Saturday, November 29, 2008

Seeing your Medical Office through the eyes of your patients

After a few years of running a medical business doctors find themselves in a rut. I suggest taking a few minutes out on a slow day to look at your business from a new perspective. Take a pad of paper and pen and begin by starting from the parking lot.

Take in a few breathes, close your eyes and when you open your eyes look at things like a new patient might see them. Study your surroundings, scrutinize what you see and see how patients might feel when they see the same things.

Starting from the parking lot does your building have any curve appeal?
- repaint the building
- add flowers or trees
- add art
- new doors
- well lit outside if you work in the evenings

Walking into the building
- how does it smell
- does the place need new tile, paint, carpet cleaning

Restrooms
- Is it clean
- Is it functional

Opening Doors to your office
- What does it smell like
- What does it look like
- What does the front office desks look like
- Is their enough seating room

Front Office
- Do girls eat lunch at desks
- How do they answer the phones
- Is everyone well groomed
- Is everyone smiling to greet the patient
- Do they call the patient by their first name
- Are they pleasant when collecting the co-payment and outstanding balances

Walking down the hall to doctors office
- How are the carpets or tile
- Is everything dusty
- Is everything sanitized
- Are their scuffs on the walls (does it need to be repainted?)

Doctor Bedside Manners
- Is the doctor exercising and keeping fit
- Breathe check
- Clothing attire (over-dressed, under-dressed or just right?)
- Hand shake
- Eye Contact
- Understanding when to nod the head and when not to
- Listening skills

Doctors Office
- Office Equipment well maintained, no rips, no holes, no stains
- Chairs for patent's family
- Reading Materials
- Any smells

Taking this small 30 minute test every few years will help you identify if the building is looking drab, if the office is getting lazy in it's neatness and if their are areas that can be improved on. Fix the issues that you can now and make a list of things that you want to change over the next few months. I have learned that it's the simple things that can have the biggest impact on retaining patients for the next 50 years.

To view over 250 articles on Medical Billing and Coding information please check out Medical Billing and Coding Articles

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Running a Successful Medical Practice

Doctors go to College to learn how to be a doctor not on how to run a profitable Medical Practice Business. For every doctor you hear about that is making 6 figure salaries each month their are 50 other providers just trying to stay afloat.

Most doctors think they need to treat more patients a day to make more money but usually when you look at the aging reports you soon see it's not about treating more patients it's about collecting on the patients already treated.

Ask yourself these questions:

~Are you billing for ALL services you treated the patient for?
~Are charges getting entered and billed the same day as treatment?
~Are charts sitting around in different locations of your office waiting on forms to be completed?
~Is your billing department educated with your allowable fee schedules so they know they are collecting 100% of what is owed to you by procedure code? Are they going after the insurance carrier for claims that were underpaid?
~Are charges getting adjusted off just because the insurance carrier denies them?
~Does anyone work claims denied for timely filing, invalid procedure codes, invalid diagnosis codes, missing information, invalid modifiers, missing paperwork etc?
~Are patient balances getting adjusted off instead of being billed?
~Are medical liens being signed by attorneys and patients, workers compensation forms completed, Documentation attached to claims
~Are you sending claims electronically for all insurance carriers that you are credentialed with?
~Are you reading your EDI reports from the clearinghouse and working the denied claims?
~Are you re-billing claims that were denied or just fixing them and letting them sit in your A/R?
~Is someone checking claim status on everything that is 25+ days old?
~Are patients getting statements within the first month of treatment ensuring they will pay out almost 100% of the time?

Is it time for a change in the way you do business? Do you desire a profitable medical practice that actually helps patients? If you need help please leave a comment with your contact information and we will contact you or visit our
www.medicalbillingsoftwarepro.com for PM vendor reviews, and www.videotrainingpro.com for online training videos. You can contact us through any of these websites for assistance on bettering your medical office flow to increase your monthly profits.

Practice Management Software Reviews

Medical Clearinghouse Reviews



To read more about Medicare updates including Health Billing Insurance Information check out Medicare Medical Coding and Billing Courses

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Medical Providers find Money in sending claims Electronically

Back in the day (12+ years ago) medical claims were completed by hand or type writer. I remember putting the claim in upside down, and rolling it up so that I could add in the patients information, subscriber information and the CPT, Modifiers, ICD-9, and charge amount. It was so tedious. The doctor would treat between 8-14 patients a day and we would complete the forms and mail everything out on Friday.

About 30-45 days later (varied by insurance carrier) we would get an Explanation of Benefit back explaining if the claim was approved or denied. We used to keep a paper ledger of our patients to track any claims not paid (like I said this was 12 years ago and our doctor was old fashioned. We begged for a computer).

12 years ago it wasn't a priority to go electronic because not all insurance carriers were accepting claims electronically but now it's a NECESSITY and any doctor that is still processing paper claims is outdated and actually losing money. Let me show you what I mean:




Medical offices that are sending claims by paper have to wait until they are first received at the insurance carrier. So, if we billed claims every Friday and it took 2 days for the post office to deliver the claims + 1 day for the insurance carrier to scan the claims into their software we are now 3 days out. It takes the insurance carrier 15-25 days to process the claim and then another 3-5 days to process the check and mail everything back to the doctors office.

With good insurance carriers and if all things in the universe go right you will get your Explanation of Benefits with a check and a list of all patients that were denied along with those reason. Medical offices usually have collectors working on any past due or outstanding accounts that are 35+, 45+, 60+, 90+ and 120+ days old. Patients receive statements 35, 45, 65, 90 and sometimes over 180 days after treatment for co-payments, coinsurance and deductible balances. Mainly patients refuse to pay because they don't remember being treated, don't feel like they owe on such a old balance etc.

Doctors would have to adjust off patient balances and old insurance claims not including denials for untimely filing issues.

Now let's fast forward to the new era and how to collect your insurance carrier money faster -

1. The charges are entered the same day the patient is treated
2. Charges are scrubbed by medical coding software within minutes notifying the biller of any possible denial issues
3. If patient information is missing or incomplete the claim will not be transmitted to the insurance carrier alerting the biller of these issues
4. All claims get fixed the "same day" and billed to the clearinghouse
5. Clearinghouse scrubs the claims and send any back that do not meet the insurance carriers requirements per their contract with the insurance carrier
6. Within 24 hours those issues are fixed and the denied claims are rebilled
7. The insurance carrier sends a notification of status of claims within 72 hours indicating those that were approved vs. denied
8. Within 5 days of the patients treatment we have notification of the check # the claim will be processed towards
9. Within 10 business days from the date the insurance carrier receives the claim electronically we have an Electronic Remittance Advice along with the date the check will either be mailed to the provider or direct deposited into the providers checking account
10. Patients get a statement normally within 15-20 days of being treated and they pay almost 100% of the time because they actually remember the office visit, they remember what it was for and they realize they have a co-payment, coinsurance or deductible that is owed.

If you are a medical practice and not receiving insurance payments within 25 days of treatment for carriers like Aetna, UHC, Cigna, BCBS, Federal, Medicare, Medicaid, Medi-Cal, Humana or other insurance carriers that accept electronic claims then you need to look for a new billing service, a new Practice Management software or a new clearinghouse based on your results.
Practice Management Software Reviews
Medical Clearinghouse Reviews

1 step to increasing your monthly revenue is to take your billing electronically using a robust clearinghouse that processes eClaims, secondary claims electronically and Electronic Remittance Advice. For more information on how a clearinghouse can help your medical office please check out:

How to read EDI clearinghouse reports

Clearinghouse EDI Reports

Clearinghouse Online Claim Status EDI Reports

Confused by Electronic Medical Claim Billing click here for additional articles on this subject and so much more: electronic medical claim billing

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Move away from handwriting EDI Agreements

More and more insurance carriers are getting away from handwriting and requiring EDI agreements for clearinghouses get completed electronically. Either type writing them (does anyone own a typewriter any more???) or by electronically completing the forms.

RelayHealth offers a online Collaboration Compass to complete EDI Agreements electronically. For medical offices that use clearinghouses it's wise to use the Clearinghouses software to complete all EDI agreements for electronic claims and electronic remittance advice to prevent any kick outs from insurance carriers.

The following list of insurance carriers are requiring electronic completion of forms and will no longer accept handwriting (except where the providers signature is required)

CPID 1455 Alaska Medicare
CPID 1456 Arizona Medicare
CPID 1459 Oregon Medicare
CPID 1462 Washington Medicare
CPID 1469 Iowa Medicaid
CPID 1523 North Dakota Medicare
CPID 1527 Utah Medicare
CPID 2411 North Dakota Blue Shield
CPID 2453 North Dakota Medicare
CPID 2454 South Dakota Medicare
CPID 2458 Utah Medicare
CPID 2466 Wyoming Medicare
CPID 2571 Iowa Medicaid
CPID 3521 Minnesota Medicare
CPID 3583 Wyoming Medicare
CPID 3584 Wyoming Blue Cross
CPID 5515 Oregon Medicare
CPID 5521 Washington/Alaska Medicare
CPID 5546 Arizona Medicare
CPID 5581 Idaho Medicare
CPID 5589 South Dakota Medicare
CPID 7400 Montana Medicare
CPID 7489 Wyoming Blue Shield

For more information on EDI's:
How to read EDI clearinghouse reports
Clearinghouse EDI Reports
Clearinghouse Online Claim Status EDI Reports
Practice Management Software Reviews
Medical Clearinghouse Reviews


Interested in Medical Billing and Coding read more articles on Medical Coding and Billing Courses

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RelayHealth offers direct connection with Kaiser Mid Atlantic

Starting November 19th 2008 RelayHealth is offering a direct connection to bill electornic claims and Remittance to Kaiser mid Atlantic for Professional (CMS-1500) and Institutional (UB-04) claims.

