Preferred Health Systems Insurance Co (PPO) (61665) Not needed Not supported
61948 COMM CHOICE HLTH PLAN (61948) Not needed Not supported
62030 American General (62030) Not needed ---
62061 Willis Administrative Services Corporation (Now UMR Kansas) (62061) Not needed Not supported
62072 Cariten Senior Health (62072) Not needed ---
62073 Cariten Commercial (62073) Not needed ---
62111 Health Cost Solutions (62111) Not needed Not supported
62129 Healthsource TN (CIGNA) (62129) Not needed Not supported
62153 Windsor Medicare Extra (62153) Not needed Not supported
62157 Health Partners - Jackson TN (62157) Not needed Not supported
62160 MedSolutions Inc. (62160) Not needed ---
62168 HealthChoice of Memphis (62168) Not needed Not supported
62170 Unified Health Services (62170) Not needed Not supported
62176 Arkansas Managed Care Organization (AMCO) (62176) Not needed Not supported
62177 Medical Reimbursements of America (62177) Not needed Not supported
62179 Health Choice of AZ (62179) Not needed ---
62180 Health Choice Generations (62180) Not needed ---
62310 CIGNA Flex Care (New Mexico only) (62310) Not needed Not supported
62324 Freedom Life Insurance Company (62324) Not needed Not supported
62553 Country Life Insurance Company (62553) Not needed Not supported
62777 TRLHN/EB (62777) Not needed Not supported
63092 HealthSpring HMO/HealthSpring Medicare+Choice (63092) Not needed Not supported
63100 Behavioral Health Systems (63100) Not needed Not supported
63103 American Behavior (63103) Not needed Not supported
63106 American Behavioral FEP/ITS (63106) Not needed Not supported
63665 GenCare Health (St. Louis only) (63665) Not needed Not supported
64067 FoxEverett - Ingalls Ship Building (64067) Not needed Not supported
64068 Creative Medical Systems (64068) Not needed Not supported
64069 Fox-Everett Inc. (64069) Not needed ---
64071 ACCLAIM (64071) Not needed Not supported
64084 Mississippi Physicians Care Network (64084) Not needed Not supported
64088 Mississippi Select Healthcare (Mississippi Select Health Care) (64088) Not needed Not supported
64158 Meritain Health / Agency Services (64158) Not needed Not supported
64159 Definity Services (64159) Not needed ---
64246 Guardian Life Insurance Company of America (64246) Not needed ---
65018 Physicians Corporation of America (Florida Plan Only) (65018) Not needed Not supported
65031 Care Plus (65031) Not needed Not supported
65054 Premier Eye Care (65054) Not needed Not supported
65056 New Market Dimensions (65056) Not needed Not supported
65062 EMI (Eye Management Inc) (65062) Not needed Not supported
65063 Florida NetPass (65063) Not needed Not supported
65064 American Therapy Administration of Florida aka ATA-FL (Only PT OT and Speech Therapy claims for FL plans to AETNA CarePlus JMH HP Sunshine St WellCare.) (65064) Not needed Not supported
65067 Capital International Management Services (65067) Not needed Not supported
65074 Olympus Management Health Care (65074) Not needed Not supported
65085 NAA (North America Administrators) (65085) Not needed Not supported
65088 Preferred Care Partners (Miami Florida) (65088) Not needed Not supported
65093 Advocate Health Partners (PHO) (65093) Not needed ---
65099 UNICARE Special Accounts (65099) Not needed Not supported
65101 HAA Preferred Partners (65101) Not needed Not supported
65113 METCARE HEALTH PLANS (65113) Not needed Not supported
65391 CBNHP Health Choices (65391) Not needed ---
66001 BCBS TEXAS MEDICAID STAR CHIP (66001) Not needed Not supported
66004 Economic Livelihood Partnership (HELP) (66004) Not needed Not supported
66006 Blue Cross Medicare Advantage (66006) Not needed Not supported
66055 Netcare Life and Health Insurance (66055) Not needed Not supported
66893 New England The (66893) Not needed Not supported
66917 Parkland Community Health Plan (66917) Not needed ---
67814 G.E. Group Life Assurance Company (67814) Not needed Not supported
67829 Sterling Medicare Advantage (67829) Not needed Not supported
68011 Capitol Administrators (68011) Not needed ---
68021 Health net Federal Services (68021) Not needed Not supported
68035 Health Plan of San Joaquin (68035) Not needed Not supported
68036 John Muir Mt. Diablo Health System (68036) Not needed Not supported
68050 Cenpatico Behavioral Health Georgia (68050) Not needed Not supported
68052 Cenpatico Behavioral Health Indiana (68052) Not needed Not supported
68055 Absolute Total Care South Carolina (68055) Not needed Not supported
68056 Medicare Advantage (68056) Not needed Not supported
68057 Sunshine State Health Plan (Remits returned under 68069) (68057) Not needed ---
68060 CeltiCare Health Plan Massachussets (68060) Not needed Not supported
68062 Magnolia Health Plan (68062) Not needed ---
68065 Cenpatico Behavioral Health Illinois (68065) Not needed Not supported
68066 IlliniCare Health Plan Illinois (68066) Not needed Not supported
68067 Kentucky Spirit (68067) Not needed Not supported
68068 Group Practice Affiliates (68068) Not needed ---
68195 Healthpoint Corporation (68195) Not needed Not supported
68241 Bell Atlantic (Prudential) (68241) Not needed Not supported
68423 The Care Network (68423) Not needed Not supported
68609 Bridgeway Arizona (68609) Not needed Not supported
70259 ProCare Health Plan Medicaid (70259) Not needed Not supported
70408 FORTIS BENEFITS (Kansas City) (70408) Not needed ---
71037 Lafayette Consolidated Government (71037) Not needed Not supported
71057 Cannon Cochran Management Services Inc. LA (Claims for Payer address of Metairie LA only.) (71057) Not needed Not supported
71064 EDS Healthchoice (formerly payer ID 22521 - For dates of service on or after 01/01/2018 ) (71064) Not needed Not supported
71074 Healthsource Arkansas - Claims must contain Healthsource specific Vendor ID & specific Rendering Provider ID (71074) Not needed Not supported
71075 Healthsource AR (Med) (CIGNA) (71075) Not needed Not supported
71079 Mercy Care Plus (Now valid only for DOS prior to 7-1-12) (71079) Not needed Not supported
71080 NOVASYS Health Network (71080) Not needed Not supported
71404 Continental General Insurance Co. (71404) Not needed ---
71768 FreedomBlue HHIC (71768) --- ---
72087 State Employees Group Benefits (72087) Not needed Not supported
72091 IMA of Lousiana Inc. (72091) Not needed Not supported
72099 American LIFECARE (Group Number required. Valid only for claims with a billing address of 1100 Poydras ST. #2600 New Orleans LA 70163) (72099) Not needed Not supported
72127 Ochsner Health Plan (72127) Not needed Not supported
72128 Vantage Health Plan Inc. (72128) Not needed Not supported
72148 PPO Plus LLC (72148) Not needed Not supported
72261 SCAN Health Plan (72261) Not needed Not supported
73066 Reserve National Insurance (For Claims rejections please contact Reserve national Customer Service at (405)848-7931.) (73066) Not needed Not supported
73067 Quicktrip Corporation (73067) Not needed Not supported
73100 Kempton Group (73100) Not needed Not supported
73126 Equitable Plan Services (73126) Not needed Not supported
73143 Community Care Managed Health Care Plans of Oklahoma (73143) Not needed Not supported
73145 Preferred Community Choice (73145) Not needed Not supported
73147 HealthCare Solutions Group (73147) Not needed Not supported
73155 Waterstone Benefit Administrators (73155) Not needed Not supported
73159 First Health Network (73159) Not needed Not supported
73172 Scan Health Plan Arizona (73172) Not needed Not supported
73288 EHI (Employers Health Insurance) (73288) Not needed Not supported
74048 American National Insurance Co (74048) Not needed Not supported
74095 USAA (74095) Not needed ---
74205 Right Care from Scott & White (74205) Not needed ---
74212 Employer Plan Services Inc. (74212) Not needed Not supported
74227 Student Resources (74227) Not needed Not supported
74234 8th Distric Electrical (74234) Not needed Not supported
74240 Assured Benefits Administrators (74240) Not needed Not supported
74431 Ohio PPO Connect (74431) Not needed Not supported
75087 States General Life Insurance (75087) Not needed Not supported
75130 UMC Health Plan (75130) Not needed Not supported
75133 Team Choice PPO (75133) Not needed Not supported
75134 Team Choice UMC (75134) Not needed Not supported
75136 CoreSource Little Rock (For claims where the 'submit claims to address' on the medical ID card is an address in Little Rock. For assistance call 800-689-0106) (75136) Not needed Not supported
75137 Ameriben Solutions (75137) Not needed Not supported
75138 First Choice of Midwest (PPO) (75138) Not needed Not supported
75139 Team Health Gold (75139) Not needed Not supported
75177 Central & Southwest Services (75177) Not needed Not supported
75185 ICON Benefit Administrators (75185) Not needed Not supported
75190 NCAS - Fairfax VA (75190) Not needed Not supported
75191 NCAS - Charlotte VA (75191) Not needed Not supported
75228 Texas Children's Health Plan (Medicaid) (75228) Not needed Not supported
75229 Medical Control Inc (ppoNext) (75229) Not needed Not supported
75232 E3 Health Inc (Formerly First Integrated Health) (75232) Not needed Not supported
75233 Employers Direct Health - SF (75233) Not needed Not supported
75234 Health First-Tyler TX (75234) Not needed Not supported
75235 CorSolutions (75235) Not needed Not supported
75236 Employers Direct Health - Employee Plan (75236) Not needed Not supported
75237 Healthsmart Accel (75237) Not needed Not supported
75240 American Administrative Group - AAG (Formerly known as UICI Administrators (75240) Not needed Not supported
75245 UICI Administrators - State of Nevada (75245) Not needed Not supported
