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UHIN's Payer List

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Professional

Payer Name Payer Id Line of Business
(NCHD) Nueces County Hospital District
Christus Health Plan Medicaid
45210
Professional
(UCS) Masonry Industry Trust
60230
Professional
1199 SEIU National Benefit Fund
1199 National Benefit Fund
13162
Professional
2020 Eyecare
2020E
Professional
21st Century Insurance and Financial Services
51028
Professional
3P ADMIN
20413
Professional
6 Degrees Health Inc.
6 Degrees Health INC
20446
Professional
A & I Benefit Plan Administrators
93044
Professional
A.G. Administrators
11370
Professional
AARP Hospital Indemnity Plans insured by UHC Insurance Co
AARP Medicare Supplement Plans insured by UHC Insurance Co
36273
Professional
Abrazo Advantage Health Plan
03443
Professional
Access Administrators
AHS01
Professional
Access Behavioral Care
Colorado Access (837P & 837)
Colorado Access HMO
COACC
Professional
Access Medical Group
AMG01
Professional
Acclaim
64071
Professional
Accountable HC IPA claims w/DOS prior to 5/1/15
AHIPA
Professional
ACS Benefits Payer Compass
PA331
Professional
ActivHealthcare
AHC01
Professional
ADMINISTRATIVE CONCEP
Adminstrative Concepts
Inc.
22384
Professional
Advance Benefit Mgmt Systems USA Incorp
66457
Professional
Advantage Care IPA
ACIPA
Professional
Advantage Health Solutions Inc.
35209
Professional
Advantage Preferred Plus
35219
Professional
Advantek Benefit Administrators
Advantek Benefit Admins
83077
Professional
Advantica Benefits
59374
Professional
Advanzeon Solutions
59314
Professional
AdventHealth Advantage Plans
RP039
Professional
AdventHealth Transplant Program
AHTP01
Professional
AdventHealth Value Based Bundle Management LLC
AdventHealth Value Based Bundle Management
VBBM13
Professional
ADVENTIST HEALTH SYSTEM
95340
Professional
Advisory Health Administrators
CB159
Professional
Advocate Health Centers (AHC)
Advocate Health Centers
36320
Professional
Advocate Health Partners
Advocate Health Partners (PHO)
65093
Professional
Aegis Administrative Services
Aegis Andministrative Services
CB637
Professional
Aegis Administrative Services
Aegis Andministrative Services
BC637
Professional
Aetna Affordable Health Choices
Aetna Affordable Health Choices (SM) SRC
57604
Professional
Aetna Better Health CA
Aetna Better Health of California
128CA
Professional
Aetna Better Health IL Medicaid
Aetna Better Health Medicaid IL
26337
Professional
Aetna Better Health Nevada
128NV
Professional
Aetna Better Health NY
34734
Professional
Aetna Better Health of Illinois INC
68024
Professional
Aetna Better Health of Kansas
Aetna Better Health Kansas
128KS
Professional
Aetna Better Health of Kentucky
128KY
Professional
Aetna Better Health of Louisiana
128LA
Professional
Aetna Better Health of Maryland
128MD
Professional
Aetna Better Health of Michigan
128MI
Professional
Aetna Better Health of New Jersey
46320
Professional
Aetna Better Health of Ohio
50023
Professional
Aetna Better Health of Pennsylvania Medicaid
Aetna Better Health - PA Medicaid
23228
Professional
Aetna Better Health of Virginia
128VA
Professional
Aetna Better Health of West Virginia
Aetna Better Health West Virginia
128WV
Professional
Aetna OHIORISE
45221
Professional
Aetna
Primary Choice (Aetna HP- NY/NJ)
Magellan Behavioral Health
Select Choice
Senior Choice (Aetna HP-NY/NJ)
Aetna 60054 (Commercial only)
Aetna Health Plan - PPO
Aetna Life & Casualty Company
60054
Professional
Affiliated Doctors of Orange County
ADOCS
Professional
Affiliated Physicians IPA
POP06
Professional
Affinity Essentials
AffinityAccess
23334
Professional
Affinity Health Plan
Affinity Health Plans
13334
Professional
AFFINITY MEDICAL GROUP
46594
Professional
Affordable Benefit Administrator
Affordable Benefit Administrators
Benefit Plan Administrators
Benefit Plan Administrators of Co Eau Claire WI
Benefit Plan Administrators CO Eau Claire WI
Benefit Plan Administrator
Benefit Plan Administrators WI
39081
Professional
Affordable Benefit Administrators Inc.
95426
Professional
Agency Services Inc
Meritain Health / Agency Services
64158
Professional
Ageright Advantage
ARA01
Professional
Agewell of New York
Agewell New York
AWNY6
Professional
Agua Caliente
AGUA1
Professional
AHF RW
95433
Professional
AHPO (Cleveland
OH)
31138
Professional
AIDS Healthcare Foundation
Positive Health Care (PHC) California
95422
Professional
AIG Chartis
19402
Professional
Aither Health
64884
Professional
Alabama Blue Shield (Professional)
Blue Shield of Alabama
Blue Cross of Alabama
ALBLS
Professional
ALAMEDA ALLIANCE
Alameda Alliance for Health (Provider must contact payer to be approved. Contact at Alameda is Anet Quiambao at 510-747-6153 or aquiambao@alamedaalliance.co m)
95327
Professional
Alamitos IPA (Customer Service 562-602-1563)
AIPAZ
Professional
Alaska Childrens Services
Inc
Alaska Laborers Construction Industry Trust
Alaska Pipe Trades Local 375
Alaska United Food & Commercial Workers Health & Welfare Trust
Cement Masons & Plasterers Health & Welfare Trust - Grp#F16
Automotive Machinists Local 289 Health & Welfare Trust - Grp#F32
University of Washington Students & Graduate Appts. - Grp#P67
Operating Engineers Locals 302 & 612 Health & Security Fund - Grp#F12
Welfare and Pension Administration
Hotel Employees & Restaurant Employees Health Trust - Grp#F19
N.W. Ironworkers Health & Security Trust Fund - Grp#F15
N.W. Roofers & Employers Health & Security Trust Fund - Grp#F14
N.W. Textile Processors - Grp#F14
Glassworkers Health & Welfare Fund - Grp# F29
Enstar Natural Gas - Grp# P61
Puget Sound Benefits Trust - Grp#F25
Puget Sound Electrical Workers Trust - Grp#33
West Coast Stationary Engineers Health & Security Trust Fund - Grp#F13
Alaska Children's Services
Inc. - Group # P68
Alaska Laborers Construction Industry Trust - Gro
91136
Professional
Alaska Medicaid
SKAK0
Professional
Albuquerque Public Schools
85600
Professional
Alexian Brothers Community Services of Tennessee
44423
Professional
AliCare
Amalgamated Life
13550
Professional
Align Senior Care (Florida)
ASFL1
Professional
Align Senior Care California
ASCA1
Professional
Align Senior Care Michigan
ASMI1
Professional
Align Senior Care Virginia
ASVA1
Professional
Alignment Healthcare
Align Senior Care Florida
CCHPC
Professional
Alivi Health
ALIVI
Professional
AllCare Pace
ACPCE
Professional
AllCare PEBB
26158
Professional
Allegiance Benefit Plan Management
Inc.
81040
Professional
Alliance Coal Health Plan
93658
Professional
Alliance Physicians of the High Desert
Alliance Physicians High Desestt
22417
Professional
Alliant Health Plans of Georgia
58234
Professional
Allianz Global Assistance
Allianz Global Assistan
50749
Professional
Allied Benefit Systems
37308
Professional
Allied Physicians of California IPA
Arroyo Vista Family Health Center
Greater Orange IPA
Greater San Gabriel Valley Physicians IPA
La Salle Medical Associates IPA
Advantage Health Network IPA
Arroyo Viata Family Health Center
NMM01
Professional
Allina Health Aetna
AMC Plus
54398
Professional
AllWays Health Plan (prev. Neighborhood Plan
Boston
MA)
04293
Professional
AlohaCare
ALOHA
Professional
Alpha Care Medical Group
ACMG1
Professional
AlphaCare
ALPHA
Professional
Alphacare Medical Group
MPM32
Professional
Alta Bates Medical Group
ABMG
A0701
Professional
AltaMed
ALTAM
Professional
Alternative Opportunities
16089
Professional
Alterwood Advantage
RP016
Professional
AM-First Insurance Morgan White
01757
Professional
Amalgamated Life - PA / Alicare
Amalgamated Life - PA/Alicare
13343
Professional
AmeraPlan
ClaimChoice Administrators
38219
Professional
Ameriben - IEC Group
97661
Professional
Ameriben Solutions
75137
Professional
America's Choice NMA
Healthsmart America's Choice
America's Choice Health
20029
Professional
America's Health Choice
21810
Professional
America's PPO / America's TPA
HealthEZ
41178
Professional
Americaid Community Care (Houston)
27515
Professional
Americaid Community Care (Maryland)
27517
Professional
Americaid Community Care (New Jersey)
27516
Professional
American Administrative Group - AAG Form known as UICI Admin
UICI - Administrators
75240
Professional
American Administrative Group AAG (Gallagher Benefits)
American Administrative Group (formerly Gallagher Benefit)
AAG - American Administrative Group
Cincinnati Financial Corporation
Gallagher
Cinncinnati Financial Corporation
37283
Professional
American Behavior
American Behavioral
63103
Professional
American Family (administered by American Republic)
American Family Insurance (Administered by American Republic)
56071
Professional
American Family Insurance
TH095
Professional
American Fidelity Assurance Company
60801
Professional
American General
AMERICAN GENERAL LIFE AND ACCIDENT
62030
Professional
American Health Advantage of Texas
31155
Professional
American Health Advantage of Utah
31145
Professional
American Healthcare Alliance
01066
Professional
American LIFECARE (Group Number required. Valid only for claims with a billing address of 1100 Poydras ST. #2600
New Orleans
LA 70163)
American Lifecare
72099
Professional
American NatIonal Insurance (ANICO)
American National Insurance Co
74048
Professional
American Plan Administrators
95606
Professional
American Postal Workers Union Healthplan
American Postal Workers Union Health Plan
44444
Professional
American Republic Insurance Company
42011
Professional
American Specialty Health
ASH01
Professional
American Therapy Administrators ATA Wisconsin
ATHAL
Professional
Americas 1st Choice Health Plans of South Carolina
20553
Professional
Americas 1st Choice of South Carolina
Inc
Americas 1st Choice of South Carolina
Inc.
55349
Professional
Amerigroup - Illlinois
Amerigroup
28804
Professional
Amerigroup - Maryland and District of Columbia
28807
Professional
Amerigroup - New Jersey
28806
Professional
Amerigroup / Americaid - Houston
28805
Professional
Amerigroup Multiple States (Claims and Encounters)
Amerigroup Multiple States
26378
Professional
Amerigroup New Mexico
Amerigroup DC
Amerigroup Georgia
Amerigroup of Iowa
Amerivantage
Amerigroup Iowa
26375
Professional
Amerigroup of Florida
28809
Professional
Amerigroup Ohio (Claims and Encounters
Amerigroup Illinois (Claims and Encounters
Amerigroup Illinois
Amerigroup Ohio
27518
Professional
Amerigroup
Amerigroup/Wellpoint New Jersey
Amerivantage
Amerigroup Wellpoint
Amerigroup Vantage
Amerigroup Wellpoint
Amerigroup/Wellpoint Arizona
Amerigroup/Wellpoint Iowa
Amerigroup/Wellpoint Texas
Amerigroup/Wellpoint Washington
Amerigroup/Wellpoint Tennessee
Wellpoint Maryland
WLPNT
Professional
Amerihealth Administrators
Inc.
AmeriHealth Administrators
54763
Professional
AmeriHealth Caritas Healthplan New Hampshire
87716
Professional
AmeriHealth Caritas Louisiana (Formerly known as LA Care)
AmeriHealth Caritas Louisiana(Formerly known as LA Care)
27357
Professional
Amerihealth Caritas Next DE
AmeriHealth Caritas Next FL
45408
Professional
Amerihealth Caritas Next FL
AmeriHealth Caritas Next DE
47073
Professional
AmeriHealth Caritas Next NC
83148
Professional
Amerihealth Caritas North Carolina
81671
Professional
AmeriHealth Caritas Ohio Inc
AmeriHealth Caritas Ohio
Inc
35374
Professional
AmeriHealth Caritas Ohio Medicaid MCE (Transportation Only)
AmeriHealth Caritas Ohio Medicaid MCE
42435
Professional
Amerihealth Caritas VIP Care - Florida DSNP
AmeriHealth Caritas VIP Care Florida DSNP
88232
Professional
AmeriHealth Caritas VIP Care Delaware DSNP
Amerihealth Caritas VIP Care - Delaware DSNP
87406
Professional
AmeriHealth Caritas VIP Care
AmeriHealth Caritas Pennsylvania Community HealthChoices
77062
Professional
AmeriHealth Caritus VIP Care Plus (Michigan)
77013
Professional
Amerihealth Delaware
77799
Professional
Amerihealth District of Columbia (For EDI Support
please email edi.dc@amerihealthdc.com or call 1-888-656-2383)
Amerihealth DC
77002
Professional
Amerihealth HMO NJ and DE
Amerihealth HMO NJ and Delaware
95044
Professional
AmeriHealth Mercy Health Plan (FKA AmeriHealth Caritas Pennsylvania. Claims containing DOS on or after 1/1/21 will need to be sent under this payer ID)
AmeriHealth Caritas Pennsylvania
22248
Professional
AmeriHealth NorthEast (Dates of Service on or before Dec. 31
2020
may continue to use the following until Dec. 31
2021. For dates of service 01/01/21 or after use payer ID 22248}
AmeriHealth NorthEast (Dates of Service on or before Dec. 31
2020
may continue to use the following until Dec. 31
2021. For dates of service 01/01/21 or after use payer ID 22248)
77001
Professional
Amerihealth-NJ (Non-HMO Claims)
AmeriHealth - New Jersey (Non- HMO Claims)
SX075
Professional
Amfirst Insurance Company
64090
Professional
Amida Care Medicare
79966
Professional
Amtrust North America
J1868
Professional
Amway Corporation
Activia Benefit Services LLC
Activia Benefit Services LLC (formerly Amway Corp)
Activa Benefits Services
LLC (Formerly Amway Corporation)
38254
Professional
Anchor Benefit Consulting Inc
Anchor Benefit Consulting
Anchor Benefit (Dental)
53085
Professional
Anchor Benefit Consulting
Anchor (Claimsbridge)
IHS10
Professional
Angeles IPA (SynerMed)
75299
Professional
Angle Insurance Company of Utah
39856
Professional
Antares Management Services
Mutual Health Services (fka Antares Management Solutions)
Antares Management Solutions
34192
Professional
Anthem BCBS Georgia
Anthem GA
00601
Professional
Anthem BCBS Indiana
00630
Professional
Anthem BCBS Kentucky
00660
Professional
Anthem BCBS Maine
00680
Professional
Anthem BCBS Missouri
Anthem BCBS Missouri
00241
Professional
Anthem BCBS Colorado
00050
Professional
Anthem BCBS Colorado (WGS Encounters)
ENCWGS
Professional
Anthem BCBS Connecticut
00060
Professional
Anthem BCBS Ohio
00834
Professional
Anthem BCBS Virginia
00423
Professional
Anthem BCBS Wisconsin
00950
Professional
Anthem Blue Cross Blue Shield
02937
Professional
Anthem Blue Cross of California
California Anthem Blue Cross
California Blue Cross
Blue Cross of California
47198
Professional
Anthem Maine Health
00958
Professional
Anthem NH
Blue Cross of New Hampshire
00770
Professional
Anthem Ohio Medicaid
29370
Professional
APEX BENEFITS SERVICE
Apex Benefit Services (Claims must contain the rendering provider ID or the claim will reject.)