This is an exciting new direct connction for medical offices that use RelayHealth/McKesson as their clearinghouse.

The CPIDs included in this new connection are:
CPID 2819 Kaiser Mid Atlantic / Professional (CMS-1500)
CPID 7506 Kaiser Mid Atlantic /Institutional (UB-04)

You will not need to complete EDI Agreements (YEAH) for these direct connections either just enter the CPID# in the correct place for your PM vendor or Clearinghouse and transmit immediately.

The following payor reports will be available:
Unsolicited 277U
RelayHealth Standardized Payor reports for the above payors) will be available as soon as possible after November 20, 2008.

The following payor edits will be required by Kaiser Mid Atlantic:
Edit 01 version 0098 ? IN LOOP 2010BA, NM109 CAN NOT BE MORE THAN 10 CHARACTERS.
Edit HU version 0019 - IN LOOP 2010AA, NM108 MUST BE SENT AND MUST BE EQUAL TO 'XX'
Edit HU version 0020 - WHENI LOOP 2010AB IS SENT, NM108 MUST BE SENT AND MUST BE EQUAL TO 'XX'
Edit HU version 0022 - IN LOOP 2310B(PROF)/2310C(INST), NM108 MUST BE SENT AND MUST BE EQUAL TO 'XX'

If you have questions on EDI Reports please check out these earlier Blogs:
How to read EDI clearinghouse reports

Clearinghouse EDI Reports

Clearinghouse Online Claim Status EDI Reports

Or to read more about Medicare updates including Health Billing Insurance Information check out Medicare Medical Coding and Billing Courses

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Oregon Medicaid transferring to a new MMIS system

The replacement of Medicaid Management Information System (MMIS) is going live December 9th 2008. This new change will have an effect on how claims are submitted and how doctors are paid on medical claims. They have also added additional tools to speed things up and make it easier on all parties (medical offices, billing services, clearinghouses etc).

For clients that use RelayHealth as your clearinghouse to submit claims electronically to CPID#s 1481 & 5517 for Oregon Medicaid please be aware of these new updates:

  • RelayHealth is submitting the last electronic file to Oregon Medicaids current sysetm up to November 28th 2008
  • Claims will be held by RelayHealth if submitted between November 28th - December 8th 2008
  • On December 9th 2008 RelayHealth will send their first file to the NEW Oregon Medicaid MMIS claim processing system

Providers already approved with EDI Agreements thankfully do not need to re-register; however any new providers do require completed EDI Agreements in order to transmit claims electronically.

Providers that want to be setup with Electronic Remittance Advice (ERA) are required to complete a EDI Agreement for eRemittance. Anyone currently setup with ERA through RelayHealth will not be required to re-credential for this feature.

Please take a few minutes to register with MMIS training which is available online and can be found by visiting www.oregon.gov/DHS/mmis/training-info.shtml

A web-based provider eCourse is available through the DHS learning Center (select course C00818)

My recommendations is to watch claims closely for the first month. With anything this major in changing software be ready for Bugs. Be patient but also be ready to drop claims to paper if their are any issues with electronic claims files.

Another idea is to hold on to all claims from November 28th - December 15th and then submit. This will give both parties (RelayHealth and MMIS) to identify any bugs and fix them. This also means you won't have your claims involved with any mishaps.

If they do have problems with transmissions do not be afraid to press the Rebill button.

Happy Billing and Collecting!

Confused by Electronic Medical Claim billing then read these articles on Billing Health Insurance medical claims

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You can bill Texas First Health Plan through RelayHealth now

All of my Texas clients need to be aware of the opportunity to bill electronic claims through RelayHealth to Texas First Health Plan starting immediately.

RelayHealth uses CPID# 4766 to transmit electronic claims to Texas First Health Plan. If you currently bill any medical claims to Texas First Health Plan by paper and use Clearinghouse RelayHealth please set up your Practice Management Vendor software or Clearinghouse Software to accept CPID#4766 and begin transmitting electronic claims immediately.

Questions on Electronic Claim Billing for Medical Health Insurance Carriers then click here for additional informationOnline Health Insurance Medical Billing



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Saturday, November 15, 2008

New Jersey Medicare transitioning to Highmark Medicare Services November 14

Payor agreements are required for electronic claims to CPID# 1465 New Jersey Medicare as they switch contractors.

Providers already approved to submit claims through RelayHealth are not required to complete an agreement.

New providers are required to complete an agreement.

Original Notification Sent on November 11, 2008: RelayHealth will be converting CPID 1465 New Jersey Medicare from National Government Services (NGS) to Highmark Medicare Services effective November 14, 2008.

Special requirements:
RelayHealth will be converting the existing Contractor ID 00805 to the new J12 Contractor ID 12402 on November 14, 2008.
Highmark Medicare Services will observes system dark days November 15, 2008 through November 17, 2008.


  1. There will be no access to the MCS processing system, claim entry or claim corrections, and verify beneficiary eligibility and claim status as well as limited EDI processing.
  2. Claims sent to Highmark Medicare Services between 4:00 PM on Friday November 15, 2008 and 4:00 PM on Monday November 17, 2008 will process on Monday night November 17, 2008. EDI report and ERA files will be available Tuesday November 18, 2008.
  3. First payment cycle will take place on Monday night November 17, 2008. Checks and EFTs created will be dated November 18, 2008.
  4. Customer Contact Center and IVR availability will not be available until Tuesday, November 18, 2008.

RelayHealth has identified the following items for you to be aware of with this change:

  • Payor agreements are not required for electronic claims.
  • Payor agreements are required for electronic remittance.

*Providers already approved to receive remittance through RelayHealth are not required to complete an agreement.
*New providers are required to complete an agreement.

  • The following payor reports will be available
    *Batch Detail Control Listing
    *Provider Summary Report & RelayHealth Standardized Payor reports for the above payor will be available as soon as possible after November 18, 2008



Additional Medical Billing and Codingquestions are answered here: Online Medical Coding and Billing Courses


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New York Empire Medicare System Issue on October 6-9th 2008

CPID 4442 New York Empire Medicare experienced a system issue from October 6, 2008 through October 9, 2008. RelayHealth has been working with the payor to receive the BATCH DETAIL CONTROL LISTING REPORT for files sent on October 7, 2008 and October 9, 2008. The payor attempted to reprocess the files which resulted in submitters receiving the HDIG CLAIMS CONFIRMATION REPORT with the following error message:

DUPLICATE FILE FOUND - FILE NOT PROCESSED.

RelayHealth is working with the payor to determine if all of the claims did process and to receive the complete reports. RelayHealth will send an update when the complete reports have been received.



To read more about Medicare updates including Health Billing Insurance Information check out Medicare Medical Coding and Billing Courses


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CPID# 3206 Healthcomp Inc will not be rerouted on Nov 19th 2008

Update: CPID 3206 Healthcomp Inc. will not be rerouting on November 19, 2008.

Original Notification Sent on November 7, 2008:RelayHealth will change the electronic claims routing for the following payors as of November 19, 2008.

CPID(s) included in this routing change:
CPID 3276 AAG Benefit Plan Administrators, Inc. - Payor ID 75240
CPID 3869 American National Ins. Co. - Payor ID 74048
CPID 4269 Anchor Benefit Consulting - Payor ID 53085
CPID 3230 Automated Benefit Services - Payor ID 38259
CPID 2409 Benefit Source, Inc. - Payor ID 38257
CPID 1830 Brokerage Concepts - Payor ID 51037
CPID 3250 Butler Benefits - Payor ID 42150
CPID 3820 Community Health Alliance - Payor ID 35193
CPID 3268 Employer Plan Services - Payor ID 74212
CPID 3850 Formax, Inc. - Payor ID 87066
CPID 3206 Healthcomp Inc. - Payor ID 85729
CPID 8435 Kempton Group Administrators - Payor ID 73100
CPID 3271 MedCom - Payor ID 59231
CPID 3229 Midland Management/MFC - Payor ID 23550
CPID 5481 PPO Plus, LLC - Payor ID 72148
CPID 3467 Smith Administrator - Payor ID 02057
CPID 1758 UMWA Health - Payor ID 52180
CPID 2241 US Benefits - Payor ID 93092
CPID 3465 William C. Earhart - Payor ID 93050

RelayHealth has identified the following items to be aware of with this change:
Payor agreements are not required for electronic claims.
The following payor reports will be available:
Initial Response Report
RelayHealth Standardized Payor Reports


Interested in additional Online Medical Billing and Coding articles? Then check out Billing and Coding Online Courses

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SCCIPA has a website for Online Claim Status

For clients who use SCCIPA (Santa Clara County Individual Practice Assn) insurance in California they do offer a website service to check online claim status. Affinity Medical Group users can also log in to view claims for themselves also.