75246 GM Southwest (75246) Not needed Not supported
75250 HealthSmart Preferred Care (75250) Not needed Not supported
75255 Healthsource North Texas - Claims must contain Healthsource specific Vendor ID & specific Rendering Provider ID (75255) Not needed Not supported
75256 Verity National Group (75256) Not needed Not supported
75258 MAPCO Inc. (75258) Not needed Not supported
75274 Superier Health (75274) Not needed Not supported
75276 World Insurance Company (75276) Not needed ---
75277 eComPPO (75277) Not needed Not supported
75278 Arkansas Best Corporation (75278) Not needed Not supported
75280 Shasta Administrative Services (Jeld-Wen Claims only) (75280) Not needed Not supported
75281 New ERA Life (75281) Not needed Not supported
75283 Linn County (75283) Not needed Not supported
75284 Consolidated Associates Railroad (75284) Not needed Not supported
75289 Healthfirst of Austin TPA (75289) Not needed Not supported
75318 HMC Healthworks aka Health Management Co. (75318) Not needed Not supported
75600 The City of Odessa (75600) Not needed Not supported
76028 Gateway Health Plan of Ohio Inc. (76028) Not needed Not supported
76045 SelectCare of Texas (HPN) Heritage Physicians Network (76045) Not needed Not supported
76049 Choice One/UTMB CHIP Health Plan (Call 281-652-8700 prior to submitting claims.) (76049) Not needed Not supported
76066 Renaissance Physicians Organization (76066) Not needed Not supported
76079 Midwest Health Partners (76079) Not needed Not supported
76343 Health Plan of Nevada (Encounter claims) (76343) Not needed Not supported
76569 Passport Advantage (For claims with dates of service after 12/31/2009. For earlier claims use SX154.) (76569) Not needed Not supported
76870 LifePath Hospice Inc. (76870) Not needed Not supported
76923 Good Shepherd Hospice (76923) Not needed Not supported
77001 AmeriHealth NorthEast (77001) Not needed ---
77015 Carilion Clinic Medicare Health Plan (77015) Not needed Not supported
77023 Carepoint Health Plan (77023) Not needed Not supported
77035 Sutter Connect - Central Valley Med Group (Claims) (77035) Not needed Not supported
77038 Sante Health Systems (77038) Not needed ---
77039 Kern Health Systems (77039) Not needed ---
77044 Department of Labor Black Lung (77044) --- Not supported
77045 Arcadian Management Services Inc (Group number should be entered if available. ) (77045) Not needed Not supported
77052 Coastal Administrative Services (77052) Not needed Not supported
77054 Fidelis Secure Care (77054) Not needed ---
77063 Maryland PMHS ValueOptions (Use for ALL Dates of Service) (77063) --- Not supported
77070 Advantage Preferred Plus (77070) Not needed Not supported
77073 VNS Choice Medicare (Formerly Visiting Nurse Service) (77073) Not needed ---
77075 Amerihealth Caritas Iowa (77075) Not needed Not supported
77078 Banner Medisun (77078) Not needed Not supported
77080 WPP Eldercare Wisconsin (77080) Not needed Not supported
77082 Care Improvement Plus (77082) Not needed Not supported
77083 American Heritage (77083) Not needed Not supported
77153 Southeastern Indiana Health (77153) Not needed Not supported
77160 Gold Coast (77160) Not needed Not supported
77170 common ground healthcare cooperative (77170) Not needed ---
77180 Healthy CT (77180) Not needed ---
77201 Clearchoice Health Plan / COIHS (77201) Not needed Not supported
77799 Amerihealth Delaware (77799) Not needed Not supported
78375 Connecticare - Medicare (78375) Not needed Not supported
78521 Greentree (78521) Not needed Not supported
78857 Medica Health Care Plan Inc. (78857) Not needed Not supported
80085 Prominence Health Plan of Texas (80085) Not needed Not supported
80087 Innovative Physician Associates (80087) Not needed Not supported
80142 Health Partners PA (80142) Not needed ---
80214 CHAMPVA-HAC Medicare Crossover (837P & 837I) (80214) Not needed ---
80440 Eastpointe (80440) Not needed Not supported
80705 AH & L (80705) Not needed ---
80942 West Suburban Health Providers (80942) Not needed Not supported
81039 EBMS (Employee Benefit Management Services Inc) (81039) Not needed Not supported
81883 Municipal Health Benefits Fund (81883) Not needed Not supported
81949 American Insurance Company of TX (81949) Not needed Not supported
82018 Health Claims Service (82018) Not needed Not supported
82048 Primary Health Network (82048) Not needed Not supported
82420 Valley Baptist Health (82420) Not needed Not supported
83028 MBA Benefit Administrators (83028) Not needed Not supported
83035 Senior Whole Health (83035) Not needed Not supported
83077 Advantek Benefit Administrators (83077) Not needed Not supported
83253 Health Plan of Michigan (83253) Not needed Not supported
84065 Rocky Mountain Health Plan Grand Junction (84065) --- Not supported
84076 Sinclair Health Plan (84076) Not needed Not supported
84096 Sloan's Lake Managed Care (84096) Not needed Not supported
84131 Denver Health Medical Plan Inc. - Medicare Choice (84131) Not needed Not supported
84132 United Medical Alliance (UMA) (84132) --- Not supported
84133 Denver Health and Hospital Authority (84133) Not needed Not supported
84134 Denver Health - Indigent (84134) Not needed Not supported
84135 Denver Health Medical Plan (84135) Not needed Not supported
84137 InterWest Health PPO (Montana) (84137) Not needed Not supported
84141 New West Health Plan (84141) Not needed Not supported
84223 Keystone VIP Choice (84223) Not needed Not supported
84980 HCSC Insurance Services Company (84980) Not needed Not supported
85256 Wabash Memorial Hospital Association (85256) Not needed ---
85362 Foundation for Medical Care of Tulare and Kings Counties (837P & 837I) (85362) Not needed ---
85729 HealthComp (85729) Not needed Not supported
86001 AmeriChoice of New Jersey Personal Care Plus (86001) Not needed Not supported
86002 AmeriChoice of New York Personal Care Plus (86002) Not needed Not supported
86033 CIGNA Healthcare for Seniors - Arizona Medicare (86033) Not needed Not supported
86040 Mountain States Administrative Services Inc. (ARIZONA ONLY.) (86040) Not needed Not supported
86048 AmeriChoice NY Medicaid & Child Health Plus (UnitedHealthcare Community Plan) (86048) Not needed Not supported
86049 AmeriChoice of PA Children's Health Insurance Program (KidsChoice) (86049) Not needed Not supported
86050 UnitedHealthcare Community Plan Missouri (86050) Not needed Not supported
86052 Mercy Health Plan (AHCCCS) (86052) Not needed ---
86066 Health Management Associates (HMA servicing Southeastern and Southwestern Regions) (Provider ID Required) (86066) Not needed Not supported
86067 Nevada Health Solutions (Provider ID Required) (86067) Not needed Not supported
86068 Hawki (Provider ID Required) (86068) Not needed Not supported
86069 Illinois Health Solutions ( ProviderID Required) (86069) Not needed Not supported
86083 Summit Administration Services Inc. (86083) Not needed Not supported
86304 Insurers Administrative Corporation I Par Plus (86304) Not needed Not supported
87042 Union Pacific Railroad Employees Health Systems (87042) Not needed Not supported
87043 First Health Coventry Health Care National Network (87043) Not needed Not supported
87065 CDO Technologies (87065) Not needed Not supported
87066 Formax Inc. (87066) Not needed Not supported
87068 P5 Health (87068) Not needed Not supported
87071 LIBERTY HEALTH ADVANTAGE (87071) Not needed Not supported
87098 Avesis Third Part Administrators (87098) Not needed Not supported
87265 Benesight (formerly The TPA) (87265) Not needed Not supported
87843 Consolidated Health Plans (87843) Not needed Not supported
88019 Teachers Health Trust (88019) Not needed Not supported
88022 CDS Group Health (88022) Not needed Not supported
88027 Northern Nevada Trust Funds (Call 775-826-7200 prior to submitting claims.) (88027) Not needed Not supported
88029 Saint Marys Health Plan (88029) Not needed Not supported
88033 Bridgestone/Firestone (Please call Bridgestone Customer Service Center at 330-379-4500 before sending claims.) (88033) Not needed Not supported
88035 AssureCare Inc. (88035) Not needed Not supported
88050 National Health Benefits Corporation - NHBC02 (88050) Not needed Not supported
88054 Teamsters (UT/ID/MT) (88054) Not needed Not supported
88056 Cypress Benefit Administrators (88056) Not needed Not supported
88057 National Health Benefit (88057) Not needed Not supported
88082 Prominence Health Plan Encounters (88082) Not needed Not supported
88090 Mayo Clinic FL/GA (88090) Not needed Not supported
88858 ZEBRAHEALTH (88858) Not needed Not supported
89070 united concordia (89070) Not needed Not supported
89461 Quality Care Partners (89461) Not needed Not supported
90001 HEALTHLINK PPO (90001) Not needed Not supported
90023 HDPC - Premier Healthcare (90023) Not needed Not supported
90060 FirstGuard Health Plan of Kansas (Contact Karen Joslin at (816)922-7225 to verify Firstguard ProviderID. Payer requires Insured ID of 8-11 numeric characters.) (90060) Not needed Not supported
90061 FirstGuard Health Plan of Missouri (90061) Not needed Not supported
90091 Nevada Health Coop (90091) Not needed Not supported
90096 Land of Lincoln Health (90096) Not needed ---
90328 Lovelace Sandia Health Plan (90328) Not needed Not supported
90440 Premier Health Systems Inc. (90440) Not needed Not supported
90441 CHP Direct SuperMed (90441) Not needed Not supported
90560 WestLake Financial Group Inc. (90560) Not needed Not supported
90956 Atlas Life Ins Co (NFIC Plan only) (90956) Not needed Not supported
91064 Wenatchee Valley Medical Center (91064) Not needed Not supported
