Emerging Medical Technologies Payer Listlast Updated - Tuesday, February 14, 2006
Emerging Medical Technologies – Payer ListLast Updated - Tuesday, February 14, 2006
Medical Payer List
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Payer Name/ EMC Type
/ Payer ID
/ States
/ Phone
/ Contact
/
1199 Local Benefit Fund / 009 / 13162 / NY / 646-473-6960 / Renaud Dufresne
Located in New York, New York
ABC Health Plan of New York / 009 / 48185 / NY / 800-298-2431 / Customer Service
Located in New York New York. Unique Provider ID number required
Access Behavioral Care / 009 / COACC / CO / 800-984-9133 / Customer Service
Located in Denver, Colorado
Accident Fund / 866 / WC141 / IN, MI
WORK-COMP
Acclaim / 009 / 64071 / ALL / 662-791-2970 / Customer Service
Accountable Health Plan - Wisconsin Only / 109 / AMS01 / WI / 800-308-3344 / Customer Service
Only claims with the address of Wisconsin can be submitted electronically.
ACE/ESIS / 866 / WC231 / CA, CT, DC, DE, FL, GA, IL, MD, MT, NJ, OR, SC, TN, VA, WI
WORK COMP
Acordia National / 109 / 87815 / ALL / 800-888-2565 / Customer Service
Only claims with the City and State of Charleston, West Virgina
ACS Consulting Services, Inc. / 666 / 72467 / ALL / 336-759-2013 / Customer Service
Located in Winston-Salem, North Carolina
ACS Consulting Services, Inc. / 372 / 72468 / ALL / 336-759-2013 / Provider Relations
Located in Winston-Salem, North Carolina
Activa Benefit Services, LLC / 099 / 38254 / ALL / 877-827-1414 / Customer Service
Located in Grand Rapids, Michigan
AdminOne / 940 / 37278 / ALL / 800-967-2077 / Customer Service
Located in Rogers, Arkansas
Advantage Dental Plan / 372 / 93524 / OR / 541-677-7624 / Ken Achterfoff
Located in Roseburg, Oregon
Advantage Health Solutions / 126 / 35209 / IN / 317-573-2719 / Provider Services
Admnistrative office: Indianapolis, Indiana
Advantra GHP / 340 / 00340 / IL, MO / 800-755-3901 / Provider Services
Unique Provider# Required Claims address - PO Box 8052, London, KY
Advica - New York Community Health Plan / 009 / 13373 / NY
NO LONGER HAS ELECTRONIC CAPABILITY.
Advocate Bethany Health Partners / 009 / 6509D / IL / 847-298-6000 / Customer Service
Claims address: P.O. Box 0378 Mt Prospect, IL 60056-0378 - SEE NOTES
Advocate Christ Health Partners / 009 / 6509F / IL / 847-298-6000 / Customer Service
Claims address: P.O. Box 0379 Mt Prospect, IL 60056-0379, - SEE NOTES
Advocate Good Samaritan Health Partners / 009 / 6509C / IL / 847-298-6000 / Customer Service
Claims address: P.O. Box 0443 Mt Prospect, IL 60056-0443
Advocate Good Shepherd Health Partners / 009 / 6509G / IL / 847-298-6000 / Customer Service
Claims address: P.O. Box 0430 Mt Prospect, IL 60056-0430
Advocate Health Centers / 009 / 36320 / IL, MO / 847-298-6000 / Customer Service
Located in Mount Prospect, Illinois Claim office ID number required
Advocate Health Partners / 009 / 65093 / IL / 847-298-6000 / Customer Service
Claim office ID must contain the Payer Sub ID.
Advocate Illinois Masonic Health Partner / 009 / 6509H / IL / 847-298-6000 / Customer Service
Claim office ID must contain the Payer Sub ID.