Please visit ppmsi.com and click on Access Express Login
Select if you want SCCIPA or Affinity
Click the Go button

If you are currently not registered click the Click Here to register for a Password or request more information.

The website is easy to use and very friendly to navigate through. In fact working claim status is a breeze and checking patient eligibility is a simplified process. No more phone calls necessary do all of your work from the website.

The website also offers a function allowing you to upload "batches" of PIF (Print Image Files) claims to their website. Within 24 hours they will indicate on the website if the whole batch was accepted or if a claim was denied for any reason. This is so much better than having to mail them paper (Costs) when you can do it Free through the PIF.

Happy Billing!

Confused by Electronic Medical Claim billing then read these articles on Billing Health Insurance medical claims

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November 14th you can begin billing Indiana University Medical Group Electronically

If you use RelayHealth as your electronic claims processing Clearinghouse you will be happy to know that you can now begin billing claims to Indiana University Medical Group for both Professional and Institutional claims.

Starting on November 14th 2008 you can bill electronically once your EDI Agreements have been approved for processing. Indiana University Medical Group supplies the 277U and standardized Payor reports.

Please use CPID# 4481 to bill the Professional claims (CMS-1500) to Indiana University Medical Group (IUMG) and CPID# 4976 to bill Institutional Claims (UB-04) to Indiana University Medical Group (IUMG).

For more course information on Medical Billing check out Online Medical Coding and Billing Courses

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Insurance Carrier EDI Reports Missing in November

Between September 15 – November 11th not the insurance carrier’s entire front end rejects were wrote out to reports being returned to RelayHealth and then passed along to the customer. These rejects would include validation edits for syntax, structure, validation for correct format of dates, Federal Tax IDs, UPINs and correct qualifiers used. On November 14th RelayHealth received bulk reports which were forwarded on to their customer base.

Please be aware of the following insurance carriers that had these reporting issues and verify all claims are accounted for and online with the insurance carrier if not already processed and paid out:

They are listed by Payor Name, RelayHealth’s CPID#, phone number or contact information if any and the Payor ID # which is the 5 digit electronic number on the back of the insurance card.

AAG Benefit Plan Administrators,Inc.
3276
Refer to Member's ID card
75240
A and I Benefit Plan Administrators
3296
Refer to Member's ID card
93044
ABAS, Inc.
2842
(630) 416-1111
37225
ABC Health Plan of New York
3710
(631) 360-3102
48185
Abrazo Advantage Health Plan
2750
(602) 824-3747
E3510
Acclaim
5430
(601) 791-2970
64071
Acclaim Repricing
3813
Refer to Member's ID card
21356
ACS Benefit Services, Inc.
1843
(336) 759-2013
72467
Administrative Concepts, Inc.
3228
Refer to Member's ID card
22384
Advantra
7405
Refer to Member's ID card
25141
Advantra Freedom
3218
Refer to Member's ID card
25152
Advantra/Health America, Inc./Health Assurance
1797
Refer to Member's ID card
25126
Affinity Health Plan
2247
Refer to Member's ID card
13334
AFTRA Health Fund
3763
(212) 499-4800,
extension 274
13346
AGA
3878
Refer to Member's ID card
37280
AGIA, Inc.
3468
Refer to Member's ID card
95241
AHP - American Family
3289
Refer to Member's ID card
AHP01
Alaska Children's Services, Inc. (Group # P68)
1744
(206) 441-7574
91136
Alaska Electrical Health and Welfare Fund
2242
(907) 276-1246
92600
Alaska Laborers Construction Industry Trust (Group # F23)
1744
(206) 441-7574
91136
Alaska Pipe Trades Local 375 (Group # F24)
1744
(206) 441-7574
91136
Alaska United Food & Commercial Workers Health & Welfare Trust (Group # F45)
1744
(206) 441-7574
91136
All Savers Insurance Company
6483
(317) 290-8100
37602
Alliant Health Plans of Georgia
3793
(800) 811-4793
58234
ALICARE
5403
(212) 539-5556
13550
Allied Benefit Systems, Inc.
1759
(312) 906-8050,
extension 262
37308
Amalgamated Life
5403
(212) 539-5556
13550
AmeriBen Solutions, Inc.
3755
(800) 786-7930
75137
American Administrators Group
3276
Refer to Member's ID card
75240
American Benefit Administrative Services, Inc.
2842
(630) 416-1111
37225
American Chiropractic Network (ACN)
3784
(800) 236-9921
41161
American Chiropractic Network IPA of NY (ACNIPA)
3270
Refer to Member's ID card
41160
American Group
3862
Refer to Member's ID card
62030
American Healthcare Alliance
3895
Refer to Member's ID card
01066
American Imaging Management, Inc.
8433
(847) 559-6511
36369
American National Ins. Co. (ANICO)
3869
(806) 473-2433
74048
American Progressive
3233
Refer to Member's ID card
48055
American Republic Insurance Company
2895
(800) 640-9016
42011
American Worker Health Plan
3273
Refer to Member's ID card
37322
AmeriChoice of New Jersey (Medicaid NJ)
2806
(973) 297-5567 /
(602) 371-9235
86047
AmeriChoice of New Jersey Personal Care Plus (Medicare)
2853
(888) 362-3368
86001
AmeriChoice of New York (Medicaid NY)
2815
(212) 898-8328 /
(602) 371-9235
86048
AmeriChoice of New York Medicare Personal Care Plus (Medicare)
3748
Refer to Member's ID card
86002
AmeriChoice of Pennsylvania (Medicaid PA)
2827
(215) 523-6108 /
(602) 371-9235
86049
AmeriChoice of Pennsylvania Medicare, via Information Network Corporation (INC)
3839
(215) 832-4500
52192
AmeriChoice Pennsylvania Personal Care Plus (Medicare)
3749
Refer to Member's ID card
76003
AmeriHealth Administrators, Inc.
2893
(800) 841-5328
54763
AmeriHealth HMO - NJ and DE
2800
Refer to Member's ID card
23037
AmeriHealth Mercy Health Plan - Northern Pennsylvania
1710
(215) 937-8580
22248
Anchor Benefit Consulting
4269
Refer to Member's ID card
53085
Ancillary Benefit Systems
3811
(602) 417-2879
86062
Angeles IPA
2497
(437) 4284-1365,
extension 213
SYMED
Antares Management Solutions
2290
(440) 414-2247
34192
APA Partners
1883
(800) 833-3650
16140
Apex Benefit Services
3814
Refer to Member's ID card
34196
Arizona Physicians IPA
3432
(602) 664-5000
03432
Arkansas Best Corporation - Choice Benefits
2823
(501) 785-6178
75278
Arnett Health Plans
8457
(248) 372-3247
95440
ASR Physicians Care
4294
Refer to Member's ID card
38265
Assurant Health
6428
(414) 299-6317
39065
Asuris Northwest
4477
Refer to Member's ID card
SX179
Atlanticare Administrators
5470
Refer to Member's ID card
22304
Atlantis Health Plan
2856
(212) 747-8393
13853
Automated Benefit Services
3230
Refer to Member's ID card
38259
Automated Group Administration
3878
Refer to Member's ID card
37280
Avera Health Plans
1786
(605) 322-4500
46045
Bakersfield Family Medical Center
4241
Refer to Member's ID card
BKRFM
Banner Health Arizona
3845
Refer to Member's ID card
SX145
BCI Administrators, Inc.
2228
Refer to Member's ID card
49153
Bellflower Hospital
2497
(437) 4284-1365,
extension 213
SYMED
Benefit Administrative Systems, LLC
4287
Refer to Member's ID card
36149
Benefit Coordinators Corporation (Pittsburgh, PA)
3864
(800) 685-6100
25145
Benefit Management Systems North Carolina
3226
Refer to Member's ID card
56139
Benefit Plan Administrators Co. (Eau Claire, WI)
2882
(800) 236-7789 /
(715) 932-5535
http://www.bpaco.com
Claim Status
39081
Benefit Plan Administrators, Inc. (Roanoke, VA)
8482
(630) 428-5397
37118
Benefit Plan Management, Inc.
1889
(877) 642-7500
44273
Benefit Planners, Inc.
6472
(800) 292-5386,
extension 227
74223
Benefit Services Inc.
3291
Refer to Member's ID card
34178
Benefit Source, Inc.
2409
Refer to Member's ID card
38257
Benefit Systems and Services Inc.
8409
(708) 789-2082
36342
Berkshire Health Plan
1433
(610) 372-8044,
extension 3019
23243
Best Life & Health Insurance Co.
3269
Refer to Member's ID card
95604
Boilermakers National Health and Welfare Fund
6425
(913) 342-6555
36609
Boon-Chapman Administrators
1777
(512) 454-2681,
extension 140
74238
Bridgestone Claims Service
3893
Refer to Member's ID card
37285
Bridgeway Arizona
4288
Refer to Member's ID card
68054
Brokerage Concepts
1830
(630) 718-8128
51037
Brown and Towland Medical Group
1750
(415) 553-6512
94316
Butler Benefit
3250
Refer to Member's ID card
42150
C&O Employees' Hospital Association
2850
(518) 456-4566
23708
California Blue Cross - FEP only
1409
(800) 995-2800
94036
California Blue Shield
1409
(800) 995-2800
94036
Cannon Cochran Management Services, Inc.
3761
(800) 634-3506
37105
Cape Health Plan
5411
(313) 537-0220,
option 2
38245
Capitol Administrators
2810
(800) 331-5301
68011
Capital Blue Cross and Capital Advantage Insurance Company (CAIC)
2858
(800) 874-8433
23045
Capital Health Plan
4246
Refer to Member's ID card
95112
Care 1st Health Plan of Arizona
2289
Refer to Member's ID card
57116
CareCore National
3894
Refer to Member's ID card
14182
CareCore National, LLC - Health Net New Jersey
2268
Refer to Member's ID card
14185
CareCore National, LLC (Oxford Radiology Claims)
1727
(845) 298-8155,
extension 121
14180
CareCore National - Healthnet
3859
Refer to Member's ID card
14184
Carelink Advantra
1884
(304) 231-5015
25139
Carelink Health Plan
1884
(304) 231-5015
25139
Carelink Medicaid
3867
(800) 845-6592
25140
CareNet
2889
(302) 283-6570
25142
CareSource of Indiana
1439
(937) 531-3385
37311
CareWorks
3274
Refer to Member's ID card
10010
Cariten Healthcare
2870
(865) 374-4638
62073
Cariten Senior Health
2869
(865) 374-4638
62072
Carelink Medicaid
3867
(302) 283-6570
25140
Care Plus
2830
Refer to Member's ID card
65031
Carolina Care Plan, Inc.
2829
(800) 358-4471
57105
Carolina Crescent Health Plan
4470
Refer to Member's ID card
SX191
Carolina Summit Healthcare, Inc.
5466
(919) 875-2360,
extension 243
56195
Carpenters' Health and Welfare of St. Louis
3789
Refer to Member's ID card
25125
CBCA Administrators
3846
Refer to Member's ID card
55438
CBCA Administrators (HRM)
6459
Refer to Member's ID card
41170
CBSA
1708
(952) 593-6550
41124
CDS Group Health
4253
Refer to Member's ID card
88022
Cement Masons & Plasterers Health & Welfare Trust (Group # F16)
1744
(206) 441-7574
91136
Cenpatico Behavioral Health - Wisconsin