91121 Kaiser Foundation Health Plan of Washington (91121) Not needed Not supported
91131 First Choice Health Network (91131) Not needed ---
91136 Alaska Childrens Services Inc (91136) Not needed Not supported
91150 Olympic Health Management Systems Inc. (91150) Not needed Not supported
91151 Sterling Option 1 (91151) Not needed Not supported
91155 Lifewise Health Plan of Arizona A Premier Health Plan (835s returned under AC032) (91155) Not needed ---
91162 Columbia United Providers (91162) Not needed Not supported
91164 Highline Medical Services MOLINA (91164) Not needed Not supported
91176 RBMS LLC (91176) Not needed Not supported
91313 MDwise Hoosier Care Connect (For DOS on or after 1-01-2017) (91313) Not needed Not supported
92579 University of Miami Behavioral Health (92579) Not needed Not supported
92600 Alaska Electrical Health & Welfare Fund (92600) Not needed Not supported
92620 Tongass Timber Trust (92620) Not needed Not supported
92649 INTER-AMERICAS INSURANCE (92649) Not needed Not supported
92805 Maxor Administrative Services (92805) Not needed Not supported
93031 PacificSource Administrators (93031) Not needed Not supported
93044 A & I Benefit Plan Administrators (93044) Not needed Not supported
93050 William C. Earhart Co Inc. (93050) Not needed Not supported
93082 Prominence Health Plan of Nevada (93082) Not needed Not supported
93092 US Benefits (93092) Not needed Not supported
93100 GulfQuest (93100) Not needed Not supported
93101 Complementary HealthCare Plans (93101) Not needed Not supported
93102 Cascade Health Partners (93102) Not needed Not supported
93128 Western Benefits Inc. (Also known as Western Grocers) (93128) Not needed Not supported
93221 Asuris NW Health (93221) Not needed Not supported
93688 Amerihealth DE (Non - HMO) (93688) --- ---
93975 CareOregon Inc. (93975) Not needed Not supported
94123 Kaiser Permanente Hawaii (94123) Not needed Not supported
94123 KAISER PERMANENTE HEALTH PLAN HAWAII (94123) Not needed Not supported
94134 Kaiser Foundation Health Plan of Southern CA Region (94134) Not needed Not supported
94177 Allied Administrators (94177) Not needed Not supported
94302 Chinese Community Health Plan (Unique Provider ID must be on claim.) (94302) Not needed Not supported
94304 Teamsters Benefit Trust (94304) Not needed Not supported
94316 Brown & Toland Medical Group (94316) Not needed ---
94321 Children First Medical Group (For questions regarding claim status providers will need to contact payer: CFMG Provider Customer Service 510-428-3154) (94321) Not needed Not supported
94998 FirstCare Star Medicaid (94998) Not needed Not supported
95009 HealthPlus of Lousiana (95009) Not needed Not supported
95019 HEALTH FIRST HEALTH PLANS (95019) Not needed ---
95112 Capital Health Plan (95112) Not needed ---
95123 Neighborhood Health Partners of Florida (95123) Not needed Not supported
95166 Cedars-Sinai Medical Network Services Claims (95166) Not needed Not supported
95167 Cedars-Sinai Medical Network Services Encounters (95167) Not needed Not supported
95170 American Benefit Plan Administrators (95170) Not needed ---
95192 Community Connect Medicaid (95192) Not needed ---
95202 SummaCare Health Plan (95202) Not needed Not supported
95213 HealthEdge Administrators (PayerID valid for claims with a submission address of PO Box 11210 Bakersfield CA 93389) (95213) Not needed Not supported
95241 AGIA Inc (Claims are printed and mailed to the payer.) (95241) Not needed Not supported
95288 Employee Benefit Administration & Management (EBA&M) (95288) Not needed Not supported
95321 Medfocus | 1199 (95321) Not needed Not supported
95327 Alameda Alliance for Health (Provider must contact payer to be approved. Contact at Alameda is Anet Quiambao at 510-747-6153 or aquiambao@alamedaalliance.com) (95327) Not needed Not supported
95340 Adventist Health System (95340) Not needed Not supported
95377 Beech Street Corp. (Payer requires that payer and employer information in box11 be attached.) (95377) Not needed Not supported
95379 One Health Plan of California (95379) Not needed ---
95386 CenCal Health (95386) Not needed Not supported
95388 One Health Plan of Illinois (95388) Not needed ---
95397 Personal Insurance Administrators (95397) Not needed ---
95399 Cap Management Systems (95399) Not needed Not supported
95412 One Health Plan of Colorado (95412) Not needed ---
95415 Lakeside Health Services (95415) Not needed Not supported
95420 MethodistCare Inc. (95420) Not needed Not supported
95426 Affordable Benefit Administrators Inc. (Claims with the following address should only be sent to this payerID: ABA PO BOX 10787 Burbank CA 91510-0787) (95426) Not needed Not supported
95432 Facey Medical Foundation (95432) Not needed Not supported
95435 Health Pledge HMO (95435) Not needed Not supported
95444 Clarian Health Plans (95444) Not needed Not supported
95453 Grand Valley Health Plan (95453) Not needed Not supported
95461 Senior Markets Medicare Advantage for WV (95461) Not needed Not supported
95462 Senior Markets Medicare Advantage for PA (95462) Not needed Not supported
95467 Great Lakes Health Plan (UnitedHealthcare Community Plan) (95467) Not needed ---
95569 One Health Plan of Georgia (95569) Not needed ---
95604 Best Life & Health Insurance Co. (95604) Not needed Not supported
95655 MEDIGOLD (95655) Not needed Not supported
95691 Northeast Georgia Health Services (95691) Not needed Not supported
95827 Healthy Palm Beaches Inc. (95827) --- Not supported
95958 UnitedHealthcare West (Encounters) formerly PacifiCare (95958) Not needed Not supported
95964 PacifiCare of AZ Arizona (95964) Not needed Not supported
95998 New Avenues Inc. (95998) Not needed Not supported
95999 PacifiCare PPO - All States (95999) Not needed Not supported
96107 Neighborhood Health Partnership (NHP) (96107) Not needed Not supported
96475 HEALTHLINK HMO (96475) Not needed Not supported
96598 Micron Tech (96598) Not needed Not supported
97055 American Service Life Insurance Company (97055) Not needed Not supported
98010 William J Sutton & Co. Ltd. (98010) Not needed Not supported
98205 Anerican Founders Life Ins Co (NFL Plans only) (98205) Not needed Not supported
98514 Trilogy Health (98514) Not needed Not supported
99157 SCAN Encounters (Diversified Data Design (DDD)) (99157) Not needed Not supported
99289 Screen Actors Guild (99289) Not needed Not supported
99320 BRMS (99320) Not needed Not supported
128KY Aetna Better Health Of Kentucky (128KY) Not needed Not supported
128LA Aetna Better Health of Louisiana (128LA) Not needed Not supported
128MI Aetna Better Health of Michigan (128MI) Not needed Not supported
128MO aetna better health of missouri (128MO) Not needed Not supported
128VA Aetna Better Health of Virginia (128VA) Not needed ---
128WV Aetna Better Health of West Virginia (128WV) Not needed ---
12B35 Blue Cross of New York State (12B35) Not needed Not supported
12B60 Blue Cross of Pennsylvania Capital (12B60) Not needed Not supported
12B81 Blue Cross of Pennsylvania Western/Central Highmark (12B81) Not needed Not supported
12K82 Central California Alliance ** Call CCA EDI support at 831-430-5510 prior to submitting claims for first time (12K82) Not needed Not supported
12K85 Carolina Crescent Health Plan (12K85) Not needed Not supported
12M09 Medicare Part A of Indiana (12M09) Not needed ---
12M12 Medicare Part A of Louisiana (remits returned under 12M17) (12M12) Not needed ---
12M17 Medicare Part A of Mississippi (12M17) Not needed ---
12M31 Medicare Part A of Texas (12M31) Not needed ---
12M53 Medicare Part A of Tennessee (12M53) Not needed ---
12M60 Medicare Part A of Pennsylvania (12M60) Not needed ---
12M64 Medicare of CA HI and NV (12M64) Not needed Not supported
12M81 PARTNERSHIP OF HEALTH CA (12M81) Not needed Not supported
12M97 Home Health & Hospice J15 Cigna (12M97) Not needed Not supported
12M98 CA Home Health & Hospice (12M98) Not needed ---
12X31 US Department of Labor (12X31) Not needed Not supported
12X42 Banner Health (12X42) Not needed Not supported
12X53 BrickStreet Insurance Company (12X53) Not needed Not supported
12X56 VALUE OPTIONS (12X56) Not needed Not supported
251CC Children's Community Health Plan Wisconsin (251CC) Not needed Not supported
3414A Klais and Company Repricing for HealthSpan Network (3414A) Not needed Not supported
3536I Medicare Part A of Georgia (3536I) Not needed ---
3833A McLaren Health Advantage (3833A) Not needed Not supported
3833C McLaren Medicaid (3833C) Not needed Not supported
3833N McLaren ABW-NHP (3833N) Not needed Not supported
3833R McLarenAdvantage SNP (3833R) Not needed Not supported
3833T McLaren ABW-THPC (3833T) Not needed Not supported
412MP MedPartners Admin Services (412MP) Not needed Not supported
4725P Little Company of Mary Health (4725P) Not needed ---
5246M March Vision Health Plan (5246M) Not needed ---
5415M Sentara Mental Health Professional (5415M) Not needed Not supported
A0701 ABMG (A0701) Not needed Not supported
A1680 Access Health Plan (A1680) Not needed ---
A1681 Muskegon Care (A1681) Not needed Not supported
A2004 Ancillary Care Services (A2004) Not needed ---
ABHOH Aetna Better Health Ohio (ABHOH) Not needed Not supported
ABRI1 Abri Healthplan (ABRI1) Not needed Not supported
ACIPA Advantage Care IPA (ACIPA) Not needed Not supported
ACMG1 Alpha Care Medical Group (ACMG1) Not needed Not supported
ADCUC United Care Medical Group (ADCUC) Not needed Not supported
ADECR Access Dental Care (ADECR) Not needed ---
ADOCS Affiliated Doctors of Orange County (ADOCS) Not needed Not supported
ADSL1 Team Choice - Alpha Care Gold I Par Plus (ADSL1) Not needed Not supported