Advocate Lutheran General Health Partners / 009 / 6509A / IL / 847-298-6000 / Customer Service
Claims address: P.O. Box 0546 Mt Prospect, IL 60056-0546 - See Notes
Aetna Health Plans / 654 / 60054 / ALL / 800-599-2435 / Customer Service
Affinity Health Plan / 666 / 13334 / NY / 866-247-5678 / Provider Relations
Located in Bronx, New York
AFL-CIO Food & Beverage Dealer's Trust Fund / 009 / 34444 / OH / 440-720-0700 ext 222 / Kathy Myers
only claims with the address: PO Box 457, Toledo, OH 43697-0457
AFTRA Health Fund / 009 / 13346 / NY / 212-499-4800 ext 274 / Deborah Jankowski
Located in New York, New York
Agency Services, Inc. / 940 / 64158 / ALL / 716-319-5483 / Christy Pidanick
Located in Amherst, New York
AH & L / 057 / 80705 / ALL / 800-537-2033 / Customer Service
One Health Plan - Kansas/Missouri
AIG / 866 / WC241 / CT, DC, DE, MD, NJ, NY
WORK-COMP
AKM Medical Group / 109 / IP080 / CA / 818-461-5554 / Fed Villaluna
IPA located in Encino, CA
Alaska Children's Services, Inc (Group # P68) / 372 / 91136 / ALL / 206-441-7574
Alaska Children's Services, Inc. / 009 / 91136 / AK, WA / 206-441-7574 / Customer Service
Group # P68 - Mailing address: PO Box 34203, Seattle, WA 98124
Alaska Children's Services, Inc. (Group #P68) / 009 / 91136 / AK, WA / 206-441-7574 / Customer Service
Group # P68 - Mailing address: PO Box 34203, Seattle, WA 98124
Alaska Laborers Construction Industry Trust / 372 / 91136 / ALL / 206-441-7574
Group # F23
Alaska Laborers Construction Industry Trust / 009 / 91136 / AK, WA / 206-441-7574 / Customer Service
Group # F23 - Mailing address: PO Box 34567, Seattle, WA 98124
Alaska Pipe Trades Local 375 ( Group # F24 / 372 / 91136 / ALL / 206-441-7574
Alaska Pipe Trades Local 375 (Group # F24) / 009 / 91136 / AK, WA / 206-441-7574 / Customer Service
Group # F24 - Mailing address PO Box 34203, Seattle, WA 98124
Alaska United Food & Commercial Workers / 372 / 91136 / ALL / 206-441-7474
Group # F45
Alicare / 009 / 13550 / ALL / 212-539-5456 / Nina Chalraborty
Located in New York, New York
Alignis / 126 / 58213 / ALL / 440-720-0700 x205 / Rebecca Karlinsky - EDI
Only claims with address: 45 Eisenhower Drive, Paramus, NJ 07652-1416.
All Savers Insurance Company / 009 / 37602 / ALL / 317-297-4187 / Client Services
Located in Lawrenceville, Illinois
Alliance Blue Cross/ Blue Shield of Missouri / 012 / 00012 / IL, MO / 800-470-9630 / Provider Services
Alliance Health Network / 666 / 25126 / PA / 814-878-1771 / Cathy Reichart
Located in Erie, PA - Effective 11/18 Payer ID 96218 was terminated.
Alliance Partners / 800 / 23172 / OH / See member id card
Claims address: PO BOX 69319; HARRISBURG, PA 17106-9319
Alliance PPO, Inc. / 109 / 52149 / DE, MD, NC, PA, VA, WV / 800-342-6141 / Customer Service
Provider ID Number required
Alliance Select - Wisconsin Only / 109 / AMS01 / ALL
Only claims with the address of Wisconsin can be submitted electronically.