34196
Professional
Apex Health
83112
Professional
APEX Healthcare
51909
Professional
APEX Healthcare (Now knows as Access Community Health Network)
ACCOM
Professional
Apostrophe
81312
Professional
Arbor Health
52312
Professional
Arcadia Healthcare Solutions IPG
11081
Professional
Arcadia Healthcare Solutions NPA
Arcadia Healthcare Solutions - NPA
36364
Professional
Argus Dental and Vision
ARGUS
Professional
Arizona Blue Cross Blue Shield
Blue Shield of Arizona
AZBLS
Professional
Arizona Priority Care Plus
27154
Professional
Arkansas Best Corporation - Choice Benefits
CIGNA
CIGNA - PPA
CIGNA - PPO
CIGNA Health Plan - HMO
Connecticut General (CIGNA)
EQUICOR
EQUICOR - PPO
Equitable (CIGNA)
HEALTHSOURCE GA
HEALTHSOURCE IN
HEALTHSOURCE KY
HEALTHSOURCE ME
HEALTHSOURCE NH
HEALTHSOURCE OH
HEALTHSOURCE PROVI
HEALTHSOURCE SOUTH
Provident
TYSON FOODS
Arkansas Best Corporation
CIGNA Premier Plus
Arkansas Best Corporation (previous payer ID 75278
new payer ID is effective for claims submitted December 15
2017 and after).
62308
Professional
Arkansas Managed Care Organization (AMCO)
62176
Professional
Arta Health Network
WMM01
Professional
ASAGEHA
06603
Professional
ASC Benefit Services
Inc.
ACS Benefit Services
inc.
72467
Professional
Ascension Bundle Program
Ascension Bundle Health
ASN99
Professional
Ascension Living Pace MI
Ascension Living St Vincent Pace INC
R3458
Professional
Ascension Living St Vincent Pace INC
R3459
Professional
Asian American Medical Group
AAMG1
Professional
Aspen Insurance
16180
Professional
Aspire Health Plan
46156
Professional
Aspirus Medicare Advantage
36483
Professional
ASR Physicians Care
Physicians Care Network
ASR Corporation
38265
Professional
ASRM LLC
ASRM Corporation
ASRM
ASRM1
Professional
Associated Hispanic Physicians Southern California
MPM44
Professional
Associates for Health Care
Inc. (AHC)
Associates for Healthcare
36326
Professional
Assurant Health
Assurant Health Self Funded
75068
Professional
ASSURED BENEFITS ADMI
Assured Benefits Administrators
74240
Professional
Asuris Northwest/MedAdvantage (REF*1B*Provider ID in Billing and Rendering required even when NPI is submitted.)
SX179
Professional
Asuris NW Health
93221
Professional
Atlantic Medical
Colonial AMI
Atlantic Medical Insurance
22285
Professional
Atlantis Eye Care
AEC01
Professional
Atlas Life Ins Co (NFIC Plan only)
National Financial Insurance Company
SunAmerica Life Ins Co (NFIC Plan only)
Midland National Life Ins Co (NFIC Plan only)
90956
Professional
Atrio Health Plan (Formerly known as Marion Polk Health Plan Advantage)
MPCHA
Professional
Atrio Health Plan
Asserta Health
IHS14
Professional
Aultcare
MNAUL
Professional
AultCare
Aultra Administrative Group
PrimeTime Health plan
204951704
AULOH
AULTC
AULTCARE
Professional
AultCare
Aultra Administrative Group
PrimeTime Health plan
Aultcare
341488123
Professional
Author by Humana
61108
Professional
Automated Benefit Services (ABS)
Automated Benefit Services
38259
Professional
Automated Group Administration
Inc.
Automated Group Administration
37280
Professional
Auxiant (Nat’l Health Benefit Corp)
National Health Benefits Corportation- NHBC02
National Health Benefits Corporation - NHBC02
88050
Professional
Avalon Healthcare Solutions (Must contact the payer directly at Provider Services @ 855-895- 1676 prior to sending claims.)
AVA01
Professional
Avalon Healthcare Solutions Capital Blue Cross
AVA03
Professional
Avalon Healthcare Solutions North Carolina
AVA02
Professional
Avalon Healthcare Solutions Vermont
AVA04
Professional
Avante Health (Customer Service 559-261-9060)
AH001
Professional
Avectus Healthcare Solutions (Call 855-AVECTUS)
Avectus Healthcare Solutions
MP001
Professional
Avera Health Plans
46045
Professional
Avesis Third Part Administrators
87098
Professional
Avmed Encounters
59275
Professional
AVMED
Avmed Inc.
59274
Professional
Axminister Medical Group
AXM01
Professional
AZ Integrated Physicians
NCHON
Professional
B Smart Health Solutions
77149
Professional
Bakersfield Family Medical Center
BKRFM
Professional
Bakery & Confectionery Union & Industry International Health
BCTF1
Professional
Bankers Life and Casualty Company or Washington National Insurance Company
90000
Professional
Banner Health
12X42
Professional
Banner Health & Aetna Health Insurance Company
67895
Professional
Banner Medicare Advantage Plus (HMO)
(HMO) Banner
16664
Professional
Banner Medicare Advantage Plus (PPO)
16663
Professional
Banner University Family Care (University of Arizona Health Plans)
Banner University Family Care
66901
Professional
Baptist Cardiac Program
BSC01
Professional
Baptist Health South Florida
65026
Professional
Barinet (L&W)
CB369
Professional
Baycare Select Health Plans Incorp
Baycare Select Health Plans Inc
81079
Professional
BC Idaho
00610
Professional
BC Idaho Medicare Advantage
BLUEC
Professional
BCBS Alabama
SB510
Professional
BCBS Arizona
BCBSAZ
Professional
BCBS Kansas
4716B
Professional
BCBS Kansas City
47171
Professional
BCBS Lousiana
53120
Professional
BCBS Michigan and Blue Care Network
00710
Professional
BCBS Minnesota
00222
00722
Professional
BCBS Minnesota
Blue Cross of Minnesota
00220
Professional
BCBS Minnesota
Comprehensive Care Services (BCBSMN)
00720
Professional
BCBS Montana
00751
Professional
BCBS North Carolina
BCSNC
Professional
BCBS North Dakota
55891
Professional
BCBS Of Michigan (Dental Claims Only)
BBMDQ
Professional
BCBS South Carolina Planned Admin
SC BCBS Planned Administrators
SC886
Professional
BCBS Texas Medicaid
BCBS Texas Medicaid (Plan effective December 1
2015)
66001
Professional
BCBS Vermont
SB915
Professional
BCBS Western NY Medicaid
WNYMD
Professional
BCBS Wyoming
53767
Professional
BCBSMN Blue Plus Medicaid
00726
Professional
Beacon Health Options
BHOVO
Professional
Beacon of Life
65432
Professional
Beaver Medical Group
45967
Professional
Behavioral Health Systems
63100
Professional
Bella Vista Med Grp IPA
Bella Vista Medical Group
MPM10
Professional
Benebay
Berkshire Health Plans
Berkshire Health Partners
23243
Professional
Benefit & Risk Management Services
Benefit & Risk Management Services (Commercial Medicare under Med3000)
99320
Professional
Benefit Administration Services
41205
Professional
Benefit Coordinators
Benefit Coordinators Corporation
25145
Professional
Benefit Management LLC/VBA
88092
Professional
Benefit Management Services for Charlotte
NC
Benefit Management Services
56139
Professional
Benefit Management Systems
Inc.
Benefit Management Systems
Inc of Mississippi
37212
Professional
Benefit Management
Inc. of KS (Only accepts claims for these groups BMI187
BMI219
BMI234
BMI236
BMI214
BMI241
BMI617 BMI246
BMI246.)
Benefit Management
Inc. of KS
48611
Professional
Benefit Plan Administrators - ClaimsBridge
Benefit Plan Administrators
IHS19
Professional
Benefit Plan Administrators
Northern Nevada Trust Fund
Northern Nevada Trust Funds (Call 775-826-7200 prior to submitting claims.)
88027
Professional
Benefit Systems and Services
Inc.
Benefit Systems & Services
Inc. (BSSI)
36342
Professional
Benesight (formerly The TPA)
87265
Professional
Benmark
BNMK1
Professional
Berkshire Intergroup
Quest EAP
10956
Professional
BEST LIFE & HEALTH CO
Best Life & Health Insurance Co.
95604
Professional
Better Health Plan of Florida (For claims rejections
contact payer at 800-514-4561 and select provider services option.)
Better Health Plan of Florida
20488
Professional
Beverly Alianza IPA
POP05
Professional
Beverly Hospital
MPM42
Professional
BHSF International
67668
Professional
Bienvivir Senior Health Plan
BSHS1
Professional
Big Lots Associates Benefit Plans
EBMC
CX025
Professional
BIND (UHC Choice Plus Multiplan)
Surest Health Plan
25463
Professional
Blackhawk
Dart Member Care ##
Dart Member Care
CB987
Professional
Block Vision of Texas
BVTX1
Professional
Block Vision
Inc.
BV001
Professional
Blue Chip of Rhode Island
RICHP
Professional
Blue Choice Medicaid (for DOS 12/31/23 and prior)
00403
Professional
Blue Choice of Rochester NY
N6BLS
Professional
Blue Choice of South Carolina
00922
Professional
Blue Cross Community Options
Blue Cross Community Solutions Effect 12-14-14 payer ID00621
MCDIL
Professional
Blue Cross Complete of Michigan
LLC
Blue Cross Complete
32002
Professional
Blue Cross Medicare Advantage of Montana
Illinois
Texas and Oklahoma
Blue Cross Medicare Advantage (For DOS after 01-01-2017 and for MemberID starting with YDL
YDJ
XOD
XOJ
ZGD
ZGI
ID
YIJ
YUX and UYB only)
66006
Professional
Blue Cross of Illinois
Blue Cross of Illinois
BLUECROSS BLUESHIELD (BCBS) IL HCSC
00621
Professional
Blue Cross of Arkansas
00520
Professional
Blue Cross of Florida
Florida Blue
00590
Professional
Blue Cross of Idaho
Idaho Blue Cross
IDBLC
Professional
Blue Cross of New Mexico
BLUECROSS BLUESHIELD (BCBS) NM HCSC
Lovelace Sandia
00790
Professional
Blue Cross of Oklahoma
BLUECROSS BLUESHIELD (BCBS) OK HCSC
00840
Professional
Blue Cross of Oregon Regence
Regence BCBS Oregon
00851
Professional
Blue Cross of Washington
Blue Cross of Washington (Premera)
00934
Professional
Blue Grass Family Health (SRRIPA)
15754
Professional
Blue Lake Rancheria
IP061
Professional
Blue Medicare Advantage
00772
Professional
Blue Shield of Alaska
AKBLS
Professional
Blue Shield of Arkansas
Arkansas Blue Cross Blue Shield
Blue Advantage of Arkansas
Health Advantage of Arkansas
ARBLS
Professional
Blue Shield of California
UFCW Loc 400-5205 -must reg at wwwblueshieldca.com
BS001
Professional
Blue Shield of Central NY HMO/PPO
N2BLS
Professional
Blue Shield of Delaware
Delaware Blue Cross Blue Shield
DEBLS
Professional
Blue Shield of Florida
Florida Blue Cross Blue Shield
Blue Cross Blue Shield of Florida
Florida Blue Shield
FLBLS
Professional
Blue Shield of Georgia (State Health of GA)
Georgia State Health Benefit Plan (Processed by GA BC/BS)
Blue Shield of Georgia
Georgia Anthem Blue Cross Blue Shield
State Merit GA
GABLS
Professional
Blue Shield of Hawaii
Hawaii Blue Cross Blue Shield
HIBLS
Professional
Blue Shield of IA 2nd claim only Medicare is primary
IABLM
Professional
Blue Shield of Idaho
Idaho Blue Shield (Regence)
Blue Shield of Idaho (Per Provider Testing)
IDBLS
Professional
Blue Shield of Illinois
Illinois Blue Cross Blue Shield
ILBLS
Professional
Blue Shield of Indiana
Indiana Anthem Blue Cross Blue Shield
Indiana Anthem Blue Cross and Blue Shield
INBLS
Professional
Blue Shield of Kansas City
Blue Cross of Kansas City
Kansas City Blue Cross Blue Shield
KCBLS
Professional
Blue Shield of Kansas
Blue Cross of Kansas
Kansas Blue Cross Blue Shield
KSBLS
Professional
Blue Shield of Kentucky
Kentucky Anthem Blue Cross Blue Shield
KYBLS
Professional
Blue Shield of Louisiana
Blue Shield of Lousiana
State Employees Group Benefits
Louisiana Blue Cross Blue Shield
LABLS
Professional
Blue Shield of Maine
Maine Anthem Blue Cross and Blue Shield
Maine Anthem Blue Cross Blue Shield
MEBLS
Professional
Blue Shield of Maryland
MDBLS
Professional
Blue Shield of Massachusetts
MABLS
Professional
Blue Shield of Michigan
Michigan Blue Cross Blue Shield
MIBLS
Professional
Blue Shield of Minnesota
CCS (aka Comprehensive Care Systems)
Minnesota Blue Cross Blue Shield
MNBLS
Professional
Blue Shield of Mississippi
Mississippi Blue Cross Blue Shield
MSBLS
Professional
Blue Shield of Missouri
Missouri Anthem Blue Cross and Blue Shield
Missouri Anthem Blue Cross Blue Shield
MOBLS
Professional
Blue Shield of National Capital Area
National Capital Area
NCABS
Professional
Blue Shield of Nebraska
77780
Professional
Blue Shield of New Jersey
Horizon BCBSNJ
22099
Professional
Blue Shield of New York
Western
Blue Cross Blue Shield Of Western New York
Blue Shield of Western New York
N1BLS
Professional
Blue Shield of Northeast NY
N5BLS
Professional
Blue Shield of Rochester NY
N7BLS
Professional
Blue Shield of South Carolina
South Carolina Blue Cross Blue Shield
SC FEP Blue Cross
Medicare Blue Advantage of South Carolina
SCBLS
Professional
Blue Shield of Utica NY
N4BLS
Professional
Blue Shield of Vermont
VTBLS
Professional
Blueride Non Emerg Transportation
BLRDE
Professional
BMC Health Net Plan
Boston Medical Center Healthnet
13337
Professional
Boilermakers National Health & Welfare Fund
36609
Professional
Bollinger
INC.