3220
(800) 225-2573,
extension 25525
68046
Cenpatico Indiana
3236
Refer to Member's ID card
68052
Centra Benefit Services
6480
(800) 344-5076
75196
Central Benefits Life
1845
Refer to Member's ID card
31118
Central Benefits Mutual
1845
Refer to Member's ID card
31118
Central Benefits National
1845
Refer to Member's ID card
31118
Central Reserve Life
6489
(800) 321-9997
34097
Central States Health and Welfare Funds
6492
(800) 325-5000
36215
CHA - Commonwealth Health Alliance
5477
Refer to Member's ID card
23171
CHAMPVA - HAC
3807
(800) 733-8387
84146
Chautauqua County Healthcare Plan - Mayville, NY
2231
Refer to Member's ID card
16600
Chesapeake Life Insurance Company
3713
(800) 733-8880
59223
Chesapeake Life Insurance Company - Student Insurance
6465
(800) 767-0700
74227
Children of Women of Vietnam Veterans - VA HAC
3807
(800) 733-8387
84146
Chinese Community Health Plan
3473
(415) 955-8800,
extension 3247
94302
CHOC - Childrens Hospital of Orange County Health
3265
Refer to Member's ID card
33065
Choicenet
3288
Refer to Member's ID card
CHCNT
CIGNA Healthcare for Seniors
5436
Refer to member's ID card
86033
City of Odessa (The)
3245
Refer to Member's ID card
75600
Claim Management Services (CMS)
2749
Refer to Member's ID card
39141
ClaimsWare, Inc. dba ManageMed
1725
Refer to Member's ID card
57080
Clear Choice Health Plan
3876
(877) 862-8644
77201
Colorado Access
2431
Refer to Member's ID card
84129
Columbia Cornell Care, LLC
1787
(212) 588-7342
25351
Commerce Benefits Group
3759
(800) 223-9941
34181
Commonwealth Administrator, LLC
3700
(859) 226-1559
37237
Commonwealth Care Alliance
3437
Refer to Member's ID card
14315
Community Care Behavioral Health Organization
5455
(412) 454-2129
25179
Community Care BHO
4248
Refer to Member's ID card
23282
Community Care Managed Health Care Plans of OK
1874
(918) 594-5295,
extension 4040
73143
Community Care Organization
2232
Refer to Member's ID card
39126
Community Family Care
2497
(437) 4284-1365,
extension 213
SYMED
Community Health Alliance
3820
Refer to Member's ID card
35193
Community Health Choice
3773
Refer to Member's ID card
48145
Community Health Electronic Claims /CHEC/webTPA
1706
(817) 633-9205
75261
Community Preferred Health Plan
5402
(715) 841-7399
39026
Community Premier Plus for Neighborhood Health Providers
3753
(631) 360-3102
32481
CompBenefits Corporation
2243
(800) 393-2873
37297
Comprehensive Behavioral Care
3462
Refer to Member's ID card
59314
Comprehensive Benefits Administrators, Inc.
3737
(800) 525-8788,
extension 8039
03036
Comprehensive Care Management Corporation
4250
Refer to Member's ID card
CCMC1
Consociate Group
3742
(800) 798-2422
37135
Consolidated Associates Railroad
2233
Refer to Member's ID card
75284
Continental General Insurance
3865
Refer to Member's ID card
71404
Cooperative Benefit Administrators (CBA)
6452
(402) 483-9200
52132
Cook Children's Health Plan
4751
Refer to Member's ID card
CCHP1
Cook Children's Star Plan
4752
Refer to Member's ID card
CCHP9
Coordinated Medical Specialists
1892
(877) 474-1713
58204
Core Administrative Services
3856
Refer to Member's ID card
58231
CoreSource AZ MN
6435
(612) 372-5466
41045
CoreSource Little Rock
3806
(972) 980-0900
75136
CoreSource of NC
1885
(704) 551-0500
35180
CoreSource Ohio
3254
Refer to Member's ID card
35183
CoreSource PA MD IL
3791
(717) 295-9201,
extension 343
35182
Corporate Benefit Services of America
1708
(952) 593-6550
41124
Corporate Benefits Services
3832
(800) 277-9476
56116
Corporate Systems Administration
3750
(423) 282-3420
37246
Correctional Medical Services, Inc.
2831
(314) 919-9817
43160
Cottage Health System
3791
Refer to Member's ID card
35182
Country Life Insurance Company
1711
(309) 821-3412
62553
Covenant Administrators, Inc. (Atlanta, GA)
3828
(800) 680-8728
58102
Coventry Diamond Plan
2474
Refer to Member's ID card
25131
Coventry Health and Life (Oklahoma)
1837
(800) 468-1442
25133
Coventry Health Care National Network
7490
(801) 954-4831
87043
Coventry Health Care of Delaware, Inc.
1813
(800) 833-7423
25130
Coventry Health Care of Georgia, Inc.
1733
(404) 526-6107
25127
Coventry Health Care of Iowa, Inc.
1836
(800) 470-6352
25132
Coventry Health Care of Kansas, Inc. - Kansas City
1837
(800) 468-1442
25133
Coventry Health Care of Louisiana, Inc.
1839
(800) 245-8327
25135
Coventry Health Care of Nebraska, Inc.
1840
(800) 471-0240
25136
Coventry Health Care of the Carolinas, Inc. / Wellpath
1762
(800) 845-6592
25129
Creative Medical Systems
5474
Refer to Member's ID card
64068
Croy-Hall Management Inc.
3244
Refer to Member's ID card
37266
CWIBENEFITS, Inc.
1725
Refer to Member's ID card
57080
Definity Services
3797
(716) 319-5129
64159
Denver Health and Hospital Authority
2433
Refer to Member's ID card
84133
Department of Labor
4754
Refer to Member's ID card
77044
Dermatology Network Solutions, Health Options
2434
Refer to Member's ID card
DNS22
Dermatology Network Solutions, LLC Blue Cross Blue Shield
2797
Refer to Member's ID card
DNS22
Dermatology Network Solutions, LLC Humana
2796
Refer to Member's ID card
DNS77
Destiny Health
3882
Refer to Member's ID card
36436
Detroit Medical Center
2406
Refer to Member's ID card
56240
Doctors Hospital of Montclair (San Bernadino
2497
(437) 4284-1365,
extension 213
SYMED
Directors Guild of America
3881
(323) 866-2200
23706
Diversified Administration
6481
(888) 498-6664
06102
Driscoll Childrens Health Plan
3234
Refer to Member's ID card
74284
Dunn & Associates
2293
(812) 378-9960
35186
E3 Health
1857
(972) 687-1805
75232
East Bay Medical Network
1809
(510) 627-4763
94318
Eau Claire Health Protection Plan
5402
(715) 841-7399
39026
Eau Claire Providers Choice
5402
(715) 841-7399
39026
Elder Health HMO of Pennsylvania
3839
Refer to Member's ID card
52192
Elder Health Maryland HMO, Inc.
3839
Refer to Member's ID card
52192
ElderPlan, Inc.
1853
Refer to Member's ID card
31625
Elmco
1498
Refer to Member's ID card
37253
El Paso First Chip
4289
Refer to Member's ID card
TH090
Employee Benefit Concepts (Farmington Hills, MI)
3705
(248) 855-8040
38241
Employee Benefit Management Corporation (EBMC)
3207
(877) 304-0761
31074
Employee Benefit Management Services (EBMS)
5483
Refer to Member's ID card
SX182
Employee Benefit Plan Administrations, Inc. (E.B.P.A.)
3737
(800) 525-8788,
extension 8039
03036
Employee Benefit Services
2836
(630) 718-8230
37216
Employee Plans, LLC
1834
(219) 436-1616,
option 2
35112
Employer Plan Services
3268
Refer to Member's ID card
74212
Employers Coalition on Health
4277
Refer to Member's ID card
27008
Employers Direct Health - FI
3241
Refer to Member's ID card
75235
Employers Direct Health - SF
2218
Refer to Member's ID card
75233
Employers Insurance of Wausau
5402
(715) 841-7399
39026
Employers Life Insurance Corporation
3884
Refer to Member's ID card
37249
Employers Mutual, Inc. (FL)
1716
(800) 697-2235
59298
Encircle PPO
2825
(888) 446-5844
35206
Encompass
1789
(630) 718-8128
37110
Encore Health Network
2825
(888) 446-5844
35206
ENH Medical Group IPA
8481
(866) 295-1403
36364
Enstar Natural Gas (Group # P61)