Alliant Health Plans of Georgia / 126 / 58234 / AL, GA, TN / 706-629-8848 / Customer Service
Only claims for Alliant Preferred and Select
Allied Administrators / 126 / 94177 / ALL / 440-720-0700 x 222 / Kathy Myers - EDI
Only claims with address: PO Box 2500, San Francisco, CA 94126-2500
Allied Administrators / 372 / 94177 / ALL / 440-720-0700 ext 222 / Kathy Myers
Only claims with address: PO Box 2500, San Francisco, California 94126-2500
Allied Benefit Systems, Inc. / 666 / 37308 / ALL / 312-906-8050 / Ray Zroback
Claims add: 208 LaSalle St., Suite 1300, PO Boxes 909786 & 909799 in Chicago, IL
Alternative Tech Resources / 940 / 37231 / CA
Located in Saremento, California
Altius Health Plan / 666 / SX113 / UT / 801-933-3130 / Madalyn Jewkes
Located in South Jordan, Utah
Altus Dental / 372 / 50503 / ALL / 877-223-0588 / Customer Service
Located in Providence, Rhode Island
AMA Insurance Agency, Inc. / 940 / AMAIA / ALL / 800-458-5736 / Customer Service
Located in Chicago, Illinois
Amalgamated Life / 009 / 13550 / ALL / 212-539-5456 / Nina Chalraborty
Located in New York, New York
Ameriben Solutions, Inc. / 940 / 75137 / ID / 800-786-7930 / Customer Service
Claims mailing address - P O Box 7186, Boise, ID 83707
Americaid Community Care (Houston) / 109 / 27515 / TX / 800-590-5745 / Customer Service
Claims address: Po Box 62947, Virginia Beach, VA - Unique Provider ID required
American Bankers Life Assurance Company / 372 / 59067 / ALL
American Benefits Management / 126 / 34187 / ALL / 440-720-0700 ext205 / Rebecca Karlinksy
Claims address: PO Box 35008, North Canton, Ohio 44735
American Capitol Insurance Company / 940 / AMC11 / ALL / 713-974-2242 / Customer Service
Located in Houston, Texas
American Chiropractic Network (ACN) / 009 / 41161 / ALL / 800-236-9921 / Provider Services
Located in Minneapolis, Minnesota
American Chiropractic Network IPA of NY (ACNIPA) / 009 / 41160 / NY / 800-236-9921 / Provider Services
Located in Kingston, New York
American Commercial Barge Lines / 109 / 37128 / ALL / 630-718-8230 / Mandy Rak
Located in Jeffersonville, Indiana
American Community Mutual Insurance / 009 / 60305 / AR, AZ, GA, IA, IL, IN, KS, LA, MI, MO, NC, NE, OH, OK, PA, TN, SC, SD, UT, WI, WY / 734-591-4120ext4361 / Cathy Shiek
American General / 009 / 62030 / ALL / 615-749-1026 / David James
Located in Nashville, Tennessee
American Health Group / 373 / AHG99 / ALL / 800-861-5770 / Customer Service
Located in Maumee, Ohio
American Healthcare Plan Net - Wisconsin Only / 109 / AMS01 / WI
Only claims with the address of Wisconsin can be submitted electronically.
American Imaging Management, Inc. / 009 / 36369 / ALL / 847-559-6511 / David Kakon
Assigned Group Policy ID is required.
American LIFECARE / 009 / 72099 / AL, AR, FL, LA, MS, OK, TN, TX / 504-561-0600 / Customer Service
Only claims with 1100 Poydras, Suite 2600, New Orleans, LA 70163-2602 -
American Medical Security / 372 / CX001 / ALL / 800-232-5432 / Customer Service
Located in Green Bay, Wisconsin
American Medical Security, Inc. (AMS) / 009 / 81400 / ALL / 800-232-5432 X15200 / Customer Service
Located in Green Bay, Wisconsin
American National Insurance Company / 940 / 74048 / ALL / 800-899-6806 / Customer Service
Located in Galveston, Texas
American Postal Workers Union Health Plan (APWU) / 372 / 44444 / ALL / 301-622-5739 / Lynn Norris
American Postal Workers Union Health Plan (APWU) / 109 / 44444 / ALL / 301-622-5706 / Mr. Tom Backer
Located in Silver Springs, Maryland
American Republic Insurance Company / 009 / 42011 / ALL / 800-641-0366 / Customer Service
Located in Des Moines, Iowa
AmeriChoice of Florida / 726 / 87726 / FL / 866-503-1380 / Physician's Helpline
Located in Sunrise, FL
AmeriChoice of New Jersey Medicaid and Family C / 009 / 86047 / NJ / 888-336-4842 / Provider Service
Claims address: PO Box 7760, Phoenix, AZ 85011 - Provider ID required
AmeriChoice of New Jersey Medicare / 009 / 86001 / NJ / 888-362-3368 / Provider Services
Claims address: PO Box 16700, Phoenix, AZ 85011 - Provider ID required
AmeriChoice of New York Medicaid / 009 / 86048 / NY / 212-509-5999 / Provider Service
Claims address: PO Box 7720, Phoenix, Arizona 85011
AmeriChoice of New York Medicare / 009 / 86002 / NY / 888-336-4845 / Provider Relations
Claims address: PO Box 16500, Phoenix, Arizona 85011
AmeriChoice of Pennsylvania Care Plus Medicare / 009 / 86003 / PA / 800-345-3627 / Provider Service
Payer ID for claims with DOS on or before 8/1/2005 - See notes for addresses.