BOLL1
Professional
Boon-Chapman Benefit Administrators
Inc.
74238
Professional
BPS Inc
48964
Professional
Brand New Day (Encounters)
Brand New Day (FFS)
UC002
Professional
Brand New Day (FFS)
Brand New Day (Encounters)
UC001
Professional
Braven Health
84367
Professional
Bravo Health (Now CIGNA HealthSprings.)
CIGNA HealthSprings
Bravo Health
Elder Health HMO of Pennsylvania
52192
Professional
Breckpoint
BRKPN
Professional
Bridgespan
BRIDG
Professional
Bright Health (for DOS after 01/01/2022)
BRGHT
Professional
Bright Health Plan
CB186
Professional
BritCay
Colonial BC
22286
Professional
Brockerage Concepts
Inc (Benefit Concepts)
Benefit Concepts
Healthsmart Brokerage Concepts
Brockerage Concepts
Inc.
51037
Professional
Broward Regional Health Planning Council
BRHPC
Professional
Brown & Toland Medical Group
94316
Professional
Brown & Toland Sutter
Brown & Toland SutterSelect
BTSS1
Professional
Buckeye Ohio Medicaid
04202
Professional
Buckeye Ohio Medicaid
42020
Professional
Butler Benefits
HealthSmart Butler Benefit
HealthSmart Fringe Benefit Coordinators
HealthSmart US Benefits
HealthSmart William C Earhart
42150
Professional
C&O Employees Hospital Association
C & O Employees Hospital Association
23708
Professional
C3 Health (fka Access Health Inc.)
A1680
Professional
Cal-Optima Direct
Caloptima
CALOPTIMA DIRECT
CALOP
Professional
California Eye Care New Century Health
NCH05
Professional
California Health and Wellness
California Health & Wellness
68047
Professional
California IPA
AMM14
Professional
California Pacific Medical Center
California Pacific Medical Center
94056
Professional
California Water Services
CWS99
Professional
Cannon Cochran Management Services
Inc. LA (Claims for Payer address of Metairie
LA only.)
CANNON COCHRAN MANAGEMENT SERVICES INC
71057
Professional
CANNON COCHRAN MGMT
Arcadia Insurance Company
Sage Technologies (Formerly CCMSI) (Claims for payer address of Rockford
IL ONLY.)
37105
Professional
CAP Management Systems
CAP Management
95399
Professional
Capital Advantage Insurance Company (CAIC) PROFESSIONAL (BCBS ProviderID and Performing ProviderID required. Call 800- 874-8433)
Capital Blue Cross PROFESSIONAL (BCBS ProviderID and Performing ProviderID required. Call 800- 874-8433)
23045
Professional
Capital District PHP
SX065
Professional
Capital Health Plan
95112
Professional
Capital International Management Services
65067
Professional
Capitol Administrators (Lucent Health)
68011
Professional
Caprock Health Plan
CapRock HealthPlans
CAPHP
Professional
Cardiovascular Care Providers
GCVCP
Professional
Care Access PSN
65063
Professional
Care Around the Clock
57721
Professional
Care Choices HMO
HM037
Professional
Care First Health Plan of AZ
Care 1st Health Plan of Arizona
57116
Professional
Care First Health Plan of CA
Care 1st Health Plan of CA
57115
Professional
Care N Care
Care N' Care
66010
Professional
Care Plus
65031
Professional
Care to Care
41222
Professional
Care Wisconsin Health Plan (Trizetto)
27004
Professional
CareCentrix
11345
Professional
CareCentrix BCBS MI
CareCentrix BCBS Michigan
11349
Professional
CareCentrix Cigna
11346
Professional
CareCentrix Florida Blue
11347
Professional
CareCentrix Wellcare
11350
Professional
CareCore Aetna Radiology
CareCore National
LLC (Aetna Radiology Claims)
New York Medical Imaging-MVP
14179
Professional
Carecore National Wellcare
14188
Professional
CareCore National
Care Core National
14182
Professional
CareCore Oxford Radiology
CareCore National
LLC (Radiology charges for Oxford)
14180
Professional
Carefirst BCBS DC National Capital Area
CareFirst BCBS - DC
National Capital Area
SB580
Professional
Carefirst Medicare Advatange
CareFirst Medicare Advantage
00193
Professional
Carelink Medicaid
25140
Professional
Carelon Aetna Home Health
34010
Professional
Carelon Anthem Home Health
34009
Professional
Carelon Health Advance Primary Care Encounters
CMENC
Professional
Caremore
CM001
Professional
CareMore Value Plus (CVP)
Caremore
Caremore IPA
CARMO
Professional
Carenet of VA (use consolidated Coventry payerID of 25133)
25142
Professional
CareOregon
Inc.
Care Oregon
93975
Professional
CarePartners of Connecticut
16307
Professional
CarePlus Cardiology - New Century Health
NCH04
Professional
Caresource Georgia
Caresource of Georgia
CareSource of GA
GACS1
Professional
CareSource Health Plan of Oregon
MRCHP
Professional
Caresource Indiana
CareSource Marketplace
CareSource IN
INCS1
Professional
CareSource KY
Caresource Humana
Humana Caresource
CareSource of Kentucky
KYCS1
Professional
CareSource MI Medicaid
CareSource Michigan Medicaid
MIMCDCS1
Professional
CareSource North Carolina
CareSource NC
NCCS1
Professional
CareSource of AR
Caresource AR
ARCS1
Professional
CareSource OH
31114
Professional
CareSource Ohio Medicaid
03150
Professional
Caresource West Virginia
CareSource WV
WVCS1
Professional
Carolina Summit Healthcare
Inc.
Carolina Summit Healthcare
Inc
56195
Professional
Carpenters Health and Welfare Fund of Philadelphia
CX101
Professional
CBHA Carolina Behavioral Health Alliance
Carolina Behavioral Health Alliance
56215
Professional
CBNHP Health Choices
CBHNP - Health Choices
65391
Professional
CBSA
CBSA (Corporation Benefit Services of America)
Corporate Benefit Services of America
IBI
Iowa Benefits Inc.
Meritain Health Minneapolis
Iowa Benefits
Inc.
Fortis Self Funded Administrative Services
41124
Professional
CCMC - Comprehensive Care Management Corp
CCMC1
Professional
CCOK
Community Care Managed Health Care Plans of Oklahoma
73143
Professional
CDO Technologies
63028
Professional
CDO Technologies
MBA Benefit Administrators
83028
Professional
Cedar Valley Community Health Plan
SISCO
Quad Cities Community Health Plan
Lake Region Community Health Plan
Northeast Iowa Community Health Plan
SISCO
Professional
Cedars-Sinai Medical Network Services Claims
Cedars-Sinai Medical Network Services
95166
Professional
Cedars-Sinai Medical Network Services Encounters
Cedars-Sinai Medical Network Services
95167
Professional
Celtic Insurance
CELTC
Professional
CeltiCare
Cenpatico - Georgia
Iowa Total Care
Centene Advantage Plans (claims for former payer ID 95567 with DOS on or after 1/1/18)
Louisiana Healthcare Connections
Ambetter of Arkansas
Home State Health Plan
Total Carolina Care
Magnolia Mississippi
Bridgeway Arizona
Managed Health Services Indiana
Managed Health Services of Wisconsin (Please contact the payer @ 800-225-2573
ext 25525 to get setup to submit electronic claims.)
Buckeye Community Health
California Health and Wellness
Healthnet Community Solutions
SilverSummit Health Plan
Illinicare Group Health
NebraskaTotal Care
Peach State Health Plan (Behavioral Health)
Peach State Health Plan (Medicaid) (Call 800-225-2573 ext 25525 prior to submitting claims.)
Kentucky Spirit Health Plan
Arkansas Total Care
BRIDGEWAY NETWORK
New Hampshire Healthy Family
California Health & Wellness
Centene Advantage Plans
Western Sky Community Care
Michigan Complete Health
Nebraska Total Care
Novasys Health Network
Peach State Health
68069
Professional
CenCal Health
95386
Professional
Cenpatico - Kansas (Prior to submitting claims please call Provider Relations Dept at 866- 896-7293 to verify your provider info is on file in the claim system.)
Cenpatico (For multiple states)
Cenpatico Behavioral Health - Wisconsin (Call 800-225-2573 ext 25525 prior to submitting claims.)
Cenpatico Behavioral Health AZ (Prior to submission
contact 866- 495-6748 to verify provider ID.)
Cenpatico Florida Behavioral Health
Cenpatico Indiana
Cenpatico Massachusetts
Cenpatico Ohio
Illinicare Behavioral Health
Cenpatico
CENPATICO ARIZONA
Cenpatico Behavior Health
CENPATICO GEORGIA
Cenpatico Kansas
CENPATICO TEXAS
GROUP PRACTICE AFFILIATES
IHS Gateway Payer South
Integrated Mental Health Services
68068
Professional
Center for Elders Independence
94312
Professional
Center for Healthy Living
CPHL1
Professional
Center IPA
POP01
Professional
CenterCare
13357
Professional
CenterLight Healthcare
13360
Professional
Centivo
45564
Professional
Centivo Direct Network Access
IHS04
Professional
CentraCare
66698
Professional
Central California Alliance for Health (Alliance EDI Support Unit 831-430-5510)
SX169
Professional
Central California Women's Health
Central California Womens Health
WH001
Professional
Central Health Medicare
Central Health MSO
CHCPI
Professional
Central Mass Heath Care
CMHC
Healthsource CMHC
Healthsource Massachusetts
Inc
Healthsource
MA
02041
Professional
Central Ohio Primary Care Senior Care Advantage
AGL02
Professional
Central Reserve Life Insurance Company
Loyal American Life
Central Reserve Life
Central Reserve Life Ins.Co. (Formertly Loyal American Life (Medicare Supplement) )
13193
Professional
Central Valley Medical Group
Sutter Connect - Central Valley Med Group (Claims)
77035
Professional
Centurion LLC
Centurion
IHS11
Professional
Centurion of Tennessee
42140
Professional
Century PHO
36393
Professional
CHA - Commonwealth Health Alliance
23171
Professional
Chaffey Medical Group
49533
Professional
CHAMPVA - HAC
Veterans Family Members Program (FKA CHAMPVA-HAC)
84146
Professional
Chautauqua County Health Plan (Mayville
NY)
16600
Professional
Children First Medical Group (For questions regarding claim status
providers will need to contact payer: CFMG Provider Customer Service 510-428-3154)
94321
Professional
Children's Community Health Plan Wisconsin
251CC
Professional
Children's Specialists of San Diego
Childrens Specialist of San Diego
CSSD2
Professional
Childrens Medical Center Health Plan
CMCHP
Professional
Chinese Community Health Plan
Chinese Community Health Plan (Unique Provider ID must be on claim.)
94302
Professional
CHIPA - College Health IPA
CHIPA
Professional
Chirometrics Inc.
33070
Professional
Chiropractic Association of South Dakota
CASD1
Professional
Chiropractic Care of Minnesota
Inc. (For Dates of service before 1-01-08
continue to use payerID of ACN01.)
Landmark Healthcare Inc.
LNDMK
Professional
CHOC Childrens Hosp of Orange Cty Health Alliance
CHOC - Childrens Hospital of Orange County Health Alliance
33065
Professional
Choice Physicians Net First Choice
CPNFC
Professional
Choice Physicians Network (Nivano Physicians)
CPNNP
Professional
Choice Physicians Network
Choice Physician Network
CPN01
Professional
ChoiceOne IPA
POP03
Professional
CHP/RPU (FABOH) (Facility physical address required on claim.)
CHP/RPU (FABOH)
39112
Professional
Christian Brother Services
Christian Brothers Services
38308
Professional
Christian Care Ministries (Medishare) (Providers should check the member ID card and use the Household ID value as the member ID when submitting claims electron
Christian Care Ministries
59355
Professional
Christie Student Helath Plan
Christie Student Health Plans
75544
Professional
Christus Health Medicare Advantage
10629
Professional
Christus Health Plam -US Family Health Plan
Christus Health Plan - US Family Health Plan
US Family Health Plan
90551
Professional
Christus Health Plan HIX
Christus Health Plan Health Exchange
52106
Professional
Christus Spohn Health Network
Spohn Health
SPOHN
Professional
CIGNA Behavioral Health
02331
Professional
CIGNA Behavioral Health
CIGNA Behavioral Health (We will also accept PID SX071 for these claims: use of either ID accomplishes the same routing.)
MCC Behavioral Care (We will also accept PID SX071 for these claims: use of either ID accomplishes the same routing.)