1744
(206) 441-7574
91136
Equitable Plan Services
3217
Refer to Member's ID card
73126
Erin Group Administrators, Inc.
5469
(717) 581-1300,
extension 224
23250
E-V Benefits Management, Inc. (Columbus, OH)
8430
(800) 321-4085
34159
Evergreen Health Plan
5418
(706) 660-6148
58233
F.A. Richard & Associates, Inc.
2211
Refer to Member's ID card
37289
FACS Group
3854
Refer to Member's ID card
37300
Family Health Partners MC + Missouri
3709
(816) 855-1843
43173
Family Medical Network
2479
(773) 572-8309
36396
FamilyCare (Medicaid HMO)
4759
Refer to Member's ID card
FCD01
FamilyCare (Medicare Advantage Plan)
4758
Refer to Member's ID card
FCR01
FARA
2211
Refer to Member's ID card
37289
FARA Benefit Services, Inc.
2211
Refer to Member's ID card
37289
FCE Benefit Administrators
3253
Refer to Member's ID card
33033
Federate Mutual Insurance
1873
Refer to Member's ID card
41041
Fidelis Secure Care
4748
Refer to Member's ID card
77054
First Carolina Care
1804
(910) 215-5268
56196
First Choice of Midwest - PPO
2256
Refer to Member's ID card
75138
First Health Network
2875
(405) 843-9551
73159
FiServe Health (Kansas and Tennessee)
1806
(615) 360-4660
62061
Florida Hospital Healthcare Systems
5414
(407) 741-4875
59321
Florida Hospital Waterman
5472
(913) 685-4740
48116
FMH Benefit Services, Inc.
5492
(913) 685-4740
48117
Formax, Inc.
3850
Refer to Member's ID card
87066
Fortis Benefits Insurance Company
1760
(800) 800-8463 or
(414) 271-3011
70408
Fortis Insurance Company
6428
(414) 299-6317
39065
Fox Everett, Inc.
5433
(601) 364-5291
64069
Fresenius
4745
Refer to Member's ID card
4745
Fringe Benefit Management
1862
(630) 428-5397
59069
Garfield Medical Center
2497
(437) 4284-1365,
extension 213
SYMED
Geisinger Health Plan
5473
(800) 447-4000
75273
Genworth Life and Health Insurance Company (GLHIC)
6419
(800) 451-2513
67815
GHI HMO - NY
1784
(914) 340-2338
25531
GI Innovative Management
1892
(877) 474-1713
58204
GIC Indemnity Plan
8473
(800) 543-4556,
extension 5661
80314
Gilsbar, Inc.
2802
(504) 898-1673
07205
Glassworkers Health & Welfare Fund (Group # F29)
1744
(206) 441-7574
91136
Golden Rule Insurance
6483
(317) 290-8100
37602
Government Employees Hospital Association (GEHA)
6467
(800) 821-6136
44054
Great Lakes Health Plan
1886
(248) 331-4348
95467
Greater La Crosse Care 65+
5402
(715) 841-7399
39026
Greater Wisconsin Rapids Provider Choice
5402
(715) 841-7399
39026
Green Bay Health Protection Plan
5402
(715) 841-7399
39026
Group Administrators LTD.
1770
(847) 519-1880,
extension 225
36338
Group Health Cooperative of South Central WI
1876
(262) 787-2705
39167
Group Health Plan (GHP) / Advantra
7405
Refer to Member's ID card
25141
Guardian Life Ins. Co. of America
6409
(414) 749-9200
64246
Gundersen Lutheran Health Plan
3833
Refer to Member's ID card
39180
Harrington Benefit Services, Inc.
6431
(800) 551-2022
95266
Harrington Benefit Services, Inc. (Oklahoma)
1751
(614) 470-7383 /
(614) 470-7427
59142
HCH Administration
1790
(630) 718-8128
37111
HCHA Albq-Self Funded
3261
Refer to Member's ID card
37329
HDPC Alliance Physicians
3471
Refer to Member's ID card
20257
Health America Inc./Health Assurance/Advantra
1797
Refer to Member's ID card
25126
Health Assurance/Health America Inc./Advantra
1797
Refer to Member's ID card
25126
Health Claim Services
3267
Refer to Member's ID card
82018
Health Cost Solutions
3805
(615) 590-1224
62111
Health First (Tyler, Texas)
1768
(972) 980-0900,
extension 218
75234
Health Future LLC
4475
Refer to Member's ID card
30946
Health Market Care Assured
4467
Refer to Member's ID card
62295
Health Net of the Northeast
4483
Refer to Member's ID card
06108
Health Net Pearl
4235
Refer to Member's ID card
SX185
Health Network America
1454
(732) 676-2637,
extension 123
20199
Health Partners - Jackson, TN
5458
(800) 825-8929
62157
Health Partners, PA
2822
(215) 991-4350
80142
Health Plan of San Joaquin
3469
Refer to Member's ID card
68035
Health Plans Inc.
1889
(800) 343-7674,
extension 140
44273
Health Plus PHSP - Brooklyn, NY
1898
Refer to Member's ID card
11324
Healthcare Group (The)
2825
(888) 446-5844
35206
Healthcare Management Administrators
1717
Refer to Member's ID card
TH049
Healthcare USA
3840
Refer to Member's ID card
25143
HealthChoice of Arizona
3232
(480) 731-3514
62179
Healthcomp Inc.
3206
(559) 499-2450,
extension 2378
85729
Healthfirst, Inc. – New York
1854
(212) 801-6078
80141
HealthGuard of Lancaster
8439
(717) 581-4569
23226
Healthhelp Networks, Inc. (HHNI)
6476
(904) 239-5709
59087
HealthLink HMO
1817
(314) 872-9643
96475
HealthLink PPO
4448
(800) 624-2680
90001
HealthPledge HMO/Plus
5435
(614) 566-0213
95435
Health Plus of Louisiana
2258
Refer to Member's ID card
95009
HealthSCOPE Benefits, Inc.
8413
(501) 225-1551
71063
HealthSource/Hudson Health Plan
6451
(914) 372-2291
13335
Healthstar, Inc.
8400
(773) 693-7827
36332
Healthways WholeHealth Networks
4740
Refer to Member's ID card
58213
H.E.R.E.I.U. Welfare Pension Plan Funds
2865
(630) 236-5262 /
(630) 428-5397 /
(630) 369-5300
(Customer Support)
37114
Heritage Consultants
2874
(863) 967-4139
59230
Heritage New York Medical Group
1723
(516) 746-2200,
extension 222
11328
High Desert Primary Care
3470
Refer to Member's ID card
33069
Hill Physicians Medical Group
2846
(800) 445-5747
00046
HIP – Health Insurance Plan of Greater New York (CareCore)
1896
(212) 630-8711
55247
HMA
4753
Refer to Member's ID card
86066
Hollywood Presbyterian
2497
(437) 4284-1365,
extension 213
SYMED
Hometown Health Plan
2839
(775) 982-3233
88023
Horizon Blue Shield of New Jersey
2414
(973) 466-7333
22099
Horizon NJ Health
1709
(215) 937-8580
22326
Hotel Employees & Restaurant Employees Health Trust (Group # F19)
1744
(206) 441-7574
91136
HPS Paradigm, Inc.
3778
(229) -387-2857
58227
Hunt Insurance Group
3478
Refer to Member's ID card
37260
I E Shaffer
3240
Refer to Member's ID card
22175
IBI
1708
(952) 593-6550
41124
ICARE, Independent Care Health
2285
Refer to Member's ID card
11695
IMCARE
3764
(800) 657-3613
41600
INDECS Corporation
3896
(201) 460-3225
40585
Independence Medical Group
4242
Refer to Member's ID card
MHM01
Indiana Health Network
2860
(317) 284-7787
35204
Indiana ProHealth Network
1754
(317) 588-7565
35161
Indiana Teamsters Health Benefits Fund (Indianapolis, IN)
2826
(440) 720-0700,
extension 222
35107
InforMed, LLC
3727
(800) 459-2110
52196
Inland Empire Health Plan
4244
Refer to Member's ID card
IEHP1
Innovative Healthware Services
2814
(877) 609-2467
04320
Insurance Administrators of America, Inc.
3237
Refer to Member's ID card
37279
Insurance Design Administrators
2871
(201) 337-0007,
extension 207
13315
Insurers Administrative Corporation
2484
Refer to Member's ID card
86304
Integra Group
1864
Refer to Member's ID card
31127
Integra Group - CHA
3860
Refer to Member's ID card
31129
Integrity Benefit Group, Inc. (The)
3712
(770) 428-1604
58200
InterCare Health Plans, Inc.
3720
(303) 770-5710
37227
InterGroup Services Corp.
5485
(800) 537-9389,
extension 103
23287
International Union of Operating Engineers Local 15
3260
Refer to Member's ID card