ADVTK Advantek Benefit Administrators (ADVTK) Not needed Not supported
AESSI Aetna Senior Supplemental Insurance (AESSI) Not needed Not supported
AH001 Avante Health (AH001) Not needed Not supported
AHS01 Access Administrators (AHS01) Not needed Not supported
AKMCD Medicaid of Alaska (AKMCD) --- ---
ALIHP Alignment Health Plan (ALIHP) Not needed ---
ALMCD Medicaid of Alabama (ALMCD) --- ---
ALMCR Medicare Part B of Alabama (ALMCR) ---  
ALOHA AlohaCare (ALOHA) --- ---
ALPHA AlphaCare of New York (ALPHA) Not needed ---
AMAIA AMA Insurance Agency INC (AMAIA) Not needed Not supported
AMG01 Access Medical Group (AMG01) Not needed Not supported
AMM01 Advanced Medical Management (AMM01) Not needed Not supported
AMS01 Dentemax (AMS01) Not needed Not supported
APP01 Downey Select IPA (Applecare Medical Mgmt) (APP01) Not needed Not supported
ARISE Arise Health Plan (ARISE) Not needed Not supported
ARMCD Medicaid of Arkansas (ARMCD) --- ---
ASHP1 American Specialty Health (ASHP1) Not needed Not supported
ASNTH Assurant Health Re-Pricing via HealthSpan (ASNTH) Not needed Not supported
ASRM1 ASRM Corporation (ASRM1) Not needed Not supported
ATEND ATENDATPA (ATEND) Not needed Not supported
ATPA1 Associated Third Party Administration (ATPA) (ATPA1) Not needed Not supported
AWNY6 AgeWell New York (AWNY6) Not needed ---
AXM01 Axminister Medical Group (AXM01) Not needed Not supported
AZBLS Blue Shield of Arizona (AZBLS) Not needed ---
AZFMC Ancillary Benefits/Arizona Foundation for Medical Care (AZFMC) Not needed Not supported
AZHNT Health Net of Arizona (AZHNT) Not needed Not supported
AZMCD Arizona Medicaid (AHCCCS) (AZMCD) Not needed ---
BANKLC BANKERS LIFE AND CASUALTY (BANKLC) Not needed Not supported
BBAMA Blue Benefit Administrators of MA (BBAMA) Not needed ---
BCBSUW Excellus BCBS Utica/Watertown (BCBSUW) Not needed ---
BCBSX BCBS Excellus (BCBSX) Not needed ---
BCCC1 Blue Cross Community Centennial (BCCC1) Not needed Not supported
BCIBC INDEPENDENCE BLUE CROSS (BCIBC) Not needed Not supported
BHI00 Behavioral Healthcare Inc. (BHI00) Not needed Not supported
BHPAL Bright Health Alabama (BHPAL) Not needed ---
BHPAZ Bright Health Arizona (BHPAZ) Not needed ---
BHPCO Bright Health Colorado (BHPCO) Not needed ---
BKFID1 Bankers Fidelity Life Insurance Company (BKFID1) Not needed ---
BKRFM Bakersfield Family Medical Center (BKRFM) Not needed Not supported
BMATP Benefit Management Admin (BMA) (BMATP) Not needed Not supported
BNMK1 Benmark (BNMK1) Not needed Not supported
BOLL1 Bollinger INC. (BOLL1) Not needed Not supported
BOONG The Boon Group (BOONG) Not needed Not supported
BRIDG Bridgespan (BRIDG) Not needed Not supported
BRTMN BROTMAN (BRTMN) Not needed ---
BSCTEST JMC Health (BSCTEST) Not needed Not supported
BSHS1 BIENVIVIR (BSHS1) Not needed Not supported
BTSS1 Brown & Toland Sutter (BTSS1) Not needed Not supported
BV001 Block Vision Inc. (BV001) Not needed Not supported
BVES1 Eye Specialists (Provider ID number required in Box33a or Box24J) (BVES1) Not needed Not supported
BVTX1 Block Vision of Texas (BVTX1) Not needed Not supported
BVVP1 VIPA (BVVP1) Not needed Not supported
CAFRS1 Care 1st (CAFRS1) Not needed Not supported
CALOP Cal-Optima Portal (CALOP) Not needed Not supported
CAMAA Cameron and Associates (CAMAA) Not needed Not supported
CAPOR Cal Optima (CAPOR) Not needed Not supported
CARD HPMS (Send claims to payerID listed on patient's insurance card.) (CARD) Not needed Not supported
CAREW Careworks (OH BWC) (CAREW) Not needed Not supported
CARMO Caremore IPA (CARMO) Not needed Not supported
CASD1 Chiropractic Association of South Dakota (CASD1) Not needed Not supported
CASD2 South Dakota Chiropractic (Sanford Health Plan) (CASD2) Not needed Not supported
CB733 Patient Services Inc. (CB733) Not needed Not supported
CB752 Lockard & Williams (CB752) Not needed Not supported
CCAI CCAI (CCAI) Not needed Not supported
CCHP1 Cook Children's Health Plan (CCHP1) Not needed ---
CCHP9 Cook Children's Star Plan (CCHP9) Not needed Not supported
CCHPL Colorado Choice Health Plans (CCHPL) Not needed ---
CCIA1 Pinnacol Assurance (CCIA1) Not needed Not supported
CCIHC CorrectCare Integrated Health (CCIHC) Not needed Not supported
CCMC1 CCMC - Comprehensive Care Management Corp (CCMC1) Not needed Not supported
CCPN1 Coastal Communities Physician Network (CCPN) (CCPN1) Not needed Not supported
CCSTPA CCSTPA (CCSTPA) Not needed Not supported
CDMN1 Delta Dental of Minnesota (837D) (CDMN1) Not needed ---
CELTC Celtic Insurance (CELTC) Not needed Not supported
CHAT1 Chatwins Healthcare Administrators C (CHAT1) Not needed Not supported
CHCN1 Community Health Center Network (CHCN1) Not needed Not supported
CHCNT CNIC Health Solutions Inc. (CHCNT) Not needed Not supported
CHCPI Central Health Medicare (CHCPI) Not needed Not supported
CHP02 Columbine Health (CHP02) Not needed Not supported
CLA11 Community Health Solutions (CLA11) --- Not supported
CLFR2 CL Frates (CLFR2) Not needed Not supported
CLUHS CARELINK UNIVERSITY HEALTH SYSTEM (CLUHS) Not needed Not supported
CMCHP Childrens Medical Center (CMCHP) Not needed ---
CMGWV Community Medical Group of the West Valley (CMGWV) Not needed Not supported
CMSEB Covenant Management Systems Employee Benefit plan (CMSEB) Not needed Not supported
CNHLT1 Central Health Plan (CNHLT1) Not needed Not supported
COA01 The City of Amarillo (COA01) Not needed Not supported
COACC Access Behavioral Care (COACC) Not needed Not supported
COIHS Pacificsource OHP (COIHS) Not needed Not supported
COKSR Kaiser Foundation Health Plan of Colorado (COKSR) Not needed ---
COMCD Medicaid of Colorado (COMCD) --- ---
COMMF Community First Health Plan Inc. (COMMF) Not needed ---
COMPU Amalgamated Transit Union Division 1001 Health & Welfare Fund (COMPU) Not needed Not supported
COPHS PacifiCare of Colorado (COPHS) Not needed Not supported
CORIZ Corizon Health Inc.(Claims with address of Brentwood TN should be submitted to this Payer ID.) (CORIZ) Not needed Not supported
COVTY00251 MAIL HANDLERS & FEHBP (COVTY00251) Not needed Not supported
COVTY00505 CHC Altius Health Plan/CHC Nevada (COVTY00505) Not needed Not supported
CPHLP Centers Plan for Healthy Living (CPHLP) Not needed ---
CPLIC Colonial Penn Life Insurance Company (CPLIC) Not needed Not supported
CRGMN Clinical Resource Group (CRGMN) Not needed Not supported
CRMRE1 Caremore (CRMRE1) Not needed Not supported
CSI001 CLINICAL SPECIALITIES INC (CSI001) Not needed Not supported
CSMED Mcare of Colorado Springs (CSMED) --- Not supported
CX025 Big Lots Associates Benefit Plans (CX025) Not needed Not supported
CX101 Carpenters Health and Welfare Fund of Philadelphia (CX101) Not needed Not supported
DAK01 DakotaCare (DAK01) Not needed Not supported
DCA62 Direct Care Administrators (DCA62) Not needed Not supported
DCMCD Medicaid of Washington DC (DCMCD) --- ---
DDENT1 Delta Dental (DDENT1) Not needed Not supported
DEAN1 Dean Health Plan (DEAN1) --- ---
DEMCD Medicaid of Delaware (DEMCD) --- ---
DESRT Desert Medical Group (DESRT) Not needed Not supported
DHS01 Delta Health Systems (DHS01) Not needed Not supported
DMERA DMERC Region A (DMERA) --- ---
DMERB DMERC Region B (DMERB) --- ---
DMERC DMERC Region C (DMERC) --- ---
DMERD DMERC Region D (DMERD) --- ---
DMG01 Illinois Health Plan (IHP) (DMG01) Not needed Not supported
DNLY1 Donley & Company (DNLY1) Not needed Not supported
DREYR Dreyer Medical (DREYR) Not needed Not supported
DVMC1 Desert Valley Medical Group (DVMC1) Not needed Not supported
E3287 Optum Care Network of Connecticut (E3287) Not needed Not supported
EBMS1 Employee Benefit Management Services (EBMS1) Not needed Not supported
EBSRM Lifetime Benefits Solutions (EBSRM) Not needed ---
EBSSA Employee Benefit Svcs (EBS) of San Antonio (EBSSA) Not needed Not supported
ECISF Ellis Consultants INC. (ECISF) Not needed Not supported
ELIG_SNDBX Eligible Sandbox (ELIG_SNDBX) --- ---
EM039 Med3000 Pedicare Title 19 (EM039) Not needed Not supported
EM205 Med3000 CMS Title 21 (EM205) Not needed Not supported
EM216 Med3000 HealthSpring (EM216) Not needed Not supported
EM284 Med3000 CMS Safety Net (EM284) Not needed Not supported
EM350 Med3000 CMS Early Steps (EM350) Not needed Not supported
EM521 Med3000 Coventry Health Kids (EM521) Not needed Not supported
EM522 Med3000 Pedicare Title 21 (EM522) Not needed Not supported
EM843 Med3000 CMS Title 19 Reform (EM843) Not needed Not supported
EMBLM Emblem Health (EMBLM) Not needed Not supported
EMP01 Empire Physician's Medical Group (EMP01) Not needed Not supported
ENVVI Envolve Vision (ENVVI) Not needed ---
EPF02 Medicaid - TX Premier Plan (Contact Provider Relations @ (915)532-2778 x1068) (EPF02) Not needed Not supported
EPF03 El Paso First - CHIP (EPF03) Not needed Not supported
EPF06 OUTSOURCING PROGRAM (EPF06) Not needed Not supported
EPF10 Preferred Administrator (Contact Provider Relations @ (915)532-2778 x1068) (EPF10) Not needed Not supported
EPF11 PREFERRED ADMIN CHILDRENS HOSP (EPF11) Not needed Not supported
EPF37 HEALTHCARE OPTIONS (EPF37) Not needed Not supported
EPIC EPIC Health Insurance (EPIC) --- Not supported
EPNSH EPN - Seton Health Plan Exclusive (Provider ID required) (EPNSH) Not needed Not supported
EVRGR Evergreen Health Plan (EVRGR) Not needed Not supported
EXCAR EXCLUSIVE CARE (EXCAR) Not needed Not supported
F2370600 DIRECTORS GUILD HEALTH FUND (F2370600) Not needed Not supported
F2512100 Coventry Health Care Carelink (F2512100) Not needed Not supported
F2512300 Coventry Health Care Group Health Plan (GHP) (F2512300) Not needed Not supported