MCCBV
Professional
CIGNA Medicare Advantage
CIGNA Senior
CIGNA Healthcare for Seniors - Arizona Medicare
86033
Professional
Citrus Valley Physician's Group
IP055
Professional
Citrus Valley Physicians Group
Physicians Data Trust
St Vincent Noble Tri Cities IPA
Ximed Medical Group
Citrus Valley Physician's Group
PDT01
Professional
CL Frates
CLFR2
Professional
Clackamas County Mental Health (Administered by PH Tech)
CCMMH
Professional
Claims Choice Administrators LLC
83063
Professional
Claims Development Corporation
43056
Professional
ClaimsBridge High Performance Network (HPN)
11752
Professional
Claimsware Inc. DBA ManageMed
ClaimsWare
Inc. DBA ManageMed
57080
Professional
Clarian Health Plans
MPLAN
Inc./HealthCare Group
LLC
MPLAN Inc. Healthcare Group
Senior Smart Choice
95444
Professional
Clear Health Alliance
CLEAR
Professional
Clear Spring Health Management Services
Family Health Network
85468
Professional
Clever Care Health Plan
CC168
Professional
Client First
41201
Professional
Clifton Health Systems D/B/A Actin Care Groups
24585
Professional
Clinical Resource Group
CRGMN
Professional
Clinical Specialties INC
Clinical Specialisties INC
CSI001
CSI01
Professional
Clover Health (FKA Carepoint Health Plan payer ID 77023)
Clover (Formerly Carepoint Health Plan
previous payer ID 77023)
13285
Professional
Coachella Medical Group
COMG1
Professional
Coastal Care
43141
Professional
Coastal Care Services Inc
47394
Professional
Coastal Communities Physician Network (CCPN)
CCPN1
Professional
Coastal Healthcare Management
LIPAZ
Professional
Cobalt Benefits Group
LLC dba CBA Blue
Blue Benefit Administrators of Massachusetts
& EBPA
03036
Professional
Colonial CMI
22287
Professional
Colonial CMI
Colonial Medical
22284
Professional
Colonial Penn Life Insurance
37077
Professional
Colorado Anthem Blue Cross Blue Shield
Blue Shield of Colorado
Anthem of Colorado
Colorado Anthem Blue Cross and Blue Shield
COBLS
Professional
Colorado Choice Health Plans
H0657
Professional
Colorado Community Health Alliance
COCHA
Professional
Colorado HealthOP
Colorado Health Insurance Cooperative
49718
Professional
Colorado Medicaid
SKCO0
Professional
Columbine Health Plan
CHP02
Professional
COMMERCE BENEFITS GRP
Commerce Benefits Group
34181
Professional
Common Ground Healthcare Cooperative
77170
Professional
Commonwealth Care Alliance
A2793
Professional
Commonwealth Care Alliance Medicare Advantage
14316
Professional
Communicare Advantage
34525
Professional
Community Care Associates
17902
Professional
Community Care Behavioral Health Organization
Community Care Behavioral Health Org (service prior to 10-1-2007)
25179
Professional
Community Care BHO
Community Care BHO (For Dates of Service after October 1
2007)
23282
Professional
Community Care Organization
Community Care Inc. (WI)
39126
Professional
Community Care PCC
Preferred Community Choice/PCCSelect/CompMed
Preferred Community Choice
73145
Professional
Community Care Plan Broward Health PPUC
BHPP1
Professional
Community Care Plan- Florida Healthy Kids
FHKC1
Professional
Community Care Plan(Palm Beach Health District)
PBHD1
Professional
Community Connect Medicaid
Group Health Cooperative of EauClaire
Group Health Cooperative of Eau Claire
95192
Professional
Community Eye Care
CECVP
Professional
Community Family Care
NMM05
Professional
Community First I Par Plus
Community First Health Plans
Community First Health Plan
Inc.
COMMF
Professional
Community Health
60495
Professional
Community Health Alliance
35193
Professional
Community Health Allliance TN
Community Health Alliance TN
27905
Professional
Community Health Center Network
CHCN1
Professional
Community Health Choice (Please include TPI Number (Texas Medicaid Number) in Field FA0-23)
Community Health Choice
48145
Professional
Community Health Electronic Claims/CHEC/webTPA
75261
Professional
Community Health Group
66170
Professional
Community Health Plan District of Columbia
L0230
Professional
Community Health Plan of Washington
CHPWA
Professional
Community Health Solutions (Claims now route to Medicaid of Louisiana)
Medicaid of Louisiana (Includes KidMed claims.)
Medicaid of Louisiana (837P
837I & 837D)
Louisiana Medicaid
LAMCD
Professional
Community IPA
AMM12
Professional
Community Medical Group of the West Valley
CMGWV
Professional
COMP - Ohio (Austintown
OH)
COMP-Ohio (Austintown
Ohio)
34177
Professional
Companion Life
American Worker Health Plan
American Worker Health Plan (Dental)
American Worker Health Plus
37322
Professional
Companion
Forethought
Bankers Reserve/Wellcare
Thrivent
Shenandoah
Combined Insurance Company
Combined Sterling
Liberty Banke
Standard Life
Western Catholic Union
Liberty Bankers
26119
Professional
CompFirst
LLC
23296
Professional
Complementary HealthCare Plans
93101
Professional
CompManagement Health
15243
Professional
Comprehensive Care Services (BCBSMN For DOS on and after 01-01-2019)
BCBSMN Blue Plus Medicaid
00562
Professional
Comprehensive Medical/Vision Program AZ
M0166
Professional
ComPsych
37363
Professional
Concordia Care Inc
Concordia Care Inc.
33632
Professional
Connecticare - Medicare
CONNECTICARE MCR
78375
Professional
Connecticare
Inc.
ConnectiCare
Inc
06105
Professional
Connecticut Anthem Blue Cross Blue Shield
Blue Shield of Connecticut
Connecticut Anthem Blue Cross and Blue Shield
CTBLS
Professional
Connective RX (PSKW)
PSKW0
Professional
Consociate Group
37135
Professional
Consolidated Associates Railroad
HealthSmart Consolidated Associates Railroad Employees (CARE)
75284
Professional
Consolidated Health Plans
Wellfleet Group
LLC
87843
Professional
Constitution State / Travelers
19046
Professional
Consumers Choice Health SC
45321
Professional
Contessa Health
CH102
Professional
Contessa Health Security Health Plan
CH101
Professional
Contra Costa Behavioral Health Plan
CCMHP
Professional
Contra Costa Health Plan
Contra Costa Health Plan
CCHS
Professional
Contra County Health Plan
CNTRA
Professional
Cook Childrens Health Plan CHIP
Cook Children's Health Plan
Cook Childrens Health Plan
CCHP1
Professional
Cook Childrens Health Plan Star
Cook Children's Star Plan
CCHP9
Professional
Cook Group Health Plan
35149
Professional
Cook Medical Group
60065
Professional
Cooperative Benefit Administrators
Inc.
National Rural Electric
52132
Professional
Coordinated Benefit Plan
14829
Professional
Core Management Resouces Group
Core Management Resources Group
Core Administrative Services
58231
Professional
CoreSource of NC (Start PayerID of 35182 Old payerID reject
35180
Professional
CoreStar
CoreSource of Illinois
CoreSource of IOWA
CoreSource of Maryland
Luminare Health
CoreSource of Pennsylvania
Luminare Health AZ IL IN MD MN NC PA fka Trustmark Health Benefits
35182
Professional
CoreStar AZ MN ( PayerID of 35182 Old ID will start reject
41045
Professional
Corizon Health
Inc
Corizon Health Inc.(Claims with address of Brentwood
TN should be submitted to this Payer ID.)
CORIZ
Professional
Cornerstone Preferred Resources
CB268
Professional
Corporate Benefits Service
Inc.
56116
Professional
Corporate Plan Management Inc.
64270
Professional
CorrectCare Integrated Health
LADOC
Professional
CorrectCare Integrated Health
CCIHC
Professional
CorrectCare Integrated Health (California Prison Healthcare Services)
CorrectCare Integrated Health (CA Prison Health)
CorrectCare Integrated Health (Non -Louisiana Jails Prison Health)
CCIH
Professional
Correction Health Partners
Physician Health Partners
PHPMC
Professional
Correctional Medical Services
Corizon
Inc. (fka Correctional Medical Services) Claims with address of St. Louis
MO should be submitted to this Payer ID.
43160
Professional
CORSOLUTIONS
Employers Direct Health - FI
75235
Professional
County Care (Behavioral Health and regular claims with a DOS after 4/1/16)
County Care
06541
Professional
County Care
County Care (Behavioral Health claims with a DOS prior to 4/1/16)
42138
Professional
County Care
County Care (formerly Centene IPA ) Claims with a DOS prior to 4/1/16)â–¡
42139
Professional
Covenant Administrators
LLC - 90 Degree
Covenant Administrators LLC - 90 Degree
Guarantee Trust Life Insurance Company
58102
Professional
Covenant Management System Employee Benefit I Par Plus
Covenant Management Systems Employee Benefit plan
CMSEB
Professional
Coventry Health Care of Florida
128FL
Professional
COVID19 HRSA Uninsured Testing and Treatment Fund
95964
Professional
Cox Health Plan (Requires Provider ID in Box 33a. Contact Cox Health Plan for ID.)
Cox Health Plan
00019
Professional
CPR Share Plan
CPR Share Plans
CB695
Professional
Creative Plan Administrators
37320
Professional
Crescent Health Solutions
56213
Professional
Crystal Run Health Plans
46430
Professional
CSI Network Services
34186
Professional
CTI Administrators Inc.
CTI Administrators Inc
42141
Professional
Curative
CURTV
Professional
Custom Design Benefits
Inc.
Custom Design Benefits Inc.
82056
Professional
D.H. EVANS & ASSOC.
EBC INC
Employee Benefit Consultants
Health Care District
Health Plan of San Mateo
Healthy Palm Beaches
MERCYCARE WI (Call 608-758- 7739 for PayerID.)
OMMS South Carolina
PA PREFERRED HEALTH
SOUTH CENTRAL PREFERRED
AllCare (Must contact AllCare
800-564-6901 for setup and payerID.)
Blue Medicare of North Carolina (Contracted providers only. Call 888-296-9790)
John Muir Trauma Physicians (Please call 925-947-5288 for Payer ID information.)
EBC Inc. (To obtain the payerID
please call (440) 262-1160)
PA Preferred Health (Call PPHN Claims Operations at 410-349- 3222)
Employee Benefit Consultants (To obtain the payer ID
please call (440) 262-1160.)
Employee Benefit Consultants
Inc. (Call (440) 262-1160 for PayerID.)
Virginia Health Network
Inc (To get the payerID
call payer at (804)320-3837)
Network Health (Before initiating submissions
please call Provider Relations at (617)806-8104 or www.network-health.org for an EDI startup plan.)
Radcon
Inc. (Please contact Kat
CALL
Professional
DakotaCare
DAK01
Professional
Davis Vision
00157
Professional
DCHS Medical Foundation
DCHSF
Professional
Dean Health Plan
DEAN1
Professional
Dean Health Plans
41822
Professional
Decent Health
DCENT
Professional
Delaware Medicaid
Medicaid of Delaware
Medicaid of Delaware
DEMCD
Professional
Dell Children's Health Plan
74272
Professional
Delta Health Systems
DHS01
Professional
Dentemax
Dentemax/DPI (MI)
Network Health PPO
AMS01
Professional
Denver Health - Indigent
84134
Professional
DENVER HEALTH MED PLN
Denver Health Medical Plan
84135
Professional
DENVER HEALTH MEDICAID CHOICE
Denver Health and Hospital Authority
84133
Professional
Denver Health Medical Plan
Inc. Medicare Choice
84131
Professional
Desert Medical Group
DESRT
Professional
Desert Valley Medical Group
DVMC1
Professional
Devoted Health
DEVOT
Professional
DGA - Diversified Group Administrators
25160
Professional
DHMN Preferred IPA Hospital Risk
DHM02
Professional
DHMN Santa Cruz
DHM01
Professional
Dignity Global
MPM27
Professional
Dignity HCLA
MPM28
Professional
Dignity Health - Sacramento Hospital claim shop for Mercy Medical Group
Woodland Clinic Medical Group and Hill Physicians Medical group (hospital risk)
Dignity Health - Sacramento Hosp claim shop-Mercy Med Group
HOSH1
Professional
Dignity Health Medical Foundation for Mercy Medical Group or Woodland Clinic Medical Group (professional risk)
for Mercy Medical Group or Woodland Clinic Medical Group
Dignity Health Med Found for Mercy Med Gr-Woodland Clin Med
PROH1
Professional
Dignity Health Medical Group (Inland Empire)
Dignity Health Med Group-Inland Empire (professional risk)
PROH4
Professional
Dignity Medical Foundation Professional Capitated Non- Payment
PROHC
Professional
DIRECT CARE ADMINISTRATORS
DCA62
Professional
DirectCare
55731
Professional
Directors Guild of America
California Anthem Blue Cross
California Blue Cross
Anthem Blue Cross of California
Blue Cross of California
BC001
Professional
District of Columbia Medicaid
SKDC0
Professional
Diversified Admin Corp
06102
Professional
DMBA
SX105
Professional
DMERC Region A Testing is required for claims requiring CMNs
DME Region A
DMERA
Professional
DMERC Region B Testing is required for claims requiring CMNs
DME Region B
DMERB
Professional
DMERC Region C Testing is required for claims requiring CMNs
DME Region C
DMERC
Professional
DMERC Region D Testing is required for claims requiring CMNs
DMERD
Professional
Doctors Healthcare Plan
DRHCP
Professional
Dolton Medical Group
DOLMG
Professional
Downey Select IPA (Applecare Medical Mgmt)
Downey Select IPA (Applecare Medical Mgmt
APP01
Professional
DPC Core INC
DPC CORE
Inc.
23212
Professional
DPSC INC
A6864
Professional
Dreyer Medical
DREYR
Professional
Driscoll Childrens Health Plan
Driscoll Childrens Health Plan (CHIP)
74284
Professional
Dunn and Associates Benefits Administrators
Inc.
35186
Professional
E.S. Beveridge and Associates
E. S. Beveridge and Associates
E.S. Beveridge
34108
Professional
E3 Health
Inc (Formerly First Integrated Health)
First Integrated Health
75232
Professional
Each Care Network- Effective 08/01/2020
88846
Professional
Early Intervention Central Billing
36434
Professional
East Boston Neighborhood Pace
NeighborhoodHealth
25849
Professional
EAST CAROLINA BEHAVIORAL HEALTH
56089
Professional
Eastern Main Healthcare Systems (EMHS)
Eastern Main Healthcare Systems (EMHS) Employee Health Plan
16565
Professional
Eastland Medical Group
EMG11
Professional
Easy Care MSO LLC
ECMSO
Professional
Easy Choice Health Plan of NY
24770
Professional
Easy Choice HP of NY
Med3000 CMS Title 19 Reform (New PID Effective For DOS After 1/31/19)
Pyramid Life Insurance Company
Wellcare HMO
Inc.
Todays Option (American Progressive and Pyramid Life)
Med3000 CMS Title 19 Reform (New PID Effective For DOS After 1/31/19)
14163
Professional
Eberle Vivian
EV001
Professional
EBMS (Employee Benefit Management Services
Inc)
81039
Professional
EDS Healthchoice (formerly payer ID 22521 - For dates of service on or after 01/01/2018 )
Healthchoice (formerly payer ID 22521)
HealthChoice
71064
Professional
El Paso First Health Plans - CHIP
El Paso First - CHIP
El Paso First - CHIP I Par Plus
EPF03
Professional
EL Paso Health Advantage Dual
EPF07
Professional
El Proyecto Del Barrio IPA
MPM04
Professional
Elder Service Plan of the North Shore.