37269
Interwest Health - Acceptius Gateway Payor
3451
Refer to Member's ID card
84137
Iowa Benefits, Inc.
1708
(952) 593-6550
41124
Jackson Memorial Health Plan
2777
(305) 575-3680
05014
Jackson Memorial Health Plan - Medicaid
2784
(305) 575-3680
09822
John Muir Mt. Diablo Health System
2284
Refer to Member's ID card
68036
John P. Pearl & Associates
3717
(630) 718-8230
37215
JP Farley Corporation
3771
(800) 634-0173
34136
Kaiser Foundation Health Plan of Southern CA Region
1703
(213) 259-4377
94134
Kaiser Foundation - Mid-Atlantic States
2819
(301) 625-6665
52095
Kaiser Permanente Insurance Company
4293
Refer to Member's ID card
94320
Kanawha HealthCare Solutions, Inc.
2837
(800) 822-1274
57038
Kanawha Insurance Company
2837
(800) 822-1274
57038
Kempton Company
8435
(405) 521-1711
73100
Kempton Group Administrators
8435
(405) 521-1711
73100
Kern Health Systems
3803
(800) 391-2000
77039
Key Benefit Administrators, Inc.
2821
(630) 718-8230
37217
Key Health Plan
5402
(715) 841-7399
39026
Keystone Mercy Health Plan
8475
(215) 937-8580
23284
La Crosse Care Plan
5402
(715) 841-7399
39026
Lakeside Health Services
8414
(800) 637-2000,
extension 1120
95415
Landmark Insurance
3294
Refer to Member's ID card
LNDMK
Leon Medical Center Health Plan
2282
Refer to Member's ID card
37316
Life Trac
3844
Refer to Member's ID card
41136
LifeWise Healthplan of Arizona
3212
Refer to Member's ID card
91155
LifeWise Healthplan of Oregon
2854
(800) 435-2715
93093
Local 135 Health Benefits Fund (Indianapolis, IN)
2826
(440) 720-0700,
extension 222
35107
Lovelace Salud
2251
(614) 212-7383
SX159
Lumenos
3837
Refer to Member's ID card
54195
MacNeal Health Providers- CHS
2270
Refer to Member's ID card
36334
Mail Handlers Benefit Plan
6402
Refer to Member's ID card
62413
Magellan Health Services (Magellan Behavioral Health)
1419
(800) 297-7821,
extension 3799
01260
Magnacare
1704
Refer to Member's ID card
11303
Makskin Management
4462
Refer to Member's ID card
22195
Managed Care America
4421
Refer to Member's ID card
25168
Managed Care Services
1878
(219) 496-4100,
extension 64139 or
(219) 496-4137
35162
Managed Care Systems (Delango Regional Medical)
4238
Refer to Member's ID card
MCS02
Managed Health Network
1495
(615) 231-7901
22771
Manatee Service Center (Bradenton, FL)
3728
(941) 742-5700
41555
Mashantucket Pequot Tribal Nation
2818
(630) 718-8230
37121
Massachusetts Blue Shield
2424
(800) 419-4419
SB700
Mayo Management Services, Inc. (MMSI)
2752
(800) 635-6671
41154
McCreary Corporation (EMI)
2844
(561) 287-7650
59331
McLaren Health Pan
3794
(888) 327-0671
38338
MDNY Healthcare
1781
(800) 707-6369
11338
MDWise Hoosier Alliance Health Plan
3214
(317) 697-7987
20475
MedAdmin Solutions (formerly Advanced Data Solutions, Inc.)
1707
(770) 850-7480
58202
MedAdmin Solutions
1892
(877) 474-1713
58204
MedCom
3271
Refer to Member's ID card
59231
MedCost Benefit Services (MBS)
1880
(336) 774-4419
56205
MedCost, Inc.
6474
(800) 433-9178,
extension 257
56162
Medfocus
3765
(800) 398-8999,
extension 150
95321
Medica
1431
(800) 458-5512
94265
Medica Health Care Plan, Inc.
4243
Refer to Member's ID card
78857
Medical Benefits Administrators (Newark, OH)
1728
(800) 423-3151
74323
Medical Benefits Companies (Newark, OH)
1728
(800) 423-3151
74323
Medical Benefits Mutual (Newark, OH)
1728
(800) 423-3151
74323
Medical Benefits Mutual Life Insurance Company
1728
(800) 423-3151
74323
Medical Claims Service, Inc.
2811
(304) 273-5384
04258
Medical Development International
2252
(904)-473-1200
52181
Medical Mutual of Ohio
4423
(800) 362-1279
29076
Medical Resource Network
3744
(972) 447-6464
58203
Mediversal
1427
(702) 248-2542
37304
MedSolutions Inc.
1825
(800) 467-6424,
extension 1714
(Customer Service) or
(800) 467-6424,
extension 1552
(Technical Assistance)
62160
MEGA Life and Health Insurance Company - OKC
3209
Refer to Member's ID card
59227
MEGA Life and Health Insurance Company - Student Insurance
6465
(800) 767-0700
74227
MEGA Life and Health Insurance Company (The)
2894
(800) 527-2845 -
numeric Insured ID,
(800) 733-8880 - alphanumeric Insured ID
59221
MEGA Life and Health Insurance Company (The) - Starbridge StarHRG
3885
Refer to Member's ID card
59225
Memphis Managed Care
1879
(901) 725-7100,
extensions 3013, 3114, 3956
36193
Mesa Mental Health
3252
Refer to Member's ID card
85035
Metro Plus Health Plan
2296
Refer to Member's ID card
13265
Michael Reese Physicians Group
2804
(630) 428-5397
37127
Mid-Atlantic Medical Services, Inc. (MAMSI)
5406
(800) 342-6141
52148
Mid-County Physicians Medical Group (San Diego)
2497
(437) 4284-1365,
extension 213
SYMED
Midland Management / MFC
3229
Refer to Member's ID card
23550
Mid-West National Life Insurance Co. of Tennessee - Student Insurance
6465
(800) 767-0700
74227
Mid-West National Life Insurance Company of Tennessee
3714
(800) 733-8880
59224
MidSouth Administrative Group
5451
(901) 821-6723
62168
Midwest Security Administrators
7482
(800) 542-6642,
extension 797
79480
Mississippi Select Health Care
3785
(800) 847-6621
64088
Missoula County Medical Benefits Plan
3446
Refer to Member's ID card
37275
Missouri Care
1479
(800) 322-6027
43179
Mississippi Public Entity Employee Benefit Trust
3871
Refer to Member's ID card
37233
MMS, LLC
3853
Refer to Member's ID card
62178
Molina Healthcare of Utah
4237
Refer to Member's ID card
SX109
Monarch IPA
2475
Refer to Member's ID card
IP095
Montefiore CMO
2817
(718) 405-4329
13174
Motorola Inc.
8429
Refer to Member's ID card
36111
Mountain States Administrative Services (Tucson, AZ)
3810
(520) 722-0811
86040
MPE Services Inc.
3871
Refer to Member's ID card
37233
MPEEBT
3871
Refer to Member's ID card
37233
MPLAN, Inc./HealthCare Group, LLC
5479
(317) 571-6538
95444
Multicultural Primary Care Medical Group (San Diego)
2497
(437) 4284-1365,
extension 213
SYMED
Mutual Assurance Administrators
3875
Refer to Member's ID card
37256
NAA (North American Administrators, L.P.) (Nashville, TN)
3812
(800) 411-3650 /
(615) 256-3561
65085
NABN (Cleveland, OH)
8430
(800) 321-4085
34159
National Benefit Administrators - New Jersey
3768
(440) 720-0700,
extension 215
56175
National Benefit Administrators - North Carolina
3769
(440) 720-0700,
extension 222
56176
National Health Insurance Company
3868
Refer to Member's ID card
75275
National Imaging Associates
4485
Refer to Member's ID card
NIA11
National Rural Electric Coop (NRECA)
6452
(402) 483-9200
52132
National Telecommunications Cooperative Association (NCTA)
2407
Refer to Member's ID card
52103
Nationwide Health Plans
6487
(800) 626-2904
31417
NCAS - Charlotte
3874
Refer to Member's ID card
75191
NCAS - Fairfax, VA
1730
(703) 934-6297
75190
Neighborhood Health Partnership of Florida
2721
Refer to Member's ID card
96107
Neighborhood Health Plan of Rhode Island
2487
Refer to Member's ID card
05047
Nesika Health Group
3251
Refer to Member's ID card
37255
Network Health
5475
(617) 806-8121
04332
Network Health Plan of Wisconsin
1783
(920) 720-1413
39144
Nevedacare
4275
Refer to Member's ID card
869066
New Era Life Insurance Company
1477
(800) 608-8366