F2512400 Coventry Health Care of Kansas (Kansas City & Wichita) (F2512400) Not needed Not supported
F2512500 Coventry Health Care Texas (includes Coventry Advantra Freedom) (F2512500) Not needed Not supported
F2512600 COVENTRY HEALTHAMERICA & HEALTHASSURANCE (F2512600) Not needed Not supported
F2512700 COVENTRY HEALTH CARE OF GEORGIA (F2512700) Not needed Not supported
F2512800 COVENTRY SOUTHERN HEALTH SERVICES (SHS) (F2512800) Not needed Not supported
F2513000 COVENTRY HEALTH CARE OF DELAWARE (F2513000) Not needed Not supported
F2513100 COVENTRY DIAMOND PLAN (MD MEDICAID) (F2513100) Not needed Not supported
F2513200 COVENTRY HEALTH CARE OF IOWA (F2513200) Not needed Not supported
F2513500 COVENTRY HEALTH CARE OF LOUISIANA (F2513500) Not needed Not supported
F2513600 COVENTRY HEALTH CARE OF NEBRASKA (F2513600) Not needed Not supported
F2513700 Coventry Health of Illinois/ Personal Care (F2513700) Not needed Not supported
F2514200 COVENTRY CARENET MEDICAID (F2514200) Not needed Not supported
F2514300 COVENTRY HEALTHCARE USA (HCUSA) (F2514300) Not needed Not supported
F2515000 OmniCare Health Plan (F2515000) Not needed Not supported
FAMR1 First Administrators Inc. (Provider ID and Group ID required on all claims. Non-participating providers should put in '0000' as their provider ID) (FAMR1) Not needed Not supported
FCD01 Family Care Medicaid (Admin by PH Tech Use for claims with DOS of 07/31/2012 and prior.) (FCD01) Not needed Not supported
FCM01 Family Care Medicaid Mental Health (FCM01) Not needed Not supported
FCR01 Family Care Medicare (Use for claims with DOS of 12/31/2012 and prior.) (FCR01) Not needed Not supported
FDMNW Freedom Network (FDMNW) Not needed Not supported
FDMNWS Freedom Network Select (FDMNWS) Not needed Not supported
FH001 Foundation Health of CA (FH001) Not needed Not supported
FHFLE Foundation Health of Florida-Encounters (FHFLE) Not needed Not supported
FLENC Health Options of Florida (Blue Shield HMO) ENCOUNTERS ONLY!! (FLENC) Not needed Not supported
FLHLT Health Options of Florida (Blue Shield HMO) (FLHLT) Not needed Not supported
FLLTH Fallon Total Care (FLLTH) Not needed ---
FQHC1 Federally Qualified Healthcare Clinic (FQHC1) Not needed ---
FRFL Freedom Insurance (FRFL) Not needed Not supported
FS802 First Solution (FS802) --- ---
FSTAG First Agency (FSTAG) Not needed Not supported
FVMC1 Fox Valley Medicine Site 451 (FVMC1) Not needed Not supported
FVMCH Fox Valley Medicine Site 199 (FVMCH) Not needed Not supported
GAMCD Medicaid of GA (GAMCD) --- ---
GASA1 Group Administrators Self-Funded Alternative (GASA1) Not needed Not supported
GCMG1 Greater Covina Medical Group (GCMG1) Not needed Not supported
GCVCP CARDIOVASCULAR CARE PROVIDERS (GCVCP) Not needed Not supported
GDCHP1 Gold Coast Health Plan (GDCHP1) Not needed Not supported
GEHA9 GEHA Group Health Nevada Medicaid (GEHA9) Not needed Not supported
GEM01 Global Excel Management (GEM01) Not needed ---
GHOKC Global Health (GHOKC) --- Not supported
GLDST1 Golden State (GLDST1) Not needed Not supported
GP133 Optum Health Dental Government Programs (GP133) Not needed Not supported
GRPCR Alliance Group Care IHSS (GRPCR) Not needed Not supported
GTLIC Guarantee Trust Life Insurance Company (GTLIC) Not needed ---
GTPA1 Golden Triangle Physician Alliance (GTPA1) Not needed Not supported
GUILD GuildNet Inc (GUILD) Not needed ---
HBI01 Human Behavioral Institute (HBI01) Not needed Not supported
HC001 Univera Healthcare - CNY (HC001) Not needed Not supported
HCDPBC HEALTH CARE DISTRICT PALM BEACH CTY (HCDPBC) Not needed Not supported
HCP01 Healthcare Partners (HCP01) Not needed Not supported
HCP02 Health Care Partners - AZ (For Dates of Service of 5-01-13 and later.) (HCP02) Not needed Not supported
HCPRO HealthComp Pro (HCPRO) Not needed Not supported
HDMCO HDM Benefit Solutions (HDMCO) Not needed Not supported
HDMDG High Desert Medical Group (Lancaster California) (HDMDG) Not needed Not supported
HER01 Heritage IPA (HER01) Not needed Not supported
HESUN HealthSun (HESUN) Not needed Not supported
HIL01 Hill Physicians Medical Group (HIL01) Not needed Not supported
HIMCD Medicaid of Hawaii (HIMCD) --- Not supported
HM001 Health Net (California Encounters Only.) (HM001) Not needed Not supported
HM015 PruCare HMO (Encounters Only) (HM015) Not needed Not supported
HM037 Care Choices HMO (HM037) Not needed Not supported
HM057 Sutter Medical Group of the Redwoods (SMGR) (Please contact Sutter to get setup to send Encounters 800-611-5191) (HM057) Not needed Not supported
HM059 Sutter Connect - SIP SMG SWMG - Encounters only (HM059) Not needed Not supported
HMLIC Horace Mann Life Insurance (HMLIC) Not needed Not supported
HMOTX TX (HMO-BLUE) ENCOUNTERS (HMOTX) Not needed Not supported
HPIPA Hispanic Physicians IPA (HPIPA) Not needed Not supported
HPKNS Health Partners of Kansas (HPKNS) Not needed Not supported
HPN11 Central Senior Care (HPN11) Not needed Not supported
HPSM1 Health Plan of San Mateo (HPSM1) Not needed Not supported
HSM01 Health Services Management Inc. (NOTE: ANSI submitters can also submit to plans AHP CMS ONP PCI PHP and VHP with proper value in SBR04.) (HSM01) Not needed Not supported
HSPAN HealthSpan Network Repricing (HSPAN) Not needed Not supported
HT001 HealthSpring HMO (No PPO claims accepted via this payerID.) (HT001) Not needed Not supported
HUMANA Humana (HUMANA) Not needed Not supported
IABLM Blue Shield of Iowa (For Secondary claims only where Medicare is primary) (IABLM) Not needed Not supported
IAC01 Insurer's Administration Corporation (IAC01) Not needed Not supported
ICS01 InovaCares for Seniors (ICS01) Not needed ---
IDBL Regence Blue Shield of Idaho (IDBL) Not needed Not supported
IDMCD Medicaid of Idaho (IDMCD) Not needed ---
IDMCR Medicare Part B of Idaho (IDMCR) --- ---
IEHP1 Inland Empire Health Plan (IEHP1) Not needed Not supported
ILMCD Medicaid of Illinois (ILMCD) Not needed ---
IMGIN International Medical Group INC (IMGIN) Not needed Not supported
IMSMS Insurance Management Services of Texas (IMSMS) Not needed Not supported
INCHN Intercommunity Health Net (INCHN) Not needed Not supported
INCS1 Caresource IN (INCS1) Not needed Not supported
INET1 Integranet I Par Plus (INET1) Not needed Not supported
INMCR Medicare Part B of Indiana (INMCR) --- ---
INVHP Inter Valley Health Plan (INVHP) Not needed Not supported
IP057 Pomona Valley Medical Group (PVMG) ProMed (IP057) Not needed Not supported
IP059 St. Joseph HUMBOLT County (IP059) Not needed Not supported
IP061 Blue Lake Rancheria (IP061) Not needed Not supported
IP062 St Joseph Health (IP062) Not needed Not supported
IP079 North American Medical Management (Provider number must be in box 33a) (IP079) Not needed Not supported
IP080 AKM Medical Group (IP080) Not needed Not supported
IP082 Key Medical Group (Providers please contact Brandi Guinn @ 559-735-3892 x233 for authorization.) (IP082) Not needed Not supported
IP083 Mosaic IPA Medical Group (Providers please contact Brandi Guinn @ 559-735-3892 x233 for authorization.) (IP083) Not needed Not supported
IP086 Good Samaritan Medical Practice Association (GSMPA) (IP086) Not needed Not supported
IP091 Sutter Connect - Sutter Gould Medical Foundation - Claims (IP091) Not needed Not supported
IP092 Sutter Connect Sutter Medical Group (SMG SWMG SIP) (Please contact Sutter to get set up to send claims 800-611-5191) Per Provider Testing Required (IP092) Not needed ---
IP097 Marin IPA (IP097) Not needed Not supported
IP099 Sutter Connect - Solano Regional Medical Group - Claims (IP099) Not needed Not supported
IP100 Sutter Connect - Delta - Claims (IP100) Not needed Not supported
IP105 Genesis Health Care (IP105) Not needed Not supported
IP106 St. Joseph Heritage Healthcare (IP106) Not needed Not supported
IP130 East Bay Medical Network (IP130) Not needed Not supported
IPAK1 IPA OF KANE COUNTY (IPAK1) Not needed Not supported
ISL11 Insurance Service of Lubbock (ISL11) Not needed Not supported
IUHPL Indiana University (IUHPL) Not needed Not supported
J5NPA J5 National Part A (J5NPA) Not needed Not supported
JAI01 JAI MEDICAL (JAI01) Not needed ---
JAIMD1 Maryland Medical Programs (JAIMD1) Not needed Not supported
JHHP Priority Partners (JHHP) Not needed Not supported
JISSP JI Sepcialty Services Inc. I Par Plus (JISSP) Not needed Not supported
JMH01 John Muir Health Network (JMH01) Not needed Not supported
JOEHD St. Joe High Desert (JOEHD) Not needed Not supported
KAMG1 Korean American Medical Group (KAMG1) Not needed Not supported
KCIPA KANE COUNTY IPA (KCIPA) Not needed Not supported
KEE01 Keenan & Associates (KEE01) Not needed Not supported
KELSE Kelsey Seybold (KELSE) Not needed Not supported
KELSI Kelsey Seybold - Institutional Claims I Par Plus (KELSI) Not needed Not supported
KENT1 Kent County Health Plan (KENT1) Not needed Not supported
KERN1 Kern Health (KERN1) Not needed Not supported
KLSY1 SelectCare of TX (Kelsey-Seybold) (Provider ID Required - Contact (713) 843-6780 to obtain ID.) (KLSY1) Not needed Not supported
KPS01 KPS Health Plans (KPS01) Not needed Not supported
KSMCD Medicaid of Kansas (KSMCD) Not needed ---
KYCS1 CareSource KY (KYCS1) Not needed Not supported
L0140 Occular Benefits (L0140) Not needed Not supported
L0230 Trusted Health Plan (L0230) Not needed Not supported
LACAR LA Care Health Plan (LACAR) Not needed Not supported
LADOC LOUISIANA DEPARTMENT OF CORRECTIONS (LADOC) Not needed Not supported
LAMCD Medicaid of Lousiana (Includes KidMed claims.) (LAMCD) --- ---
LAREH Medicaid of Lousiana Rehab (for Rehabilitation claims) (LAREH) --- ---
LIICA Life Investors Ins Co of America (Specialized claims only. Call 866-745-3545 with claim routing questions.) (LIICA) Not needed Not supported