Element Care Incorporated
Elder Service Health Plan of the North Shore
04326
Professional
ELDERPLAN
ElderPlan
Inc. (Elderplan Provider ID necessary on all claims. Contact (718)921-7979 for Provider ID.)
31625
Professional
Ellis Consultants
INC.
ECISF
Professional
Elmcare L.L.C.
Elmcare
NAELM
Professional
Elmco
37253
Professional
Emblem Health
81336
Professional
EmblemHealth Plan (HMO)
GHI HMO Select
25531
Professional
Emerald Health
16755
Professional
EMI HEALTH
SX110
Professional
Empire BCBS Anthem BCBS NY
00803
00803R
Professional
Empire Physician's Medical Group
EMP01
Professional
Employee Benefit Administration & Management (EBA&M)
HealthSmart Employee Benefit Administrators & Management
95288
Professional
Employee Benefit Concepts
Employee Benefit Concepts MI
38241
Professional
Employee Benefit Management Corp.
Employee Benefit Management Corp. (EBMC)
31074
Professional
Employee Benefit Services
Key Benefit Administrators (Ft. Mill
SC)
Employee Benefit Systems
Key Benefit Administrators (Ft.Mill
SC)
37216
Professional
Employee Benefit Svcs (EBS) of San Antonio
EBSSA
Professional
Employee Benefit System
Employee Benefit Systems
42149
Professional
Employee Logistics
92135
Professional
Employee Plans
LLC
Employee Plans LLC
35112
Professional
Employees Mutual (EMC)
21415
Professional
Employer Health Network
Employers Health Network
IHS07
Professional
Employer Plan Services
Inc.
74212
Professional
Employer's Direct SF
Employers Direct Health - SF
75233
Professional
Employers Direct Health
Employers Direct Health - Employee Plan
75236
Professional
Employers Health Cooperative (EHC)
Employers Coalition On Health (ECOH)
Claimshop- Employers Coalition on Health
27008
Professional
Employers Mutual
Inc. (Florida Providers only)
Employers Mutual
Inc (FL)
59298
Professional
Empower Arkansas
12956
Professional
Enterprise Group Planning
EGPIN
Professional
Entrust
36878
Professional
Eon Health
73780
Professional
EPN - Seton Health Plan Exclusive (Provider ID required)
EPN (Seton Health Plan Exclusive PR I Par Plus)
EPNSH
Professional
Erin Group Administrators
Significa Benefit Services
Inc.
Erin Group Administrators (Now known as Significa Benefit Services
Inc.)
23250
Professional
Essence Healthcare
20818
Professional
Essence Healthcare
57082
Professional
Essential Health Partner
EHPSC
Professional
Essential Health Partners
EIPA9
Professional
Everence
Mennonite Mutual (Now known as Everence)
Mennonite Mutual Aid Association and Affiliates (Now known as Everence)
35605
Professional
Evergreen Health Coop check the member ID Card for Payer ID
93240
Professional
Evolutions Healthcare Systems
Evolutions Healthcare
59313
Professional
Evry Health
EH001
Professional
Exceedent LLC
22344
Professional
Excellus BCBS New York Rochest
Excellus BCBS New York Rochester Area
SB804
Professional
Excellus BCBS New York Utica Watertown
SB806
Professional
Exclusive Care
Exclusive Care (ALL providers must contact Exclusive Care prior to submitting claims electronically. Please contact Martha Cuevas at 951-955-8853)
EC999
Professional
Eye Specialists (Provider ID number required in Box33a or Box24J)
BVES1
Professional
Eyefinity VSP
94163
Professional
EyeMed
31165
Professional
EyeQuest
63740
Professional
Facey Medical Foundation
95432
Professional
FACS Group
37300
Professional
Falling Colors
FCC20
Professional
Fallon (Transplant claims)
Fallon Transplant
FT254
Professional
Fallon Community Health
Fallon Community Health Plan
22254
Professional
Family Care
Family Care - Milwaukee WI
60995
Professional
Family Care Specialists
MPM40
Professional
Family Practice Medical Group
10145
Professional
Farm Bureau Health Plans MAPD
RP061
Professional
FCE BENEFIT ADMINISTRATORS
33033
Professional
Federal Employee Program (Connecticut)
C2BLS
Professional
Federated Mutual Insurance
41041
Professional
Fenix Med Group
60818
Professional
Fidelis Care New York
11315
Professional
Fire Department Cityof New York World Trade Center Health
FDNYP
Professional
Firefly Health
FRFLY
Professional
First Agency
88055
Professional
First Carolina Care
FCC01
Professional
First Choice Medical Group
FCMG1
Professional
First Choice Next A Product of Select Health of South Carolina
Inc.
57103
Professional
First Choice VIP Care Plus SC #3
First Choice VIP Care Plus SC
77009
Professional
First Choice VIP Care(SC D SNIP) by Select Health of South Carolina
Inc.
32456
Professional
First Health Network
PPO Oklahoma (WinterBrook HealthCare Management)
73159
Professional
First Service Administrators
Florida 1st - Winterhaven
Florida
59276
Professional
First Solution
FS802
Professional
FirstCare
94999
Professional
FirstCare Star Medicaid
94998
Professional
Fitzharris & Company
11244
Professional
FL MCO PHC/PHP
FL MCO PHC PHP
95411
Professional
Florida Community Care
FLCCR
Professional
Florida Complete Care
FLCPC
Professional
Florida Health Plan
Florida Healthcare
59322
Professional
Florida Hospital VBR
VB001
Professional
Florida Medicaid
SKFL0
Professional
Florida Pace Centers
FLPAC
Professional
Flume Health INC
Flume Health Inc.
FH205
Professional
FMH Benefit Services
Luminare Health KC
Luminare Health KC fka Trustmark Health Benefits
FMH Benefit Services
Inc.
48117
Professional
Forest County Potawatomi Ins Dept
25059
Professional
Foundation Health of CA
FH001
Professional
Foundation Health of Florida-Encounters
FHFLE
Professional
Fox Valley Medicine Site 199
FVMCH
Professional
Fox Valley Medicine Site 451
FVMC1
Professional
Fox-Everett
Inc.
Fox Everett
64069
Professional
Franciscan Purdue
FAIPUR
Professional
Freedom Health Plan
41212
Professional
Freedom Life
Freedom Life Insurance Company
62324
Professional
Fresenius Medical Care
TH118
Professional
Fresno PACE
99660
Professional
Friday Health Plan
A2700
Professional
Fringe Benefit Coordinators
HealthSmart Fringe Benefit Coordinators
HealthSmart Fringe Benefit Coordinators (Dental)
59204
Professional
FrontPath
FrontPath Health Coalition
34171
Professional
Galveston County Indigent Health
GALVESTON COUNTY INDIGENT HEALTHCARE
30005
Professional
Gateway Health Plan - Medicare Assured Ohio
Gateway Health Plan - Medicare Assured OH
91741
Professional
Gateway Health Plan ((Yellow Card). Check the ID card to verify the Payer ID before submitting)
Assured
60550
Professional
Gateway Health Plan of Ohio
Inc.
76028
Professional
Gateway Health Plan
Gateway Health Plan - Medicaid PA
25169
Professional
Gateway to Better Health
4317M
Professional
GBS Group Benefit
GBS Global Benefit
Group Benefit Services
CB951
Professional
GBS Group Benefit Services
80241
Professional
GEHA (Government Employees Health Association)
Government Employees Health Association Inc. (GEHA)
Government Employees Health Association
Inc. (GEHA)
44054
Professional
GEHA Group Health Nevada Medicaid
GEHA9
Professional
Geisinger Health Plan
75273
Professional
GEMCare (Golden Empire Managed Care System)
Gemcare Golden Empire Managed
MCS01
Professional
Gemcare Health Plan
MCS03
Professional
Gemcare IPA (former payer ID PMGSC)
27133
Professional
General American Life Insurance Company
General American Life Insirance Company
63665
Professional
Generations Health
46050
Professional
Genesis Health Care
IP105
Professional
Georgia Health Advantage
A2327
Professional
Georgia Medicaid
SKGA0
Professional
Gettysburg Health
Gettysburg Health Administrators
Core Value (Part of Gettysburg Health.)
23274
Professional
GHA Orthopedic Providers INC
GHA Othopedic Providers
GHAOP
Professional
GHI - New York (Group Health Inc.)
EmblemHealth Plan (MCR)
Group Health Incorporated (GHI) (New York)
13551
Professional
GHI Medicare Part B of New York
Medicare Part B GHI
GHMCR
Professional
GHP (Group Health Plan)
25141
Professional
Global Care Inc
HealthSmart Global Care INC
Global Care
07689
Professional
Global Care Med Grp IPA
MPM05
Professional
Global Excel Management
GEM01
Professional
Global Health
GHOKC
Professional
Global Health of TX
GHTX0
Professional
Global One Ventures
GLOBA
Professional
Global Repricing Solutions
Innovative Healthware Payer 6
IHS06
Professional
Global TBSP
MPM64
Professional
Global Women's Health Plan
Global Womens Health Providers
GHAWH
Professional
Gloria Gates
IHS20
Professional
GMMI CC
GMICC
Professional
GMR HEALTHCARE
85664
Professional
GMS
Inc.
GMS INC
HealthSmart GMS Inc
47083
Professional
Gold Coast
77160
Professional
Gold Coast MSO
GCMSO
Professional
Gold Kidney Health Plan
Gold Kidney Healthcare
A6865
Professional
Golden Shore Medical Group (GSMG)
NMM03
Professional
Golden State Medical Group
Nivano Physicians IPD
Nivano Physicians IPA
MBA01
Professional
Gonzaba Medical Group
GMGSA
Professional
Good Samaritan Medical Practice Association (GSMPA)
IP086
Professional
Good Shepherd Hospice
76923
Professional
GRAVIE
90923
Professional
Great Lakes Health Plan (UnitedHealthcare Community Plan / MI)
Great Lakes Health Plan (UnitedHealthcare Community Plan)
UnitedHealthcare Community Plan / MI (formerly Great Lakes Health Plan)
95467
Professional
Great Lakes PACE
39640
Professional
Greater Covina Medical Group
GCMG1
Professional
Greater Newport IPA
GNPMG
Professional
Greater Newport Physicians Medical Group
33010
Professional
Greater Oregon Behavioral Health
GOBHI
Professional
Group Administrators Ltd
Group Administrators Ltd.
36338
Professional
Group Administrators Self-Funded Alternative
GASA1
Professional
Group and Pension Administrators
48143
Professional
Group Health Coop of South Central Wisconsin Encounters
South Central Wisconsin
39168
Professional
Group Health Cooperative of South Central Wisconsin Claims
Family Health Systems - WI/Group Health Cooperative
Group Health Cooperative
39167
Professional
Group Insurance Service Center
Inc.
Group Insurance Service Center
INC
37276
Professional
Group Marketing Services INC.
Group Marketing Services INC
66701
Professional
Group Resources PHCS
28680
Professional
Guarantee Trust Life Insurance Company
65810
Professional
Guardian Life Insurance Company of America
64246
Professional
Gulf South
60389
Professional
Gulf South Risk Services
60652
Professional
GulfStream- General Dynamics/CoreSource
CB624
Professional
Gundersen Lutheran Health Plan
Gundersen Lutheran Health Care
39180
Professional
H.E.R.E.I.U Welfare Pension Funds
Unite Here Health
H.E.R.E.I.U. Welfare Pension Funds
37114
Professional
HAA Preferred Partners
65101
Professional
Halcyon Behavioral Health
HALCY
Professional
Hamaspik Choice
Inc.
Hamaspik Choice Inc.
47738
Professional
Hammerman & Gainer
97258
Professional
HAP Caresource
MIMCDS1
Professional
HAP Caresource MI Dual
MIMCRCS1
Professional
Harbor Advantage
58305
Professional
Harmony Health Plan of Illinios
Harmony Health Plan of Illinois (Wellcare Provider ID required
call (800) 960-2530 opt. 2 then 5)
36406
Professional
Harmony Health Plan of Indiana
Harmony Health Plan of IA ( claims for Hoosier Healthwise me
36405
Professional
Harrington Health - Kansas ((Formerly known as Fiserv Health-Kansas)
Harrington Health - Kansas
Willis Administrative Services Corporation (Now known as UMR Kansas.)
62061
Professional
Harrington Health BPO
Harrington Health
59143
Professional
Harvard Community Health Plan
04245
Professional
Harvard Pilgrim Healthcare
Harvard Pilgrim
04271
Professional
Hawaii Mainland Administrators PHCS HMA Employees PMO
86070
Professional
Hawaii Medical Assurance Association (HMAA)
48330
Professional
Hawaii Medical Assurance Association (HMAA)
Hawaii Western Management (HWMG)
99208
Professional
Hawaii Medical Services Association (HMSA)
SB971
Professional
Hawaii Medicare
Medicare Part B of Northern Mariana Islands
Medicare Part B of Guam
Medicare Part B of Hawaii
HIMCR
Professional
HCC Life Insurance
HCCMI
Professional
HCH Administration
37111
Professional
HCP Nevada
20501
Professional
HCSC Insurance Services Company
84980
Professional
HDM Benefit Solutions
HDMCO
Professional
HDPC - Premier Healthcare
90023
Professional
Health 2 Business
55213
Professional
Health Alliance Medical Plans of Illinois
Health Alliance Medical Plans Illinois
77950
Professional
Health Alliance Plan of Michigan (Use payer ID 38224 for claims with a date of service 01-01-20 and greater. For dates of service 12-31-19 and prior please use payer ID 70259)
Medical Value Plan - Ohio (MVP)
HEALTH ALLIANCE P (Use payer ID 38224 for claims with a date of service 01-01-20 and
MVP - Ohio (Previous payer ID MHP77; Use payer ID 38224 for claims with a date of service 07-01- 19 and greater)
38224
Professional
Health Care District of Palm Beach
HCDPB
Professional
Health Care LA IPA (HCLA)
Healthcare LA
IPA
MPM06
Professional
Health Care Network of Wisconsin (HCN)
42102
Professional
Health Care Partners AZ
Health Care Partners of AZ
Health Care Partners -AZ (Dates of Service of 5-01-13&later)
HCP02
Professional
Health Choice Generations
Health Choice Utah
45399
Professional
Health Claims Service
82018
Professional
Health Cost Solutions
Health Coast Solutions
62111
Professional
Health Design Plus
Contigo Health
Health Design
34158
Professional
Health EZ
America's PPO (Formerly known as ARAZ.)