AmeriChoice of Pennsylvania Medicaid & KidChoic / 009 / 86049 / PA / 800-345-3627 / Customer Service
Old claims add: PO Box 16000 Phoenix, AZ new add: PO Box 659778, San Antonio TX
Amerigroup Corporation (Dallas/Ft Worth) / 109 / 27514 / TX / 800-454-3730 / Customer Service
Claims address: PO Box 61117, Virginia Beach, VA - Unique Provider ID required.
Amerigroup Florida / 109 / 27519 / FL / 800-454-3730 / Provider Inquiry Line
Claims address: PO Box 61010, Virginia Beach, VA - Unique Provider ID required
Amerigroup Illinois / 940 / 27518 / IL / 800-454-3730 / Provider Line
Claims address: PO Box 62469, Virginia Beach, VA - Unique Provider ID required.
Amerigroup Maryland / 109 / 27517 / MD / 800-454 3730 / Customer Service
Claims: PO Box 61749, Virginia Beach, VA - Requires State Medicaid Provider ID
Amerigroup New Jersey / 109 / 27516 / NJ / 800-590-5745 / Customer Service
Requires Provider's Medicaid Number or American Comm. unique ID
Amerigroup/Americaid / Fort Worth, TX / / 940 / 26375 / TX / 800-454-3730 / Provider Services
Claim address: PO Box 61117, Virginia Beach, VA - Provider ID required.
Amerigroup/Americaid / Houston / 940 / 26374 / TX / 800-454-3730 / Provider Services
Claim address: PO Box 62947, Virginia Beach, VA 23466-2947
Amerihealth Administrators, Inc. / 763 / 54763 / ALL / 800-841-5328 / Provider Relations
Located in Horsham, Pennsylvania Unique Provider ID required
Amerihealth Delaware - Non-HMO / 688 / 93688 / DE / 800-595-3627 / Customer Service
Located in Wilmington, Delware - Claims processed in Philadelphia, PA
AmeriHealth HMO New Jersey and Delaware / 504 / 95044 / DE, NJ / 800-888-8211 / Customer Service
Claims add: PO Box 41574, Philadelphia, PA Unique Provider ID number required
Amerihealth Mercy Health Plan / 009 / 22248 / PA / 800-521-6007 / Provider Service
Medicaid Managed Care
Amerihealth New Jersey - Non-HMO / 606 / 60061 / NJ / 800-595-3627 / Customer Service
Located in Iselin, New Jersey - claims processed in Philadelphia, PA
Ameritas Bankers Assurance / 372 / 72630 / ALL
Ameritas Life Insurance Corp. / 372 / 47009 / ALL
AMVI / 109 / IP080 / CA / 818-461-5554 / Fed Villaluna
IPA located in Encino, CA
Amway Corporation / 009 / 38255 / ALL / 616-787-4908 / Angie Berg
Located in Ada, MI
Anchor Benefits Consulting, Inc. / 940 / 53085 / FL / 800-845-7629 / Customer Service
Located in Maitland, Florida
Ancillary Care Management / testing / 485 / 95485 / ALL
testing
Anthem BCBS (IN, OH & KY) / 372 / 84105 / ALL / 800-828-3677 / Indiana Customer Service
Administered by HMS in Colorado Springs, Colorado
Anthem Health & Life Ins. Co. of New Jersey / 057 / 80705 / ALL / 800-537-2033 / Customer Service
APA Partners / 372 / 16140 / ALL / 800-833-3650 / Karen Matheson
Located in Latham, New York
APA Partners / 009 / 16140 / ALL / 800-833-3650 / Karen Matheson
Corporate office: 13 British Ave. Blvd, Latham, NY
APS Healthcare, Inc. / 009 / 54160 / ALL / 301-563-5718 / EDI Provider Rep.