75281
New Jersey Carpenters Health Fund
2214
(732) 417-3900,
extension 358
22603
New Market Dimensions
3892
(800) 570-6745
65056
New West Health Plan
1812
Refer to Member's ID card
84141
New York Group Health Inc. - Commercial
2744
(212) 615-0234
13551
New York Presbyterian Community Health Plan
3711
(631) 360-3102
48186
NHP/SHP - Neighborhood Health Providers/Suffolk Health Plan
1811
(631) 360-4955,
extension 302
11325
North American Benefits Network (Cleveland, OH)
8430
(800) 321-4085
34159
North Broward Hospital District
2269
Refer to Member's ID card
37314
North Texas Healthcare Network
1746
Refer to Member's ID card
35212
Northern California Sheet Metal Workers Health Care Plan
2219
Refer to Member's ID card
38238
Northern Illinois Health Plan
2291
(815) 599-7050
36347
Northern Nevada Trust Fund
3721
(800) 423-1841,
extension 203
88027
Northridge Medical Group
3227
Refer to Member's ID card
NMG01
Northwest Suburban IPA (Illinois)
3736
(888) 747-2264 /
(815) 490-6798
36346
Nova Healthcare Administrators, Inc. (Grand Island, NY)
5486
(800) 999-5703
16644
NovaSys Health Network
3733
(501) 219-4444
71080
N.W. Ironworkers Health & Security Trust Fund (Group # F15)
1744
(206) 441-7574
91136
N.W. Roofers & Employees Health & Security Trust Fund (Group # F26)
1744
(206) 441-7574
91136
N.W. Textile Processors (Group # F14)
1744
(206) 441-7574
91136
Nyhart
3842
Refer to Member's ID card
37299
NYMI / Aetna (CareCore)
2835
Refer to Member's ID card
14179
OATH (The) - A Health Plan of Alabama, Inc.
2851
(800) 743-7141
63092
Ohio Health Choice, PPO
1860
(800) 544-0027
34189
Ohio Health Group
5435
(614) 566-0213
95435
Omnicare, A Coventry Health Plan
3872
(866) 440-3818
25150
One Call Medical
4254
Refer to Member's ID card
22321
OneNet PPO, LLC
3777
(800) 324-6141
52149
Operating Engineers Locals 302 & 612 Health & Security Fund (Group # F12)
1744
(206) 441-7574
91136
Orthonet Corporation - CIGNA
2264
(866) 874-0727
13381
Optimum Choice of the Carolinas, Inc. (OCCI)
3277
Refer to Member's ID card
52152
OSF Health Plan
2723
Refer to Member's ID card
62171
Oshkosh Area Health Protection Plan
5402
(715) 841-7399
39026
Orthonet - Aetna
2263
Refer to Member's ID card
13383
Orthonet - HealthNet
3208
Refer to Member's ID card
25681
P5 Health Plan Solutions of Utah
2217
Refer to Member's ID card
87068
Pacific Alliance Medical Group and Hospital
2497
(437) 4284-1365,
extension 213
SYMED
PacifiCare Behavioral Health
2867
(800) 716-1166
33053
PacifiCare Claims (CA, OK, OR, TX, WA)
2816
(800) 624-8822,
(Customer Service)
(714) 226-2442,
(General EDI)
(714) 226-5139,
(Technical EDI)
95959
PacifiCare Health Systems - PPO
3808
(800) 778-8887
95999
PacifiCare of Arizona
3439
(602) 350-9500
95964
PacifiCare of California (Encounters only)
2740
(714) 236-5841
95958
PacifiCare of Colorado
2428
Refer to Member's ID card
95962
PacifiCare of Oklahoma (Encounters only)
2740
(714) 236-5841
95958
PacifiCare of Oregon (Encounters only)
2741
(503) 617-3550
95958
PacifiCare of Texas (Encounters only)
2740
(714) 236-5841
95958
PacifiCare of Washington – Encounters
5468
(206) 230-7313
95958
PAI
3883
Refer to Member's ID card
37287
Paragon Benefits, Inc.
3453
Refer to Member's ID card
58174
Parity Healthcare LLC
1892
(877) 474-1713
58204
Parkland Community Health Plan
1763
(888) 672-2277 or
(214) 932-4549
66917
Passport Advantage
2446
Refer to Member's ID card
SX154
Passport Health Plan (Kentucky Medicaid Region 3)
6473
(215) 937-8580
61129
Patient Advocates
3247
Refer to Member's ID card
10525
Pennsylvania Preferred Health Network - PPHN
4746
Refer to Member's ID card
06161
People's Health Network
8455
(504) 461-4145
72126
Perfect Health
4236
Refer to Member's ID card
13522
Performax, Inc.
1708
(952) 593-6550
41124
Personal Care
3796
(314) 506-1917
25146
Phoenix Health Plans
3440
(602) 824-3720
03440
PHP Tenncare
1893
(865) 470-7563
(865) 374-4638
62155
Physicians Alliance Corporation (The) / SRRIPA
3235
Refer to Member's ID card
15749
Physician Associates of Louisiana
1892
(877) 474-1713
58204
Physician Health Association of Illinois
3770
(800) 598-3986 /
(815) 490-6797
37136
Physicians Care Network (Rockford, IL only)
2840
(815) 963-6699 /
(800) 642-2948
36345
Physicians Health Plan of Northern Indiana
3815
(800) 982-6257,
extension 549 /
(260) 969-2428
12399
Physicians Plus Insurance Corporation
5478
(972) 577-7404
39156
Piedmont Administrators
1880
(630) 718-8230
56205
Pinnacol
2798
Refer to Member's ID card
CCIA1
Pittman & Associates
3743
(630) 718-8230
37224
Planned Administrators, Inc.
3883
Refer to Member's ID card
37287
Podi Care Managed Care
1892
(877) 474-1713
58204
Podiatry First
4251
Refer to Member's ID card
PDFST
Poly America Medical & Dental Benefits Plan
2220
Refer to Member's ID card
32680
POMCO
1779
Refer to member's ID card
16111
PPOPlus LLC
5481
(806) 473-2433
72148
Practicare
1888
(770) 795-3488
04334
Prairie States Enterprises
3891
Refer to Member's ID card
36373
Preferred Benefits Administrator
2432
Refer to Member's ID card
61665
Preferred Care Partners
2240
Refer to Member's ID card
65088
Preferred Community Choice/PCCSelect/CompMed
1791
(800) 884-4776 or
(918) 594-5212
73145
Preferred Health Plan, Inc.
1807
(502) 339-7500,
extension 213
61106
Preferred Healthcare System - PPO Altoona, PA (The)
2814
(877) 609-2467
04320
Preferred Healthcare Systems Insurance Company - Kansas
3767
(800) 238-9900
60110
Preferred IPA
3225
Refer to Member's ID card
PFIPA
Preferred Network Access, Inc.
3831
(630) 493-0905
36401
Preferred Plus of Kansas
3767
(877) 609-2467
60110
Premier Health Systems, Inc.
2292
Refer to Member's ID card
90440
Presbyterian - New Mexico
2255
(505) 923-8726
05003
Presbyterian Salud
4252
Refer to Member's ID card
PRESA
Prime Vision Health
1795
Refer to Member's ID card
56190
PrimeSource Health Network PPO - Harrisburg, PA
2814
(877) 609-2467
04320
Professional Benefit Administrators, Inc. (Oak Brook, IL)
2807
(630) 655-3755,
option 1
36331
Professional Claim Administrators (ProClaim)
3708
(952) 546-0310
41163
Professional Claims Management (PCM)
2899
(330) 493-7278
37242
Puget Sound Benefits Trust (Group # F25)
1744
(206) 441-7574
91136
Puget Sound Electrical Workers Trust (Group # F33)
1744
(206) 441-7574
91136
Puget Sound Health Partners
4762
Refer to Member's ID card
42712
Pyramid Life
3233
(800) 444-0321
48055
QualCare, Inc.
1713
(800) 992-6613,
extension 5
23342
QualChoice of Arkansas
5428
(501) 228-7111,
extensions 5113 and 5052
35174
Quincy Health Care Management, Inc.
8410
(217) 222-9157,
extension 5151
37129
QVI Risk Solutions
1769
Refer to Member's ID card
57117
RBMS, LLC
3863
(806) 473-2433
91176
Redland IPA (Synermed)
2497
(437) 4284-1365,
extension 213
SYMED
ResourceOne Administrators
3257
Refer to Member's ID card
37278
RMSCO, Inc.
3272
Refer to Member's ID card
16117
Rooney Life, Inc.
6483
(317) 290-8100
37602
Saint Barnabas System Health Plan
1897
(732) 562-2834
22240
St. John's Claims Administration
3855
Refer to Member's ID card
37264
Saint Mary's Health Plan
4256
Refer to Member's ID card
88029