America's PPO (Formerly ARAZ)
ARAZ (Now known as America's PPO.)
16120
Professional
Health First-Tyler
TX
Health First - Tyler
TX
75234
Professional
Health First
Health First Health Plans
95019
Professional
Health IN Tech
IHS09
Professional
Health Management Associates (HMA
servicing Southeastern and Southwestern Regions) (Provider ID Required)
HMA Hawaii
86066
Professional
Health Net (California Encounters Only.)
Health Net of California (for claims with DOS prior to 12/31/17. For claims with DOS on or after 1/1/18
please use payer ID 68069 )
Health Net - California
95567
Professional
Health Net of Arizona
AZHNT
Professional
Health Net Oregon
22340
Professional
Health Network One
EMI (Eye Management Inc)
65062
Professional
Health New England
04286
Professional
Health Options of FL(Blue Shield HMO) ENCOUNTERS ONLY!!
FLENC
Professional
Health Options of Florida (Blue Shield HMO)
FLHLT
Professional
Health Options of Illinois I Par Plus
Health Options of Illinois
NAHOI
Professional
Health Partners
07003
Professional
Health Partners
PA
80142
Professional
Health Payment Systems
Health Payments Systems
Inc.
20270
Professional
Health Plan of Michigan (Now known as Meridian Health Plan)
Meridian Health Plan Michigan (Meridian Health Plan Michigan Complete and Meridian Health Plan Michigan Medicaid) effective until 12/31/20
MeridianHealth Michigan
Meridian Health Plan Michigan
52563
Professional
Health Plan of San Joaquin
68035
Professional
Health Plan San Mateo
Health Plan of San Mateo
HPSM1
Professional
Health Plan Services
Tampa Office
American Benefits Plan Administrators (Las Vegas
NV)
Consolidated Group
HEALTH PLAN SERVICES
Culinary Health & Welfare Fund (Las Vegas
NV)
59140
Professional
Health Plans Inc.
Health Plans
Inc.
44273
Professional
Health Plus Physicians Organization
63363
Professional
Health Select IPA (Enrollment required Contact 866-703-1444)
M3IL1
Professional
Health Services for Children with Special Needs (HSCSN)
Health Services for Children with Special Needs
37290
Professional
Health Services Management
Inc. (NOTE: ANSI submitters can also submit to plans AHP
CMS
ONP
PCI
PHP and VHP with proper value in SBR04.)
Health Services Management
Inc. for AHS
Health Services Management
Inc. for BPA
Health Services Management
Inc. for ECOH
Health Services Management
Inc. for EHC
Health Services Management
Inc. for ENCR
Health Services Management
Inc. for FCM
Health Services Management
Inc. for HF
Health Services Management
Inc. for HT
Health Services Management
Inc. for MMSI
Health Services Management
Inc. for MSHO
Health Services Management
Inc. for PNET
Health Services Management
Inc. for PONE
Health Services Management (HSM)
Health Services Management
Inc. for SC
Health Services Management
Inc. for WEA
HSM01
Professional
Health Services Mgmt/Magellen Health
41150
Professional
Health Services Preferred (HSP) by Emerald Health
Health Srv Pref. (HSP) Emerald Hlth
Integrated Care Network (ICN) by Emerald Health
Health Srv Pref (HSP) Emerald Hlth
PPO Business)
Emerald Health Network
Emerald Health Network
Inc. (All HMO Business)
34167
Professional
Health Systems Inc
11889
Professional
Health Texas Medical Group
HTHTX
Professional
HEALTH WEST ADMINISTRATORS
U7876
Professional
HealthBridge
74853
Professional
Healthcare Highways
HCH01
Professional
Healthcare Highways Health Plan
HCHHP
Professional
Healthcare Management Administrator
Healthcare Management Administrators
Inc.
HMA01
Professional
Healthcare Options I Par Plus
EL Paso First Health Plan HCO Healthcare Options
EPF37
Professional
Healthcare Partners
Physician Associates of Greater San Gabriel Valley
Arta Health Network
Northridge Medical Group
OCN01
Professional
HealthCare Partners
IPA (Formerly Heritage New York Medical Group)
Healthcare Partners
IPA
Liberty Health Advantage
11328
Professional
Healthcare Resources NW
56731
Professional
HEALTHCARE SOLUTIONS
HealthSmart HealthCare Solutions Group
HealthCare Solutions Group
73147
Professional
Healthcare Strategic Initiatives
HSICS
Professional
Healthcare USA
Coventry Health Care (Coventry old Legacy Payer ID's are still accepted)
Coventry Health Care (Coventry old Legacy Payer ID's are still accepted.)
25133
Professional
HealthChoice Dept of Corrections & Rehab
71065
Professional
Healthchoice Select
71070
Professional
HealthComp
85279
Professional
HealthComp
Benefit Administrative Systems
BENEFIT ADMIN. SYSTEM
36149
Professional
HealthComp
Gilsbar
Inc
HealthPlus of Louisiana (Old PayerID of 95009 is no longer valid)
360 Alliance PPO Gilsbar
360 Alliance Gilsbar
Gilsbar
Health Plus of LA
07205
Professional
Healthease
Wellcare of FL
59608
Professional
HealthEdge Admin-claims PO Box 11210
Bakersfield
CA 93389
95213
Professional
HEALTHEOS
Multiplan Wisconsin Preferred Provider Network
34080
Professional
Healthfirst TPA - Austin
Healthfirst of Austin TPA
75289
Professional
Healthfirst
Inc. (NY)
Healthfirst of NY
80141
Professional
Healthgram
Ingham Health Plan Corp.
Ingham Health Plan Corp
38343
Professional
Healthnet of AZ
Healthnet of Arizona
Inc.
38309
Professional
Healthnow BCBS New York Northeastern
SB800
Professional
Healthnow BCBS New York Western
SB801
Professional
Healthnow New York INC
55204
Professional
Healthpartners of MN
HealthPartners of Minnesota
55764
Professional
Healthscope
40026
Professional
HealthSCOPE Benefits EHC Repricing
HealthScope Benefits EHC Repricing
52429
Professional
HealthSCOPE Benefits
INC
CNA Health Partners
HealthScope Benefits
71063
Professional
Healthsmart Accel
75237
Professional
HealthSmart Farm Family Life
14140
Professional
Healthsmart Management Services Organization Inc
Healthsmart Mgmt Services Org Inc
A0067
Professional
HealthSmart Medcom
MedCom
59231
Professional
HealthSmart MFC & HealthPlus Peoria
Methodist First Choice
Midland Management/MFC
23550
Professional
Healthsmart MyDecision
18840
Professional
HealthSmart NAMCI Global Care
NAMCI/Global Care
L0110
Professional
HealthSmart OKC
73140
Professional
HealthSmart Preferred Benefit Administrators
Preferred Benefit Administrators
53476
Professional
HealthSmart Preferred Care
HSPC1
Professional
HealthSmart Preferred Care
North Texas Healthcare Network
North Texas Healthcare Network (Effective 01-01-2019)
75250
Professional
HealthSmart University Medical Center
11149
Professional
Healthsource AR-Claims cont Healthsource spec VendID&Rend Pr
71074
Professional
Healthsource Kentucky - Claims must contain Healthsource specific Vendor ID & specific Rendering Provider ID
Healthsource
KY
61127
Professional
HEALTHSOURCE MSO
HSMSO
Professional
Healthsource New Hampshire - Claims must contain Healthsource specific Vendor ID & specific Rendering Provider ID
02038
Professional
Healthsource
AR (Med) (CIGNA)
71075
Professional
Healthsource
GA (CIGNA)
58210
Professional
Healthsource
ME (CIGNA)
Healthsource Maine - Claims must contain Healthsource specific Vendor ID & specific Rendering Provider ID
01041
Professional
Healthsource
OH
31141
Professional
Healthsource
TN (CIGNA)
62129
Professional
HealthSpan Integrated Care accept claims DOS to 1-31-2017
HealthSpan Integrated Care
RH007
Professional
Healthspan
aka Kaiser of Ohio
NG007
Professional
HealthSpring
HT001
Professional
Healthspring HMO/Medicare + Choice
The Oath - Health Partners of Alabama (Now known as HealthSpring HMO/HealthSpring Medicare+Choice)
HealthSpring HMO/HealthSpring Medicare+Choice
63092
Professional
HealthSun
HESUN
Professional
Healthteam Advantage
88250
Professional
Healthteam Advantage HMO Diabetes and Heart Plan
88350
Professional
Healthways WholeHealth Networks
58213
Professional
Healthy Blue (MO)
00541
Professional
Healthy Blue (NE)
00544
Professional
Healthy Blue Dual Advantage Louisiana
00551
Professional
Healthy Blue Louisiana
00661
Professional
Healthy Blue North Carolina
00602
Professional
Healthy Blue SC (for DOS on or after 1/1/24)
00403R
Professional
Healthy CT
77180
Professional
Healthy Texas
68064
Professional
Healthy Valley Provider Network
HVPNI
Professional
Healthy York Network
22251
Professional
Heath Choice AZ
Health Choice of AZ
BCBSAZ ACA Standard Health with Health Choice
62179
Professional
Hemet Community Med Group ( 951-791-1111 prior to submitting
Hemet Community Medical Group
HCMG1
Professional
Hennepin Health / Northstar Advantage
60058
Professional
Heritag+A601e Physician Network I Par Plus
SelectCare of TX (Houston) (Provider ID Required - Contact (713) 843-6780 to obtain ID.)
Texas Plus
HPN11
Professional
Heritage Consultants (Must use 9 digit subscriber ID on all claims)
59230
Professional
Heritage IPA
HER01
Professional
HFN
Inc.
Arkansas Managed Care Organization
Inc. (AMCO)
HFN
Inc
36335
Professional
High Desert Medical Group (Lancaster
California)
HDMDG
Professional
High Desert Primary Care
HDPC Premier Healthcare
Mission HospitalAffiliates
STJOE
Professional
Highline Medical Services MOLINA
91164
Professional
Highmark BCBS (NY) Medicaid and CHP
Highmark BCBSD NY - Medicaid and CHP
00246
Professional
Highmark BCBSD Health Options.
Highmark BCBSD
47181
Professional
Highmark Senior Health Company (PA Blue Shield Medicare Plan)
15460
Professional
Highmark Senior Solutions Company (WV Blue Shield Medicare Plan)
15459
Professional
Hill Physician Cigna PPO
HLPCG
Professional
Hill Physicians Aetna PPO
HLPAE
Professional
Hill Physicians Blue Cross PPO
HLPBC
Professional
Hill Physicians Blue Shield PPO
HLPBS
Professional
Hill Physicians Health Net PPO
HLPHN
Professional
Hill Physicians Medical Group
00046
Professional
Hill Physicians Medical Group
HIL01
Professional
Hill Physicians United Healthcare PPO
HLPUH
Professional
Hillsborough County Health Care
Administrative Services
Administrative Services
Inc.
59141
Professional
HIP - Health Insurance Plan of Greater New York
HIP-Health Insurance Plan of Greater NY
55247
Professional
Hispanic Physicians IPA
HPFFS
Professional
HMC Healthworks aka Health Management Co.
HMC Healthworks aka Health Management Co
75318
Professional
HMO Louisiana Blue Advantage (For claims with DOS 2020
for claims with DOS on or after 01/01/21 use payer ID 72107)
HMO Louisiana Blue Advantage (For claims with DOS 2020
for claims with DOS 01/01/21 use payer ID 72107)
84555
Professional
HMO Louisiana Blue Advantage (Use this claim for DOS on or after 01/01/21)
HMO Louisiana Blue Advantage (Use payer ID 72107 for claims with a DOS on or after 01/01/21)
72107
Professional
Hockenberg's Equipment (UCS)
59573
Professional
Hollywood Presby Medical Center
MPM29
Professional
Hollywood Presbyterian Medical Center
AMM18
Professional
Holy Cross Health Partners
NAHLX
Professional
Homelink
30750
Professional
Homelink
50701
Professional
Homelink Healthpartners
55744
Professional
Hometown Health Plan Nevada
Hometown Health of NV
88023
Professional
Hopkins Health Advantage
66003
Professional
Horace Mann Life Insurance
HealthSmart Horace Mann Life Insurance Company
HMLIC
Professional
Horizon Pace
R4569
Professional
Horizon Pace
Mercy Health Plan of New Jersey (Provider ID Required in Box33a - Contact (800) 682-9091 to obtain ID)
Horizon NJ Health
22326
Professional
HP Administrative Services LLC DOS prior to 01/01/2018)
22521
Professional
HPMS Send claims to payerID listed on patient's ins card)
0CARD
Professional
HRSA COVID-19 Coverage Assistance Fund – 99999-0AQS
90AQS
Professional
HSBS Memphis
Pittman & Associates (Now known as HSBS Memphis)
HSBS Memphis (Formerly Pittman and Associates)
37224
Professional
HSBS Oklahoma City
Mutual Assurance (Now known as HSBS Oklahoma City)
HSBS Oklahoma Cityi (Formerly Mutual Assurance Administrators)
37256
Professional
Human Behavioral Institute
HBI01
Professional
Humana Health Plan of Ohio
Inc
Humana Health Plan of Ohio Inc
61103
Professional
Humana Health Plan Ohio
95348
Professional
Humana Long Term Care
Humana Long Term Care
61115
Professional
Humana Puerto Rico
L0200
Professional
HUMANA
Encounters Only
61102
Professional
Humboldt Del Norte Foundation IPA
HDNFC
Professional
Hylton Payroll (Benefit Plan Administrators)
19753
Professional
I. E. Shaffer
I E SHAFFER
22175
Professional
IA Teamsters Health Ben Fund Local 135 Health Benefits Fund
35107
Professional
IBA Self Funded Group
38234
Professional
IBG Administrators
LLC
IBG Administrators
81810
Professional
iCARE (Independent Care Health Plan)
11695
Professional
ICARE Health Options TPA
iCircle Health Solutions
26054
Professional
iCircle Care
ICRCL
Professional
iCircle of New York
33884
Professional
Idaho True Blue
TRUEB
Professional
IH Plans INC
IHP21
Professional
IHPlans
Imperial Health Plan of California Incorporated
IHP01
Professional
IHS Gateway Payer South
CB711
Professional
IHS Gateway Payer South
A2352
Professional
Illinois Health Plan (IHP)
Boncura Health (Dupage Medical Group)
Boncura Health Solutions (Dupage Medical Group)
DMG01
Professional
Illinois Health Solutions ( ProviderID Required)
86069
Professional
Illinois Physician Alliance IPA
Illinicare Physicians Alliance IPA
IPA99
Professional
IMA of Louisiana Inc.