LIPA1 Lipa/Agate Resources (LIPA1) --- Not supported
LMG11 Lakeside Medical Group Inc. (LMG11) Not needed Not supported
LNDMK Chiropractic Care of Minnesota Inc. (For Dates of service before 1-01-08 continue to use payerID of ACN01.) (LNDMK) Not needed ---
LWMCM Leisure World Managed Care Medical (LWMCM) Not needed ---
M3CA0001 MED3000 CALIFORNIA (M3CA0001) Not needed Not supported
M3CA1 AFFILIATED PHYSICIANS GROUP LLC (M3CA1) Not needed ---
M3FL3 Healthy Kids I Par Plus (M3FL3) Not needed Not supported
M3FL4 Wellcare Choice I Par Plus (M3FL4) Not needed Not supported
M3FL5 HFN Healthease I Par Plus (M3FL5) Not needed Not supported
M3FL7 Partner Care (M3FL7) Not needed Not supported
M3FL8 Pedicare Title 21 I Par Plus (M3FL8) Not needed Not supported
M3IL0002 MED3000 SOUTHWEST IPA BCBS (M3IL0002) Not needed Not supported
M3IL1 Health Select IPA (Enrollment required. Contact 866-703-1444.) (M3IL1) Not needed ---
MAGNA Magna Care (MAGNA) Not needed Not supported
MAHP1 Medical Associates Health Plan (MAHP1) Not needed Not supported
MAMCD Mass Health (MA Medicaid) (MAMCD) --- ---
MAXOR MaxorPlus, Ltd. (MAXOR) Not needed ---
MBA01 Medical Benefits Administrations (MBA01) Not needed Not supported
MBIPA Monterey Bay IPA (MBIPA) Not needed ---
MC104 First Services Medicaid (MC104) Not needed Not supported
MCA11 Memorial Clinical Associates (MCA11) Not needed Not supported
MCDIL Blue Cross Community Solutions (MCDIL) Not needed Not supported
MCS01 GEMCare (Golden Empire Managed Care System) (MCS01) Not needed ---
MCS02 Managed Care Systems (Delango Regional Medical) (MCS02) Not needed ---
MDAHLT MODA (MDAHLT) Not needed Not supported
MDAPN MD ANDERSON PHYSICIAN NETWORK (MDAPN) Not needed Not supported
MDC01 MD CARE HEALTH PLAN (MDC01) Not needed Not supported
MDCA2 MEDICA 2 (MDCA2) Not needed Not supported
MDMCD Medicaid of Maryland (MDMCD) --- ---
MDXHI MDX Hawaii (MDXHI) Not needed Not supported
MEMCD Medicaid of Maine (MEMCD) --- Not supported
MHCA1 Managed Health Care Administration EPS (MHCA1) Not needed Not supported
MHCA2 Managed Healthcare Administration Inc- Blue Choice (MHCA2) --- Not supported
MHHNP Memorial Hermann Health Network (MHHNP) Not needed ---
MHIPA Acclaim IPA (MHIPA) Not needed Not supported
MHM01 Independence Medical Group (MHM01) Not needed Not supported
MHP77 Midwest Health Plans INC. (MHP77) Not needed Not supported
MM001 M-CARE (Payer no longer accepting electronic claims. Claim will be printed and mailed to payer.) (MM001) Not needed Not supported
MMFMC MemorialCare Medical Foundation (MMFMC) Not needed Not supported
MMLIC Monumental Life Ins Co. (MMLIC) Not needed Not supported
MMPHB Masters Mates and Pilots Plan (MMPHB) Not needed Not supported
MNAUL Aultcare (MNAUL) --- Not supported
MNDH1 Sage (MNDH1) Not needed Not supported
MNM99 Mennonite Mutual (MNM99) Not needed Not supported
MOMCD Medicaid of Missouri (MOMCD) Not needed ---
MP001 MedPay Assurance (Must be a Medpay Assurance Provider to submit. Call 888-9-MEDPAY.) (MP001) Not needed Not supported
MP340 Three Rivers Preferred (MP340) Not needed Not supported
MPCHA Atrio Health Plan (Formerly known as Marion Polk Health Plan Advantage) (MPCHA) Not needed ---
MPCHP Willamette Valley Community Health CCO (Formerly known as Marion Polk Health Plan) (MPCHP) --- Not supported
MPHC2 Martin's Point Health Care USFHP/Generations Advantage (MPHC2) Not needed Not supported
MPI01 Motion Picture Industry Health Plan (These claims now processed by Anthem BC of CA) (MPI01) Not needed Not supported
MPM04 El Proyecto Del Barrio IPA (MPM04) Not needed Not supported
MPM05 Global Care Med Grp IPA (MPM05) Not needed Not supported
MPM06 Healthcare LA IPA (MPM06) Not needed Not supported
MPM07 Mission Community IPA Med Grp (MPM07) Not needed Not supported
MPM08 Riverside Family Health Med Grp IPA (MPM08) Not needed Not supported
MPM09 Watts Healthcare Corp IPA (MPM09) Not needed Not supported
MPM10 Bella Vista Med Grp IPA (MPM10) Not needed ---
MPM15 United Physicians International IPA (MPM15) Not needed Not supported
MPM18 Medi-Cal by MedPoint (MPM18) Not needed Not supported
MPMG1 Mills Penisula Medical Group (MPMG1) Not needed Not supported
MRCHP Caresource Health Plan of Oregon (MRCHP) Not needed Not supported
MRIPA MD Rogue Oregon Health Plan (MRIPA) Not needed Not supported
MSMCD Medicaid of Mississippi (MSMCD) --- ---
MSO11 San Diego County Medical Services (CMS) (MSO11) Not needed Not supported
MSO22 San Diego County Physician Emergency Services (MSO22) Not needed Not supported
MSO33 San Diego County Ryan White Primary Care Program (MSO33) Not needed Not supported
MSO44 San Diego County Primary Care Services (MSO44) Not needed Not supported
MTNST Mountain States Administrators (COLORADO ONLY) (MTNST) Not needed Not supported
MUTOM Mutual of Omaha (MUTOM) Not needed ---
MWMCR Medicare Part B of Western Missouri (MWMCR) --- Not supported
MWP01 JPS Preferred Care (MWP01) Not needed Not supported
MWSHN MDWise Select Health Network (MWSHN) Not needed Not supported
N6BLS Blue Choice of Rochester NY (N6BLS) Not needed ---
NACDM CENTRAL DUPAGE MEDICAL GROUP (NACDM) Not needed Not supported
NAELM Elmcare (NAELM) Not needed Not supported
NAHLX Holy Cross Health Partners (NAHLX) Not needed Not supported
NAHOI Health Options of Illinois (NAHOI) Not needed Not supported
NAING Ingalls Provider Group (NAING) Not needed Not supported
NANPR NAMM Partners (NANPR) Not needed ---
NANWC Northwest Community Health Partners (PID only for DOS prior to 1/1/2013. DOS 1/1/2013 and after send to 35199) (NANWC) Not needed Not supported
NAOAK Oak West Primary Physician Association (NAOAK) Not needed Not supported
NAPCP PRIMARY CARE PARTNERS (NAPCP) Not needed Not supported
NASCO National Accounts (NASCO) (NASCO) Not needed ---
NASCR Silver Cross Managed Care Organization (NASCR) Not needed Not supported
NASTA SAINT ANTHONY PPO (NASTA) Not needed ---
NCH04 CarePlus Cardiology - New Century Health (NCH04) Not needed Not supported
NCH08 Vista Oncology New Century Infusion Solutions (NCH08) Not needed Not supported
NCH09 New Century Health - Vista Cardiology (NCH09) Not needed Not supported
NCHON AZ Integrated Physicians (NCHON) Not needed Not supported
NCHOR New Century Health Arizona Integrated Physicians (NCHOR) Not needed Not supported
NCMCD Medicaid of North Carolina (NCMCD) --- ---
NDMCD Medicaid of North Dakota (NDMCD) --- Not supported
NDMCR Medicare Part B of North Dakota (NDMCR) --- ---
NDX99 New Directions (NDX99) Not needed Not supported
NEMCD Medicaid of Nebraska (NEMCD) --- ---
NG008 Kaiser Foundation Health Plan of the Mid-Atlantic (NG008) Not needed ---
NG010 Kaiser Foundation Health Plan of Georgia (NG010) Not needed ---
NHAIN National Health Administrators Inc. (NHAIN) Not needed Not supported
NHC04 CAREPLUS (NHC04) Not needed ---
NIA11 National Imaging Associates (NIA11) Not needed Not supported
NJMCD Medicaid of New Jersey (NJMCD) --- ---
NMG01 Northridge Medical Group (NMG01) Not needed Not supported
NMM02 LaSalle Medical Associates (NMM02) Not needed Not supported
NMMCD Medicaid of New Mexico (NMMCD) --- ---
NMMCR Medicare Part B of New Mexico (NMMCR) --- ---
NPN11 Northwest Physicians Network (NPN11) Not needed Not supported
NTA11 National Teachers Association (NTA) (NTA11) Not needed Not supported
NTWKS SIHO (NTWKS) Not needed Not supported
NVBLS Anthem of Nevada (NVBLS) Not needed ---
NWADM Central California Electricial Workers Health and Welfare Trust (NWADM) Not needed Not supported
NWDC1 Northwest Diagnostic Clinic I Par Plus (NWDC1) Not needed Not supported
NYL11 New York Life - Long Term Care (NYL11) Not needed Not supported
NYMCD Medicaid of New York (NYMCD) --- ---
OCFMC Orange County Foundation for Medical Care (OCFMC) Not needed Not supported
OEHWF Operating Engineers Health & Welfare Fund (OEHWF) Not needed Not supported
OHMCD Medicaid of Ohio (OHMCD) Not needed ---
OHMSP Oregon Health Mgmt OHMS aka Primary Health of Josephine (OHMSP) Not needed Not supported
OKMCR Medicare Part B of Oklahoma (OKMCR) --- ---
OLRMC OLOLRMC Uninsured Patient Services Program (OLRMC) Not needed Not supported
ORMCD Medicaid of Oregon (ORMCD) --- ---
OSCAR oscar (OSCAR) Not needed Not supported
PA513 Physician Associates of Greater San Gabriel Valley (PA513) --- Not supported
PAMCD Medicaid of Pennsylvania (PAMCD) Not needed ---
PCLMP Pro-Claim Plus, Inc. (PCLMP) Not needed ---
PCN12 Physicians Care Network/The Polyclinic (PCN12) Not needed Not supported
PCU01 Point Comfort Underwriters (PCU01) Not needed Not supported
PEBLS Pennsylvania Keystone Health Plan East (encounters only) (PEBLS) --- ---
PEBSI Producer's Exchange (PEBSI) Not needed Not supported
PEPL1 People 1st Health Strategies, Inc. (PEPL1) Not needed ---
PFIPA Preferred IPA (PFIPA) Not needed Not supported
PH018 North West Life (PH018) Not needed Not supported
PHCS1 Physicians Health Choice - Claims (Administered by Wellmed) (PHCS1) Not needed Not supported
PHD01 Family Care CCO (Admin by PH Tech. Use for claims with DOS of 08/01/2012 and later.) (PHD01) Not needed Not supported
PHHMO PROGRESS HEALTH HMO (PHHMO) Not needed Not supported
PHIF4 Phifer Wire Insurance (Per request from Payer claims are printed and mailed.) (PHIF4) Not needed Not supported
PHIPA Physicians Healthways IPA (PHIPA) Not needed Not supported
PHP00 Providence Preferred (PPO) (ProviderID and Enrollment required.) (PHP00) Not needed Not supported
PHP02 Partnership Health Plan (PHP02) --- Not supported
PHP03 Providence Health Plan (PHP03) Not needed Not supported