Saint Therese Physician Associates
1851
(630) 428-5397
37116
Sante Health System and Affiliates
2281
(559) 228-5479
77038
Scan Health Plan
4464
Refer to Member's ID card
72261
Seabury and Smith
6493
(319) 351-2667,
extension 5640
13310
Secure Health Plans of Georgia, LLC
3774
(800) 648-7563,
option 1 /
(478) 314-2437,
option 1
28530
Security Health Plan
5427
(715) 387-5983
39045
Select Benefit Administrators (Des Moines, IA)
1890
(800) 397-0427 /
(515) 223-7000
42137
Select Benefit Administrators of America
2747
Refer to Member's ID card
37282
Select Health of South Carolina
2890
(888) 394-3100
23285
SelectCare
7449
(800) 858-9060
00014
Self Funded Plans (IL, PA, OH)
6494
(216) 566-1455,
extension 116
34131
Self Insured Benefit Administrators (Clearwater, FL)
2213
Refer to Member's ID card
59111
Self Insured Plans (Naples, FL)
5471
(630) 428-5397
36404
Senior Whole Health
3443
Refer to Member's ID card
83035
Sentinel Management Services
3256
Refer to Member's ID card
23249
Shasta Administrative Services
3847
Refer to Member's ID card
75280
Sheet Metal Workers
4432
Refer to Member's ID card
TH047
Signature Care Health Network
2825
(888) 446-5847
35206
Signature Health Alliance
5497
(615) 460-7234,
extension 225
62159
Sinclair Health Plan
3886
(630) 789-2082
84076
Smith Administrators
3467
Refer to Member's ID card
02057
Southcare/Healthcare Preferred
3825
(800) 323-5000
25147
Southern California Children's Network
2497
(437) 4284-1365,
extension 213
SYMED
Southern Group Administrators
2229
Refer to Member's ID card
56131
Southern Health Systems, Inc.
1752
(412) 497-3690
25128
Southwest Service Life
3244
Refer to Member's ID card
37266
Special Risk International (SRI)
3745
(410) 321-7568,
extension 102
52190
Spina Bifida - VA HAC
3807
(800) 733-8387
84146
Star HRG
3885
Refer to Member's ID card
59225
Starmark
6401
(708) 615-1500,
extension 2135
61425
State Employees Group Benefits Program
1832
(225) 922-2856 or
(225) 925-3985
72087
State Farm Insurance Companies
5419
(309) 766-5564
31053
States General Life Insurance
5425
Refer to Member's ID card
75087
Stoner and Associates - Cincinnati, OH
2222
Refer to Member's ID card
31121
Student Insurance - MEGA Life and Health Insurance Company
6465
(800) 767-0700
74227
Student Insurance - Midwest National Life Insurance Co. of Tennessee
6465
(800) 767-0700
74227
Suffolk Health Plan of New York
2223
Refer to Member's ID card
88331
SummaCare Health Plan
1755
(330) 996-8400
95202
Sun Health Corporation
3454
Refer to Member's ID card
SX186
Superior Administrators, Inc. (Santa Ana, CA)
3760
(888) 429-9000
23218
Synermed
2497
(437) 4284-1365,
extension 213
SYMED
Tarrant Health Services
3752
(817) 740-8513
37228
Teachers Health Trust
1827
(702) 794-0272
88019
Teamcare
6492
(800) 325-5000
36215
Team Choice PPO
1822
(972) 980-0300,
extension 212
75133
Teamsters Local Union # 301
2876
(630) 789-2082,
extension 203
36612
Texas Children's Health Plan
1729
(713) 770-2422
76048
Texas Children's Health Plan (Medicaid)
2483
Refer to Member's ID card
75228
Texas Municipal League Group
6456
(512) 719-6500
74214
Third Party Administrators, Inc.
2842
(630) 416-1111
37225
Third Party Claims Management
3258
Refer to Member's ID card
06131
Time Insurance Company
6428
(414) 299-6317
39065
Todays Option
3233
Refer to Member's ID card
48055
Tooling and Manufacturing Association
6401
(708) 615-1500,
extension 2135
61425
Total Carolina Care
4272
Refer to Member's ID card
68055
Total Healthcare, Inc.
3852
Refer to Member's ID card
38201
Touchstone Health / Health Net Smart Choice
2224
Refer to Member's ID card
13402
Touchstone Health PSO
4737
Refer to Member's ID card
23856
Tower Life Insurance Company
5453
(210) 554-4565
69493
TPA Inc.
2842
(630) 416-1111
37225
TR Paul Inc.
3242
Refer to Member's ID card
37230
Trans Health Protection Plan
5402
(715) 841-7399
39026
TransAmerica Life Insurance Company
2892
(800) 527-2845
59222
Transchoice Key Benefit Administrators
3249
Refer to Member's ID card
37284
Trisurant
1847
(800) 242-8936
34185
TrustMark Insurance Company
6401
(708) 615-1500,
extension 2135
61425
UBH RIOS
2833
(763) 732-6174
16412
UICI - Administrators (State of Nevada)
6472
(800) 292-5386,
extension 227
74223
UNICARE
8473
(800) 543-4556,
extension 5661
80314
Unified Group Services
3838
Refer to Member's ID card
35198
Unified Health Services
5420
(901) 843-2667
62170
Uniform Medical Plan/Harrington Benefit Services
8404
(972) 301-8303
75243
Union Labor Life Insurance Company (The)
1426
(202) 682-0900
13142
Union Pacific Railroad Employee Health System
3724
(800) 547-0421 or
(801) 595-4300
87042
Union Security Insurance Company
1760
(800) 800-8463 or
(414) 271-3011
70408
United Healthcare (
Plans)
3429
(800) 842-1109
87726
United Heatlhcare of the River Valley (
Plans)
6442
(866) 509-1593 /
(309) 765-1593
95378
United Medical Alliance
1802
(970) 224-4600
84132
United Medical Resources
5408
Refer to Member's ID card
31107
United Mine Workers of America (UMWA)
1758
(888) 865-5290
52180
United Resources Network
3824
(763) 797-4871
41194
Universal Care - California
3836
Refer to Member's ID card
33001
Universal Health Care, Inc.
2405
Refer to Member's ID card
50528
University Family Care – Healthcare Group
2748
Refer to Member's ID card
07503
University Family Care - Maricopa Health Plan
2719
Refer to Member's ID card
09908
UPMC Health Plan - Commercial
2803
Refer to Member's ID card
23281
Upper Peninsula Health Plan
3741
(847) 887-8088
38337
US Benefits
2241
(800) 866-8318
93092
USAA (U.S. Automobile Association)
6477
(210) 456-2906
74095
USFHP - St. Vincent Catholic Medical Centers of New York
2845
(646) 230-2384
13407
Vanguard Health Systems
2497
(437) 4284-1365,
extension 213
SYMED
Vantage Health Plan
1816
(318) 361-0900
72128
Virginia Premier Health Plan
2245
Refer to Member's ID card
54176
Veteran's Administration Fee Based Programs
3887
Refer to Member's ID card
12115
VHP Community Care
2891
(800) 457-5683
23173
Vida Care
3466
Refer to Member's ID card
24818
Volusia Health Network
3239
Refer to Member's ID card
59266
Vytra Healthcare
8440
(516) 844-2640
22264
Watkins Associated Industries, Inc.
3756
(800) 333-3841
58082
Wausau Benefits, Inc.
5402
(715) 841-7399
39026
Wausau Preferred Health Plans
5402
(715) 841-7399
39026
Wells Fargo Third Party Administrators, Inc.
6410
(800) 888-5256 (FL) or (800) 888-2565
87815
Western Southern Financial Group (Cincinnati, OH)
2260
Refer to Member's ID card
37306
Western Mutual Insurance
3827
Refer to Member's ID card
37247
William C. Earhart
3465
(800) 547-1314 or
(503) 282-5581 /
info@wcearhart.com
93050
William J. Sutton & Company, LTD - Toronto, Canada
2226
Refer to Member's ID card
98010
Windsor Medicare Extra
2294
Refer to Member's ID card
62153
Winhealth
4761
Refer to Member's ID card

Worksite Benefit Services
3243
Refer to Member's ID card
20333
World Insurance Company
2849
(800) 786-7557
75276
Writers' Guild Industry Health Plan
2847
(800) 227-7863,
option 2
23710
Young Life
3248
Refer to Member's ID card
75285

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