Insurance Management Administrators
72091
Professional
IMCARE
41600
Professional
Immigration Services
Homeland Security (ATTN: Deportation)
INS Health Services
VAICE
Professional
Imperial Health Holdings Medical Group
IHHMG
Professional
INDECS Corporation
40585
Professional
Independence Administrators
TA720
Professional
Independence American Insurance Comp
Independence American Insurance
Independence American Ins. Co.
CB231
Professional
Independence Medical Group
MHM01
Professional
Independence Medical Group of Kern County
IMG01
Professional
Independence Medical Group Tulare County
IMG02
Professional
Independent Blues of PA
Personal Choice PPO of PA (Also know as Independent BLC)
Independent BLC of PA (Also known as Personal Choice PPO of Pennsylvania.)
54704
Professional
Independent Health
SX073
Professional
Independent Living Systems
45048
Professional
Indian Health Services
00290
Professional
Indiana Department of Health Children's Health
35600
Professional
INDIANA PROHEALTH
Indiana ProHealth Network
35161
Professional
Indiana University
IUHPL
Professional
INETICO
INC.
43471
Professional
InforMed
LLC
52196
Professional
Ingalls Provider Group (New PID for DOS 1-1-19 & after only)
Ingalls Provider Group
66727
Professional
Inland Empire Health Plan.
Inland Empire Health Plan
IEHP1
Professional
INNOV_OSF Healthcare Center
Innov_OSF Healthcare Central
OSFC9
Professional
Innovante Benefit Admin/ (HSBS WTC) (Effective 3-1-17)
World Trade Center Health Program (WTCHP)
Innovante Benefit Administrators (HSBS WTC)+A174
31172
Professional
Innovation Health
40025
Professional
Innovative Healthware Payer 12
IHS12
Professional
Innovative Healthware Payer 13
IHS13
Professional
Innovative Healthware Payer 16
IHS16
Professional
Innovative Healthware Payer 21
NextPA
IHS21
Professional
Innovative Healthware Payer 22
IHS22
Professional
Innovative Healthware Payer 25
IHS25
Professional
Innovative Healthware Services Payer 5
IHS05
Professional
Innovative Physician Associates
80087
Professional
Innovista Health
INDPM
Professional
Insurance Administrators of America
Insurance Administrator of America
37279
Professional
Insurance Design Administrators
13315
Professional
Insurance Management Services (Amarillo TX)
Insurance Management Services
(Amarillo TX)(This payerID is only valid for claims submission address of PO Box 15688 Amarillo
TX 79105)
15688
Professional
Insurance Management Services of Texas
Insurance Management Services
IMSMS
Professional
Insurance Service of Lubbock
Insurance Services of Lubbock
ISL11
Professional
Insurer's Administration Corporation
IAC01
Professional
Insurers Administrative Corporation I Par Plus
Insurers Administrative Corp. (Please visit website prior to submitting claims: edihelp.iacusa.com)
86304
Professional
Integra Administrative Group
Integra Administrative Group (Seafor d
DE)
INTEGRA Administrative Group
Inc.
51020
Professional
Integra Group
Integra Group (Also known as Rehab Provider Network
but not the same as Colorado payer of same name.)
31127
Professional
Integra Group - CHA
31129
Professional
Integra Managed Long Term Care
45302
Professional
Integranet I Par Plus
Integranet
INET1
Professional
Integrated Homecare Services
IHCS1
Professional
Integrated Medical Solutions
20050
Professional
Integrated Veterans Care (formerly known as VA FEE Basis Program)
Veterans Administration Fee Basis Programs
VA Fee Basis Programs
12115
Professional
Integrity Administrators (Champion Chevrolet)
99795
Professional
INTER UNION OF OPER15
International Union Operating Engineers
37269
Professional
Interactive Medical Systems
56132
Professional
Intercommunity Health Net
INCHN
Professional
Interface EAP
HealthSmart Interface EAP (IEAP)
Interface EAP -IEAP
60280
Professional
Intergroup Services Corporation
Western Pennsylvania Electrical Employees Insurance Trust Fund
Western Growers Assurance Trust (aka Pinnacle Claims Management)
23287
Professional
International Benefit Administration
International Benefit Administrator
11329
Professional
International Funding Inc.
Insurance TPA.CLM LLC
39182
Professional
International Medical Group
INC
International Medical Group
Inc. I Par Plus
IMGIN
Professional
Interwest Health
InterWest Health PPO (Montana)
84137
Professional
Intl Brotherhood Boilermakers EMPL Health Care Plan IBBEHC
International Brotherhood of Boilermakers Employee Health Care Plan(IBBEHC)
48603
Professional
INTotal Health
35115
Professional
Iowa Health Solutions (Provider ID Required)
Southeast Iowa Health Plan (Provider ID Required)
Hawki (Provider ID Required)
86068
Professional
Iowa Medicaid
SKIA0
Professional
Iron Road Healthcare
Union Pacific Railroad Employees Health Systems
87042
Professional
Island Home Insurance Company
Island Hone Health Insurance Company
85502
Professional
IU Health Transplant Evaluation Program
47262
Professional
IU Medical Group Primary Care
SX172
Professional
J1 Mutual of Omaha
CA
HI
NV (Legacy)
01911
Professional
JAI Medical Systems
JAI Medical
JAI01
Professional
Jericho Share
IHS02
Professional
John Hopkins Healthcare (EHP/PP) (Submit Billing NPI and Rendering/Servicing NPI)
Johns Hopkins (USFHP)
52189
Professional
John Morrell Company - AHPBA
38310
Professional
John Muir Health Network
JMH01
Professional
John Muir Mt. Diablo Health System
John Muir Mt Diablo Hlth System
68036
Professional
Johns Hopkins (USFHP) (New submitter should send in their Billing NPI & Rendering servicing NPI)
Johns Hopkins Medical Service
52123
Professional
Joplin Claims
43178
Professional
JP Farley Corporation
34136
Professional
JPS Preferred Care
MWP01
Professional
JSL Administrators AKA Wells Fargo Third Party Administrators aka Healthsmart Benefits Solutions
Healthsmart Benefit Solutions.
JSL Administrators AKA Wells Fargo Third Party Aministrators
Wells Fargo Third Party Aministrators AKA Healthsmart Benefit Solutions.
37272
Professional
JVHL Health Alliance Plan (Fee for Service Contracts)
JHJVL
Professional
JVHL Priority Health
JZJVL
Professional
JVHL United Healthcare (Golden Rule Members)
KRJVL
Professional
JVHL United Healthcare Community Plan (Great Lakes Health Plan)
JRJVL
Professional
JVHL WellCare
MMJVL
Professional
JVHL Aetna Better Health Premier Plan
M5JVL
Professional
JVHL Aetna U.S. Healthcare
J1JVL
Professional
JVHL AmeriHealth Caritas VIP Care Plus
MDJVL
Professional
JVHL BCBSM Medicare Plus Blue PPO
KCJVL
Professional
JVHL Blue Care Network (BCN Commercial Labs)
JVHL Blue Care Network* (BCN Commercial Labs)
JJJVL
Professional
JVHL Blue Care Network (BCN Reimbursable Labs)
JVHL Blue Care Network* (BCN Reimbursable Labs)
JQJVL
Professional
JVHL Blue Care Network* (Critical Access / Small Volume Labs)
JVHL Blue Care Network (Critical Access / Small Volume Labs)
MJJVL
Professional
JVHL Blue Care Network* (JVHL Network)
JVHL Blue Care Network (JVHL Network)
J9JVL
Professional
JVHL Blue Cross Complete
KPJVL
Professional
JVHL CIGNA – (Health Partners members only)
KQJVL
Professional
JVHL CIGNA (Non-HAP and CIGNA- HAP members)
JVHL CIGNA (Non-HAP and CIGNA-HAP members)
KDJVL
Professional
JVHL Community Care Associates (Healthchoice)
JWJVL
Professional
JVHL CoventryCares - Aetna Better Health of MI
J8JVL
Professional
JVHL Genesee County Health Plan
MBJVL
Professional
JVHL HAP Empowered (Midwest) Health Plan
JBJVL
Professional
JVHL Health Alliance Plan (Capitated Contracts)
JGJVL
Professional
JVHL Humana
KVJVL
Professional
JVHL McLaren Health Plan
K7JVL
Professional
JVHL Meridian Health Plan of MI (Health Plan of Michigan)
J2JVL
Professional
JVHL Molina Healthcare of Michigan
JIJVL
Professional
JVHL Physicians Health Plan
MNJVL
Professional
JVHL Reliance HMO
MKJVL
Professional
JVHL United Healthcare (non- Golden Rule Members)
JVHL United Healthcare (non-Golden Rule Members)
J5JVL
Professional
JVHL VA Community Care Network
MSJVL
Professional
Kaiser Foundation Health Plan
21313
Professional
Kaiser Foundation Health Plan of CO (Remits returned KAISR)
Kaiser Foundation Health Plan of Colorado
COKSR
Professional
Kaiser Foundation Health Plan of GA(835 returned under KAISR
Kaiser Foundation Health Plan of Georgia
NG010
Professional
Kaiser Foundation Health Plan of Mid-Atlantic St(835 KAISR
Kaiser Foundation Health Plan of the Mid-Atlantic
Kaiser Foundation Health Plan of the Mid Atlantic
NG008
Professional
Kaiser Foundation Health Plan of Northern CA
Kaiser Foundation Health Plan of Northern CA Region
94135
Professional
Kaiser Foundation Health Plan of Southern California
Kaiser Permanente Southern CA
KS001
Professional
Kaiser Foundation Health Plan of the NW (835 ret KAISR)
Kaiser Foundation Health Plan of the NW
NG009
Professional
Kaiser Foundation Health Plan of Washington (Formerly Group Health Cooperative of WA)
Kaiser Foundation Health Plan of Washington
Group Health Northwest (Old PayerID of 91121 is being retired. Now use payerID of 91051)
Group Health Options (Formerly KPS Health Plans)
91051
Professional
Kaiser Foundation Health Plan PPO
Kaiser Self Funded (also known as KPIC Self-Funded Claims and Kaiser Self Funded Plan Harrington) Hawaii
Kaiser Self Funded (also known as KPIC Self-Funded Claims and Kaiser Self Funded Plan Harrington)
94320
Professional
Kaiser Foundation Northwest
Kaiser Foundation of the Northwest
93079
Professional
Kaiser Foundation of Northern California
Kaiser Foundation Health Plan of Northern California
Kaiser Permanente Northern CA
KS003
Professional
Kaiser Foundation Southern California
Kaiser Foundation Health Plan of Southern CA
94134
Professional
Kaiser Permanente Hawaii
RH011
Professional
Kalos Gold Health Plan
61185
Professional
Kalos Health
Kane County IPA
40137
Professional
KBA
14503
Professional
Keenan & Associates
KEE01
Professional
Keenan Associates
95279
Professional
Kelsey Seybold
KELSE
Professional
Kemper Benefits
61453
Professional
Kempton Company
Kempton Group Administrators
Kempton Group
73100
Professional
Kent County Health Plan
KENT1
Professional
Kentucky Health Administrators
Inc.
27215
Professional
Kentucky Medicaid
SKKY0
Professional
Kentucky Medicare Part A Jurisdiction 15
Medicare Part B of Kentucky
KYMCR
Professional
Kern County CDCR
28021
Professional
Kern Health Care Network (Valid DOS prior to 01-01-2016)
22149
Professional
Kern Health Systems
77039
Professional
Kern Legacy Health Plan
89890
Professional
Key Benefit Administrators
37217
Professional
Key Health Medical Solutions
95460
Professional
Key Medical Group (Providers please contact Brandi Guinn @ 559-735-3892 x233 for authorization.)
IP082
Professional
KEY SELECT
37321
Professional
Key Solution
Key Solution (Dental)
37323
Professional
KeyCare Maryland
KCMD1
Professional
Keystone First Community Health Choices
42344
Professional
Keystone Health Plan East - Claims
Pennsylvania Keystone Health Plan East (claims only)
PAKeystone Health Plan East (claims(835s returnedPAKEY)
PCBLS
Professional
Keystone Mercy Health Plan
23284
Professional
Klais & Company (Part A and Part B)
80089
Professional
Klais and Company
34145
Professional
Klais and Company
31147
Professional
Klais and Company Repriced HealthSpan
3414A
Professional
Know The Costs
04430
Professional
Kopp Billing Agency
RP091
Professional
Kova Healthcare Incorporated
KOVA1
Professional
KPIC-Kaiser Permanente (CA
CO
DC
GA
HI
MD
OH & OR)
KPIC1
Professional
LA Care Health Plan
LACAR
Professional
LACH HealthNet by MedPoint
MPM19
Professional
Lakeside Medical Group
66125
Professional
Lakeside Medical Group Inc.
LMG11
Professional
Lancaster General Health
Lancaster General Health (LGH)
16109
Professional
Las Vegas Firefighters Health & Welfare Trust
NWADM
Professional
LaSalle Medical Associates
NMM02
Professional
Lasso Healthcare MSA
10550
Professional
Lawndale Christian Health Center
LAWND
Professional
LBA HealthPlans
LBA Health Plans
52193
Professional
Leisure World Managed Care
LWMC1
Professional
Leon Health Plans
A3565
Professional
Leon Medical Center Health Plan
37316
Professional
LEON Medical Center Health Plan I Par plus
Leon Med Center
65055
Professional
Liberty Advantage
LIB01
Professional
Liberty Union
Life Assurance Company
Mid-America Associates Inc.
Mid-America Associates
37281
Professional
Lien On Me
LM005
Professional
Life Investors Ins Co of America (Spec claims
LIICA
Professional
Life St Mary (Trinity Health Pace)
76184
Professional
Life St. Joseph of the Pines
59847
Professional
LIFE TRAC
41136
Professional
LifeCircles PACE
71498
Professional
LifePath Hospice Inc.