PHPMC Correction Health Partners (PHPMC) Not needed Not supported
PHPMD Physician Health Partners Medicare (PHPMD) Not needed Not supported
PHPPPO Preferred Health Professionals PPO (PHPPPO) Not needed Not supported
PHR01 Family Care Medicare (Admin by PH Tech. Use for claims with DOS of 01/01/2013 and later.) (PHR01) Not needed Not supported
PHYCR Phycor (Ft Collins office only) (PHYCR) --- Not supported
PIH01 PIH Health (PIH01) Not needed ---
PMA86 Pima Health System (PMA86) --- Not supported
PMGSJ PMG of San Jose (PMGSJ) --- Not supported
POD1S PODIATRY FIRST (POD1S) Not needed Not supported
POD1ST PODIATRY FIRST INC (POD1ST) Not needed Not supported
PPM01 Desert Family Practice Association (PPM01) Not needed Not supported
PPNZZ Pioneer Provider Network (PPNZZ) --- ---
PREHP Presbyterian Health Plan (Commercial) (Provider ID is required. Contact (888) 923-5757 #6 then #2 to obtain ID. New Mexico Providers only.) (PREHP) Not needed Not supported
PRESA Presbyterian Salud (Please add provider number in 2010AA REF02 or 2310B REF02 Number is 11 digits or less. Contact 888-923-5757 #6 #2 to obtain ID.) (PRESA) Not needed Not supported
PRI01 PRINCETON PREMIER IPA (PRI01) Not needed Not supported
PRIME Primary Health Plan (PRIME) Not needed Not supported
PRINT Cimarron Salud (Receiver type 'D' - Claims are printed and mailed to the Payer.) (PRINT) Not needed Not supported
PROSP Prospect Medical Group (PROSP) Not needed Not supported
QCTPA QuantumCare (We Care Health Plan) (QCTPA) Not needed Not supported
RCMG1 RIVER CITY MEDICAL GROUP (RCMG1) Not needed Not supported
REGAL Regal Medical Group (REGAL) Not needed Not supported
REHNA Rehn and Associates (REHNA) Not needed Not supported
RENRB RENASSAINCE RIVEROAKS BLUE (RENRB) Not needed Not supported
RENRO RENASSAINCE-RIVER OAKS (RENRO) Not needed Not supported
RGA01 Regence Group Administrators (RGA01) Not needed Not supported
RH007 HealthSpan Integrated Care (RH007) Not needed Not supported
RHPHS Relay Health Prospective Health Services (RHPHS) Not needed ---
RICHP Blue Chip of Rhode Island (RICHP) --- ---
RIMCD Medicaid of Rhode Island (RIMCD) --- ---
RIMCR Medicare Part B of Rhode Island (RIMCR) --- ---
RLH01 LIFEMAP (RLH01) Not needed Not supported
RMWIN WINHealth Partners Medicare Plan administered by Rocky Mountain HMO (RMWIN) --- Not supported
RPAWC RAVENWOODS PHYSICIAN ASSOCIATES (RPAWC) Not needed Not supported
RPPG1 Resurrection Physician Provider Group (RPPG1) Not needed Not supported
RRWMC Medicare Railroad (MetraHealth Medicare) (RRWMC) --- ---
RVC01 Revclaims (Provides TPL benefits services for Providers. Providers must be contracted with RevClaims to submit claims. For mor info call 601-345-8500.) (RVC01) Not needed Not supported
SAM00 Samaritan Employer Group Plan (SAM00) Not needed Not supported
SAMAD Samaritan Advantage (SAMAD) Not needed Not supported
SAMBA SAMBA Health Benefit Plan (SAMBA) Not needed Not supported
SAMCP Samaritan Choice Plan (SAMCP) Not needed Not supported
SAMHK Samaritan Health Kids Connect (SAMHK) --- Not supported
SAMSE Samaritan Select (SAMSE) --- Not supported
SB613 Community Health Plan of Washington (SB613) Not needed Not supported
SB731 MS BCBS State Employees (SB731) Not needed Not supported
SBSMG Santa Barbara Select IPA Medical Group, Inc. (SBSMG) Not needed ---
SC315 Thomas Cooper (Provider must be enrolled with SC Blue Shield.) (SC315) Not needed Not supported
SC359 Sherman Choice (SC359) Not needed Not supported
SC400 SC BCBS State Employee Health Plan (SC400) Not needed ---
SC402 SC FEP Blue Cross (SC402) Not needed ---
SC886 SC BCBS Planned Administrators (SC886) Not needed ---
SCAN Scan Health (SCAN) Not needed Not supported
SCAN1 Scan CA (SCAN1) Not needed Not supported
SCH01 Schaller Anderson CHOC Health Alliance (SCH01) Not needed Not supported
SCMCR Medicare Part B of South Carolina (SCMCR) --- ---
SCMG1 Sharp Community Medical Group (SCMG1) --- Not supported
SCOK1 SelectCare of OK - Tribute (SCOK1) Not needed Not supported
SCP01 Southern Cal Physicians Managed Care Services (SCP01) Not needed Not supported
SDMCD Medicaid of South Dakota (SDMCD) --- ---
SDMCR Medicare Part B of South Dakota (SDMCR) --- ---
SFHP San Francisco Health Plan (SFHP) Not needed Not supported
SHC30 Sandhills Center (SHC30) --- Not supported
SHEBP Seton Employee Plan (SHEBP) Not needed Not supported
SHMAP Seton Map Program - Mediview (Provider ID required) (SHMAP) Not needed Not supported
SHPCH Seton CHIP (Provider ID required.) (SHPCH) Not needed Not supported
SINAI SINAI MEDICAL GROUP (SINAI) Not needed Not supported
SIPA1 SOUTHLAND IPA (SIPA1) Not needed Not supported
SISCO SISCO (SISCO) Not needed ---
SMITH Smith Administrators (SMITH) Not needed Not supported
SPOHN Christus Spohn Health Network (SPOHN) Not needed Not supported
STAR1 Seton Star (STAR1) Not needed Not supported
STJOE Mission Hospital Affiliates (STJOE) Not needed Not supported
STM01 ST THOMAS MEDICAL NTWK (GULFQUEST) (STM01) Not needed Not supported
SUMCHP Summa Care (SUMCHP) Not needed Not supported
SVIPA Seaview IPA (SVIPA) Not needed ---
SX087 Univera Health Care Plan/ChoiceCare Buffalo (SX087) --- Not supported
SX089 Preferred Care NY (SX089) --- Not supported
SX091 Univera Healthcare (SSA) (SX091) --- Not supported
SX109 Molina Healthcare Utah (SX109) Not needed ---
SX142 South Indiana Health Options - HMO (SX142) Not needed Not supported
SX158 Paramount Health (SX158) Not needed Not supported
SX159 Lovelace Medicaid (As of 8-1-13 payer will not accept MEDICAID claims with DOS on/after 7-1-13. Submit claims with DOS on/after 7-1-13 to PID 09824.) (SX159) --- Not supported
SX172 IU Medical Group Primary Care (SX172) Not needed ---
SX179 Asuris Northwest/MedAdvantage (REF*1B*Provider ID in Billing and Rendering required even when NPI is submitted.) (SX179) Not needed Not supported
SYMED Redlands IPA (Synermed) (SYMED) Not needed Not supported
TALMG Talbert Medical Group (TALMG) Not needed Not supported
TCARE Total Care of NY (TCARE) Not needed Not supported
TCHD1 TRAVIS COUNTY HOSP DISTRICT (TCHD1) Not needed Not supported
TCUSA True Choice USA (This PayerID is only valid thru 12/29/13. Any claims after that date should be sent to the PayerID on the member's ID card.) (TCUSA) Not needed Not supported
TEX01 UnitedHealthcare Community Plan / TX (formerly AmeriChoice) (TEX01) Not needed ---
TH055 Texas True Choice (This PayerID is only valid thru 12/29/13. Any claims after that date should be sent to the PayerID on the member's ID card.) (TH055) Not needed Not supported
TH095 American Family Insurance (TH095) Not needed Not supported
TH118 Fresenius Medical Care (TH118) Not needed ---
THS01 Texas HealthSpring (THS01) Not needed Not supported
TLC01 TLC Advantage in Sioux Falls (TLC01) Not needed Not supported
TLC79 Smart Data Solutions (TLC79) Not needed Not supported
TLINS Transamerica Life Ins. Co.(Specialized claims only. Call 501-277-1284 for information.) (TLINS) Not needed Not supported
TNMCD Medicaid of Tennessee (TennCare) (TNMCD) --- ---
TNMCR Medicare Part B of Tennessee (TNMCR) --- ---
TRAN1 Transwestern Insurance Administrators Inc. (TRAN1) Not needed Not supported
TRUEB Idaho True Blue (TRUEB) --- Not supported
TX1ST Texas First Health Plans (TX1ST) Not needed Not supported
TXCSM Texas Childrens Star Medicaid (Enrollment verification calls should be directed to 800-990-TCHP (8247)) (TXCSM) Not needed Not supported
TXMCD Medicaid of Texas (TXMCD) --- ---
TXMCDAC Texas Medicaid Acute Care (TXMCDAC) Not needed Not supported
TXMCDLT Texas Medicaid Long Term Care (TXMCDLT) --- Not supported
TXPLN TexanPlus North Texas Area (TXPLN) Not needed Not supported
TXPLSE TexanPlus Southeast Texas Area (TXPLSE) Not needed Not supported
U1439 Chiropractic Health Plans (Enrollment required please contact Provider Relations 801-352-7270) (NOTE that this payer accepts Chiropractic claims only.) (U1439) --- ---
UABT1 United Agriculture Benefit Trust (UABT1) Not needed Not supported
UH133 CHP/DMBA (Enrollment required please contact Provider Relations 801-352-7270)(NOTE that this payer accepts Chiropractic claims only for Choice & Select Plans.) (UH133) Not needed Not supported
UH134 CHP/EMIA (Enrollment required please contact Provider Relations 801-352-7270)(NOTE that this payer accepts Chiropractic claims only.) (UH134) Not needed Not supported
UH135 CHP/MEDICAID (Enrollment required please contact Provider Relations 801-352-7270)(NOTE that this payer accepts Chiropractic claims only.) (UH135) Not needed Not supported
UH137 CHP/UUHP (Enrollment required please contact Provider Relations 801-352-7270)(NOTE that this payer accepts Chiropractic claims only.) (UH137) Not needed Not supported
UHCRAD UHC, Radiology Precerts Only (UHCRAD) Not needed Not supported
UNINW Univera Traditional PPO (UNINW) Not needed Not supported
UNLICA United National Life Insurance Company of America (UNLICA) Not needed ---
UNTDA1 United American Insurance Company (UNTDA1) Not needed Not supported
USFHP US Family Health Plan (USFHP) (USFHP) Not needed Not supported
UTAIMS United Teacher Association Insurance Company Medicare Supplement (UTAIMS) Not needed Not supported
VACPH Valley Care Physicians (VACPH) Not needed ---
VAICE Homeland Security (ATTN: Deportation) (VAICE) Not needed Not supported
VALHLTH Pennsylvania Health Care Plan (VALHLTH) Not needed ---
VALHP1 Valley Health Plan (VALHP1) Not needed Not supported
VAMCD Medicaid of Virginia (VAMCD) Not needed ---
VAMCR Medicare Part B of Virginia (VAMCR) --- ---
VAPCCC6 VA Patient Centered Community Care Region 6 (VAPCCC6) --- Not supported
VEST1 Wisconsin Dept of Corrections (VEST1) Not needed Not supported
VHA11 Valley Health Administrators (VHA11) Not needed Not supported
VMMH1 Verity (VMMH1) Not needed Not supported
VTBLS Blue Shield of Vermont (VTBLS) Not needed Not supported
WALAI Washington State Labor and Industry (WALAI) --- Not supported
WAMCD Medicaid of Washington State (WAMCD) Not needed Not supported
WCOHP OHANA Health Plan (WCOHP) Not needed ---
WCSWK StayWell Kids (WCSWK) Not needed Not supported
WELM2 WellMed (Claims) (WELM2) Not needed Not supported
WELMD WellMed (Encounters) (WELMD) Not needed Not supported
WHAP Western Health Advantage (WHAP) Not needed ---
WID01 UnitedHealthcare Community Plan / WI (formerly AmeriChoice) (WID01) Not needed ---
WIMCD Medicaid of Wisconsin (WIMCD) Not needed ---
WITH1 Today's Health (WITH1) Not needed Not supported
WNHLT WINhealth partners (WNHLT) Not needed ---
WP481 WPPA-ProviDRs Care Network (WP481) Not needed Not supported
WVMCD Medicaid of West Virginia (WVMCD) Not needed ---
WYBLS Blue Shield of Wyoming (WYBLS) --- ---
WYMCD Medicaid of Wyoming (WYMCD) --- ---
WYMCR Medicare Part B of Wyoming (WYMCR) --- ---
WYSCH Wyoming School Boards Association Insurance Trust (WYSCH) Not needed Not supported
AKBLS Blue Shield of Alaska (AKBLS) Not needed *
AKMCR Medicare Part B of Alaska (AKMCR) 2 - 6 4 - 6
ALBLS Blue Cross Blue Shield of Alabama (ALBLS) Not needed 6 - 9
AMGRP Amerigroup (AMGRP) Not needed *
ARBLS Blue Advantage of Arkansas (ARBLS) 2 - 4 2 - 4
ARMCR Medicare Part B of Arkansas (ARMCR) 2 - 4 4 - 5
AZMCR Medicare Part B of Arizona (AZMCR) * *
BC001 Anthem Blue Cross of California (BC001) Not needed *
BCBSCNY Excellus BCBS CNY (BCBSCNY) Not needed 6 - 9
BCBSRA Excellus BCBS Rochester area (BCBSRA) Not needed 5 - 9
BS001 Blue Shield of California (BS001) Not needed 4 - 8
C2BLS Federal Employee Program (Connecticut) (C2BLS) Not needed *
C3BLS BCBS BlueCare Family Plan (Connecticut) To be used on all CT BlueCare claims with dates of service on or after 7/01/06 (C3BLS) Not needed *
CAPHP CapRock HealthPlans (CAPHP) Not needed *
CNMCR Medicare Part B of Northern California (CNMCR) 6 - 9 *
COBLS Anthem of Colorado (COBLS) Not needed *
COMCR Medicare Part B of Colorado (COMCR) 6 - 8 5 - 8
CSMCR Medicare Part B of Southern California (CSMCR) 8 - 13 8 - 9
CTBLS Blue Cross Blue Shield of Connecticut (CTBLS) Not needed *
CTMCD Medicaid of Connecticut (CTMCD) Not needed *
CTMCR Medicare Part B of Connecticut (CTMCR) * *
DEBLS Blue Shield of Delaware (DEBLS) 2 - 4 2 - 4
FLBLS Blue Cross Blue Shield of Florida (FLBLS) Not needed 2 - 4
FLMCD Medicaid of Florida (FLMCD) * 2 - 6
FLMCR Medicare Part B of Florida (FLMCR) 6 - 9 *
FOREN Tricare Overseas (837I and 837P) (FOREN) Not needed *
GABLS Blue Shield of Georgia (State Health of GA) (GABLS) Not needed *
GAMCR Medicare Part B of Georgia (GAMCR) * ---
HIBLS Blue Shield of Hawaii (HIBLS) 4 - 8 6 - 9
HIMCR Medicare Part B of American Samoa (HIMCR) --- 4 - 6
HMA01 Healthcare Management Administrators Inc. (also known as HMA servicing Western Region) (HMA01) Not needed *
IABLS Blue Shield of Iowa (IABLS) 6 - 8 6 - 9
IAMCD Medicaid of Iowa (IAMCD) * *
IAMCR Medicare Part B of Iowa (IAMCR) * *
IDBLC Blue Cross of Idaho (IDBLC) 6 - 9 *
IDBLS Blue Shield of Idaho (Per Provider Testing) (IDBLS) Not needed 6 - 9
IHP02 Intotal Health (Formerly Amerigroup of VA.) (IHP02) Not needed 8 - 9
ILBLS Blue Cross Blue Shield of Illinois (ILBLS) Not needed *
ILMCR Medicare Part B of Illinois (ILMCR) 6 - 8 *
INBLS Blue Cross Blue Shield of Indiana (INBLS) Not needed *
INMCD Medicaid of Indiana (INMCD) Not needed *
IP095 Monarch Healthcare IPA (Rendering provider ID# required on all claims.) (IP095) Not needed ---
KCBLS Blue Shield of Kansas City (KCBLS) Not needed 6 - 9
KCMCR Medicare part B of Kansas City Missouri (KCMCR) --- *
KPIC1 KPIC - Kaiser Permanente (Valid in the states of CA CO DC GA HI MD OH and OR) (KPIC1) Not needed *
KS001 Kaiser Foundation Health Plan of Southern California (KS001) Not needed *
KS003 Kaiser Foundation Health Plan of Northern California (KS003) Not needed *
KSBLS Blue Shield of Kansas (KSBLS) Not needed 2 - 4
KSMCR Medicare Part B of Kansas (KSMCR) * *
KYBLS Blue Cross Blue Shield of Kentucky (KYBLS) Not needed *
KYMCD Medicaid of Kentucky (KYMCD) 3 - 4 4 - 5
KYMCR Medicare Part B of Kentucky (KYMCR) * *
LABLS Blue Cross Blue Shield of Louisiana (LABLS) 6 - 8 6 - 9
LAMCR Medicare Part B of Louisiana (LAMCR) 2 - 4 2 - 4
LIFE1 Lifeprint (AARP MedicareComplete insured through UnitedHealthcare) (LIFE1) Not needed 6 - 9
MABLS Blue Cross Blue Shield of Massachusetts (MABLS) 6 - 9 6 - 9
MAMCR Medicare Part B of Massachusetts (MAMCR) 6 - 9 6 - 9
MCCBV CIGNA BEHAVIORAL HEALTH (MCCBV) Not needed 4 - 8
MDBLS Blue Cross Blue Shield of Maryland (MDBLS) Not needed *
MDCAL MediCal of California (MDCAL) --- *
MEBLS Blue Shield of Maine (MEBLS) Not needed *
MEMCR Medicare Part B of Maine (MEMCR) * *
MIBCN Michigan Blue Care HMO (BCN of Michigan) (MIBCN) 6 - 9 6 - 9
MIBLS Blue Shield of Michigan (MIBLS) 4 - 8 6 - 8
MIFEP Federal Employee Program (Michigan) (MIFEP) 4 - 8 4 - 8
MIMCD Medicaid of Michigan (MIMCD) * *
MIMCR Medicare Part B of Michigan (MIMCR) 6 - 8 *
MIMPB Michigan Medicare PlusBlue (MIMPB) * *
MNBLS Blue Cross Blue Shield of Minnesota (MNBLS) Not needed 2 - 4
MNMCD Medicaid of Minnesota (MNMCD) * *
MNMCR Medicare Part B of Minnesota (MNMCR) 4 - 8 *
MOBLS Blue Shield of Missouri (MOBLS) Not needed 6 - 9
MOMCR Medicare Part B of Eastern Missouri (MOMCR) --- *
MSBLS Blue Shield of Mississippi (MSBLS) 6 - 9 *
MSMCR Medicare Part B of Mississippi (MSMCR) 4 - 5 4
MTBLS Blue Shield of Montana (MTBLS) Not needed *
MTMCD Medicaid of Montana (MTMCD) Not needed *
MTMCR Medicare Part B of Montana (MTMCR) 6 - 8 *
N1BLS Blue Shield of Western New York (N1BLS) Not needed 2 - 4
N1MCR Medicare Part B of Upstate NY (N1MCR) 2 - 4 4 - 5
N5BLS Blue Shield of Northeast NY (N5BLS) Not needed 4
NCBLS Blue Cross Blue Shield of North Carolina (NCBLS) Not needed 2 - 4
NCMCR Medicare Part B of North Carolina (NCMCR) 6 - 9 *
NDBLS Blue Cross Blue Shield of North Dakota (NDBLS) --- *
NEBLS Blue Cross Blue Shield of Nebraska (NEBLS) Not needed *
NEMCR Medicare Part B of Nebraska (NEMCR) * *
NG009 Kaiser Foundation Health Plan of the NW (NG009) Not needed *
NHBLS Blue Shield of New Hampshire (NHBLS) Not needed *
NHMCD Medicaid of New Hampshire (NHMCD) 4 - 5 4
NHMCR Medicare Part B of New Hampshire (NHMCR) --- 2 - 4
NJMCR Medicare Part B of NJ (Specialty testing required) (NJMCR) 6 - 8 6 - 9
NM505 Molina Healthcare of New Mexico (NM505) Not needed *
NMBLS Blue Cross Blue Shield of New Mexico (NMBLS) Not needed *
NVMCD Medicaid of Nevada (NVMCD) 6 - 9 6 - 9
NVMCR Medicare Part B of Nevada (NVMCR) --- *
NYBLS Blue Shield of New York (Empire) (NYBLS) Not needed *
NYMCR Medicare Part B of New York (Empire) (NYMCR) 4 - 4 4
OHBLS Blue Cross Blue Shield of Ohio (OHBLS) Not needed *
OHMCR Medicare Part B of Ohio (OHMCR) * *
OKBLS Blue Shield of Oklahoma (OKBLS) Not needed *
OKMCD Medicaid of Oklahoma (OKMCD) Not needed 2 - 4
OOWPS WPS Commercial (OOWPS) * *
ORBLS Blue Cross Blue Shield of Oregon (ORBLS) Not needed 2 - 4
ORMCR Medicare Part B of Oregon (ORMCR) * *
PABLS Blue Shield of Pennsylvania (PABLS) 2 - 4 4 - 8
PAMCR Medicare of Pennsylvania (PAMCR) 2 - 4 2 - 6
PCBLS Pennsylvania Keystone Health Plan East (claims only) (PCBLS) 4 - 6 ---
PHP01 Providence Choice Option (PHP01) Not needed *
RGBLS Regence Blue Shield of Washington (RGBLS) Not needed 2 - 4
RIBLS Blue Cross Blue Shield of Rhode Island (RIBLS) Not needed *
RMHMO Rocky Mountain HMO (RMHMO) * *
SB580 CareFirst BCBS - DC National Capital Area (SB580) Not needed 4 - 8
SC922 SC BCBS Companion Health (SC922) Not needed *
SCBLS Blue Cross Blue Shield of South Carolina (SCBLS) Not needed *
SCMCD Medicaid of South Carolina (SCMCD) 4 - 5 2 - 4
SDBLS Blue Shield of South Dakota (SDBLS) 2 - 4 *
SX065 Capital District PHP (SX065) Not needed 6 - 9
SX075 AmeriHealth - New Jersey (Non-HMO Claims) (SX075) 8 - 9 6 - 8
SX083 IBC Personal Choice (SX083) --- 4 - 6
SX105 Deseret Mutual (SX105) * 6 - 8
SX106 PEHP - Utah Public Employee Health Plan (Enrollment required please contact Provider Relations 800-765-7347) (SX106) 4 - 8 4 - 8
SX110 Educators Mutual (EMIA) (SX110) 6 - 9 *
SX155 University of Utah Health Plans (SX155) 6 - 8 3 - 8
TA720 Independence Administrators (TA720) 6 - 9 6 - 9
TDDIR Tricare for Life (All Regions 1-12) (TDDIR) * 6 - 9
TNBLS Blue Cross Blue Shield of Tennessee (TNBLS) 6 - 8 *
TREST Tricare East (TREST) 6 - 9 6 - 9
TRSTH Tricare South (TRSTH) * *
TXBLS Blue Cross Blue Shield of Texas (TXBLS) Not needed *
TXMCR Medicare Part B of Texas (TXMCR) 6 - 9 6 - 8
UH107 SELECT HEALTH IHC INTERMOUNTAIN HEALTH (UH107) 4 - 8 *
UTBLS Blue Shield of Utah (UTBLS) Not needed 2 - 4
UTMCD Medicaid of Utah (UTMCD) * *
UTMCR Medicare Part B of Utah (UTMCR) 6 - 8 *
VABLS Blue Shield of Virginia (VABLS) Not needed *
VAPCCC3 VA Patient Centered Community Care Region 3 (VAPCCC3) * Not supported
VAPCCC5A VA Region 5A (VAPCCC5A) 6 - 9 Not supported
VAPCCC5B VA Region 5B (VAPCCC5B) * Not supported
VTMCD Medicaid of Vermont (VTMCD) 2 - 4 2 - 4
VTMCR Medicare Part B of Vermont (VTMCR) 2 - 4 *
WABLC Washington State Premera Blue Cross (WABLC) Not needed 6 - 9
WAMCR Medicare Part B of Washington (WAMCR) 6 - 9 *
WIBLS Blue Shield of Wisconsin (WIBLS) Not needed *
WIMCR Medicare Part B of Wisconsin (WIMCR) * *
WVBLS Blue Shield of West Virginia (WVBLS) 6 - 8 6 - 8
WVMCR Medicare Part B of West Virginia (WVMCR) * *

Additional resources:

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