LifePath Hospice Inc
76870
Professional
Lifewise A Premier Health Plan
Lifewise Health Plan of Oregon A Premier Health Plan
LifeWise Assurance Company
LifeWise HealthPlan of Oregon
93093
Professional
Lifewise Assurance Company
93095
Professional
Lifewise Health Plan of Washington A Premier Health Plan
91049
Professional
Lifewise Health Plan of Washington
LifeWise HealthPlan of Washington
93094
Professional
Lifeworks Advantage
LWA01
Professional
Lipa/Agate Resources
LIPA1
Professional
Little Company of Mary
LCM1
Professional
Little Company of Mary Health
4725P
Professional
Live Beaver County
Life Beaver County
25924
Professional
Local 137 Operating Engineers Welfare Fund
84041
Professional
Lockard & Williams
CB752
Professional
Loma Linda University Adventist
37267
Professional
Loma Linda University Health Care
Loma Linda University Health Plan
33036
Professional
Loma Linda University Medical Center
95352
Professional
Lone Star TPA
45289
Professional
Long Beach Memorial IPA (MHCLB)
Medical Orange Coast Memorial IPA
Anaheim Memorial IPA (MHCAN)
Memorial Healthcare IPA
Acclaim IPA
Acclaim IPA (MHCAC)
Orange Coast Memorial IPA
MHIPA
Professional
Longevity Health Plan of NY
LNY01
Professional
Longevity Illinois
LIL01
Professional
Longevity Michigan
LMI01
Professional
Longevity NJ
LNJ01
Professional
Longevity of North Carolina
LNC01
Professional
Louisiana Medicaid
SKLA0
Professional
Luminare Health Detroit
NGS Coresource
Luminare Health Detroit fka Trustmark Health Benefits
38225
Professional
Luminare Health Internal
CoreSource
CoreSource Internal #3
35187
Professional
Luminare Health Little Rock
CoreSource Little Rock
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)
Luminare Health Little Rock fka Trustmark Health Benefits
75136
Professional
Luminare Health OH
Coresource of OH
CORESOURCE OH
Luther Care (CoreSource)
Luminare Health OH fka Trustmark Health Benefits
35183
Professional
Luther Care (CoreSource)
CB212
Professional
Luther Care (Coresource)
A2351
Professional
Lutheran Preferred
39198
Professional
Mabuhay Medical Group
CAPMN
Professional
MacNeal Health Providers - CHS (Contact 708-783-7100 prior to first submission.)
Macneal Hlth Providers-CHSZ
36334
Professional
Magellan Complete Care AZ
Magellan Complete Care Of AZ
Molina Complete Care of Arizona
MCC01
Professional
Magellan Complete Care Of VA
MCCVA
Professional
Magellan Health Services
Magellan Behavioral Health - UNUSABLE/MUST SEND PAPER CLAIM (Payer Address required on all claims)
Magellan Complete Care FL
01260
Professional
MagnaCare Administrative
Brighton Health Plan Solutions (for DOS prior to 01/01/2022)
Brighton Health Plan Solutions (formerly MAGNACARE)
MagnaCare Administrative Services
11303
Professional
Maine Community Health Options
45341
Professional
Maksin Management Corporation (Now known as AIG Educational Markets)
Maksin Management Corporation
AIG Educational Markets (Formerly Maksin Management Corporation)
22195
Professional
Managed Care Network
Managed Health Networks (MHN)
22771
Professional
Managed Care Services
LLC
35162
Professional
Managed Care Systems (Delango Regional Medical)
MCS02
Professional
Managed Care Systems CDCR (Customer Service: (800) 494-4662)
MCS04
Professional
Managed Health Care Associates
36312
Professional
Mapfre Life Commercial
46012
Professional
March Vision Health Plan
52461
Professional
Marin Headlands Medical Group
Sutter Medical Group Of The Redwoods
Sutter Pacific Medical Foundation
Sutter West Bay Medical Group
77304
Professional
Marin IPA
IP097
Professional
Marrick Medical Finance
LLC
Marrick Mement Finance
20805
Professional
Marrick WRx
Aspirion
46478
Professional
Martins Point Health Care
Martin's Point Health Care USFHP/Generations Advantage
MPHC2
Professional
Mary Washington Health Plan
83269
Professional
Maryland Medicaid
SKMD0
Professional
Maryland Physicians Care
22348
Professional
Maryland Physicians Care (MPC)
Maryland Physicians Care (MCP)
76498
Professional
Maryland PMHS ValueOptions (Use for ALL Dates of Service)
77063
Professional
Mashantucket Pequot Tribal Nation
Pequot Pharmaceutical Network
Bluebonnet Administrators
37121
Professional
Mass Health (MA Medicaid)
Medicaid of Massachusetts (Mass Health)
Medicaid of Massachusetts
Massachusetts Medicaid
MAMCD
Professional
Massachusetts Behavioral Health (BHO)
Massachusetts Behavioral Health (BHO) (BHO)
BHOMA
Professional
Massachusetts Mutual also known as Mass Mutual
Unicare Life & Health Insurance Company
UNICARE Major Accounts
80314
Professional
Masters
Mates and Pilots Plan
Masters
Mates and Pilots Program
MMPHB
Professional
Max Specialty Benefits
27320
Professional
MaxCare (Universal Fidelity Administrators Company)
93220
Professional
Maxor
92805
Professional
Mayo Clinic FL/GA
88090
Professional
MBA Benefit Administrators
MBA of Wyoming
87065
Professional
MBACLM
IHS24
Professional
Mcare of Michigan (Payer no longer accepting electronic claims. Claim will be printed and mailed to payer.)
38264
Professional
McCreary Corporation
Employers Mutual Inc Stuart FL
59331
Professional
McLaren Health Advantage
3833A
Professional
McLaren Health Plan
McLaren
38338
Professional
McLaren Medicaid
3833C
Professional
McLaren Medicare Supplement
3833S
Professional
McLaren State of Michigan
3833M
Professional
McLarenAdvantage SNP
3833R
Professional
MCS
6197P
Professional
MCS Life
66039
Professional
MD Anderson Physician Network
MDAPN
Professional
MD CARE HEALTH PLAN
MDC01
Professional
MDsave
MDSV
Professional
MDwise Healthy Indiana Plan
MDwise Health Indiana Plan
3135M
Professional
MDwise Hoosier Care Connect (For DOS on or after 1-01-2017)
91313
Professional
MDwise Hoosier Healthwise
3519M
Professional
MDwise Medicare Advantage
MDADV
Professional
MDWise Select Health Network
35199
Professional
MDX Hawaii
MDXHI
Professional
Med Pay
Med Pay (For claims repriced by Premier Health Care Exchange)
88058
Professional
Med-Pay
Anthem IN
00130
Professional
Med3000 CMS Safety Net
EM284
Professional
Med3000 Early Steps
Med3000 CMS Early Steps
EM350
Professional
MedAdmin Solutions
Network TPA
JIPA Network
Podicare
58204
Professional
MedAdmin Solutions
Network TPA
JIPA Network
Podicare
Advanced Data Solutions
58202
Professional
MedCost
56162
Professional
MedCost /Liberty Healthshare
MedCost / Liberty Health Share
90753
Professional
MEDCOST BENEFIT SVCS
MedCost Benefit Services
56205
Professional
MedCost Virginia
54138
Professional
Medfocus
95321
Professional
Medi-Cal by MedPoint
MPM18
Professional
Medica
94265
Professional
Medica Government Programs
MEDM1
Professional
Medica Health Plan Solutions
71890
Professional
Medica HealthCare Plans / FL
Medica Health Plan of Florida
78857
Professional
Medica2
12422
Professional
Medicaid - TX Premier Plan I Par Plus
Medicaid - TX Premier Plan (enroll at (915)-532-3778 x1507)
EPF02
Professional
Medicaid of Alabama
Alabama Medicaid
Medicaid of Alabama (for 837P & 837I claims)
ALMCD
Professional
Medicaid of Alaska
AKMCD
Professional
Medicaid of Arizona (AHCCCS)
Arizona Medicaid (AHCCCS)
Medicaid of Arizona (AHCCCS)
Medicaid of Arizona (AHCCCS)(837I & 837P)
AZMCD
Professional
Medicaid of Arkansas
Arkansas Medicaid
ARMCD
Professional
Medicaid of California (MediCal)
MediCal of California
MDCAL
Professional
Medicaid of Colorado
Colorado Medicaid
COMCD
Professional
Medicaid of Connecticut
Connecticut Medicaid
Medicaid of Connecticut (for 837P & 837I claims)
CTMCD
Professional
Medicaid of Florida
Florida Medicaid
Medicaid of Florida (for 837P & 837I claims)
FLMCD
Professional
Medicaid of Idaho
Idaho Medicaid
IDMCD
Professional
Medicaid of Illinois
IL621
Professional
Medicaid of Illinois
Illinois Medicaid
ILMCD
Professional
Medicaid of Indiana
Indiana Medicaid
INMCD
Professional
Medicaid of Iowa
18049
Professional
Medicaid of Iowa
Iowa Medicaid
IAMCD
Professional
Medicaid of Kansas
Kansas Medicaid
KSMCD
Professional
Medicaid of Kentucky
Kentucky Medicaid
KYMCD
Professional
Medicaid of Maine
Maine Medicaid
MEMCD
Professional
Medicaid of Maryland
Maryland Medicaid
MDMCD
Professional
Medicaid of Michigan BCCCP
SKMI1
Professional
Medicaid of Michigan Encounters
MCDMI
Professional
Medicaid of Michigan
Michigan Medicaid
MIMCD
Professional
Medicaid of Minnesota
Minnesota Medicaid
MNMCD
Professional
Medicaid of Mississippi
Medicaid of Mississippi (for 837P & 837I claims)
Mississippi Medicaid
MSMCD
Professional
Medicaid of Missouri
70029
Professional
Medicaid of Montana
Montana Medicaid
SKMT0
Professional
Medicaid of NC
SKNC0
Professional
Medicaid of Nevada
NVMMIS
Professional
Medicaid of Nevada
Nevada Medicaid
NVMCD
Professional
Medicaid of New Hampshire
New Hampshire Medicaid
NHMCD
Professional
Medicaid of New Jersey
New Jersey Medicaid
NJMCD
Professional
Medicaid of New Mexico
New Mexico Medicaid
NMMCD
Professional
Medicaid of New York
New York Medicaid
NYMCD
Professional
Medicaid of North Carolina
North Carolina Medicaid
Medicaid of North Carolina (for 837P and 837I claims)
NCMCD
Professional
Medicaid of North Dakota
NDDHS
Professional
Medicaid of North Dakota
North Dakota Medicaid
NDMCD
Professional
Medicaid of Ohio
Medicaid of Idaho
AIDID
Professional
Medicaid of Ohio
Ohio Medicaid
OHMCD
Professional
Medicaid of Oklahoma
OKMCD
Professional
Medicaid of Oregon
Oregon Medicaid
ORMCD
Professional
Medicaid of Pennsylvania
236003113
Professional
Medicaid of Pennsylvania
Pennsylvania Medicaid
Medicaid of Pennsylvania (837P
835s returned under SKPA0)
PAMCD
Professional
Medicaid of Rhode Island
RIMCD
Professional
Medicaid of SC
SKSC0
Professional
Medicaid of South Carolina
South Carolina Medicaid
SCMCD
Professional
Medicaid of South Dakota
South Dakota Medicaid
SDMCD
Professional
Medicaid of Tennessee (TennCare)
TennCare (Medicaid of Tennessee)
Tennessee Medicaid (TennCare)
TNMCD
Professional
Medicaid of Texas
Texas Medicaid
TXMCD
Professional
Medicaid of Texas
TX Medicaid Direct
86916
Professional
Medicaid of Vermont
Vermont Medicaid
VTMCD
Professional
Medicaid of Virginia
AIDVA
Professional
Medicaid of Virginia
Virginia Medicaid
VAMCD
Professional
Medicaid of Washington DC
District of Columbia Medicaid
Medicaid of DC
DCMCD
Professional
Medicaid of Washington State
Washington Medicaid
Medicaid of Washington
WAMCD
Professional
Medicaid of West Virginia
West Virginia Medicaid
WVMCD
Professional
Medicaid of Wisconsin
Wisconsin Medicaid
WIMCD
Professional
Medicaid of Wyoming
Wyoming Medicaid
WYMCD
Professional
Medical Associates Health Plan
MAHP1
Professional
Medical Associates Health Plan
MAHC1
Professional
Medical Benefit Administration
Inc.
68041
Professional
Medical Benefits Mutual
MedBen (Newark
OH)
Medical Benefits Administrators
Inc. (Newark
OH)
Medical Benefits Companies (Newark
OH)
Medical Benefits Mutual (Newark
OH)
Medical Benefits
74323
Professional
Medical Control
9043P
Professional
Medical Mutual of Ohio (Payer requires a 12 digit rendering provider ID#
which needs to be obtained from payer by calling 800-321-7223)
Health Span of Ohio (Payer has ceased operations using payerID 31434. claims should now be sent to Medical Mutual of Ohio
PayerID 29076_
Carolina Care Plan
Medical Mutual of Ohio
Carolina Care Plan (Part of the Medical Mutual Family of companies. Former payerID was 57105.)
29076
Professional
MEDICAL MUTUAL OF OHIO CAREWORKS
Careworks of Ohio
10010
Professional
Medical Reimbursement Associates
Medical Reimbursements of America
62177
Professional
Medical Resource Network (MRN
INC)
58203
Professional
Medical Services Initiative
12057
Professional
Medicare & Much More Florida Incorporated
Medicare & Much More Florida Incorporated (Effective 1/1/19)
MMMFL
Professional
Medicare Advantage Physicians Health Plan Michigan
Physicians Health Plan of Michigan Medicare
Medicare Advantage PHP Michigan
83276
Professional
Medicare Blue HMO PPO
56152
Professional
Medicare DME MAC Jurisdiction C
18003
Professional
Medicare DMERC Region A
16013
Professional
Medicare Florida Blue
FBM01
Professional
Medicare of MO (For pre-existing providers) Eastern & Wests
Medicare Part B of Kansas City (ASK)
KCMCR
Professional
MEDICARE PART B Alaska
02102
Professional
MEDICARE PART B Arizona
03102
Professional
MEDICARE PART B HI
American Samoa
Guam
Northern Marianas
01212
Professional
MEDICARE PART B Idaho
02202
Professional
MEDICARE PART B Montana
03202
Professional
MEDICARE PART B Nevada
01312
Professional
MEDICARE PART B North Dakota
03302
Professional
MEDICARE PART B Northern California
01112
Professional
Medicare Part B of Alabama
Alabama Medicare Part A Jurisdiction J
ALMCR
Professional
Medicare Part B of Arkansas
ARMCR
Professional
Medicare Part B of Colorado
SMCO0
Professional
Medicare Part B of Connecticut
CTMCR
Professional
Medicare Part B of Delaware
00902
Professional
Medicare Part B of Florida
FLMCR
Professional
Medicare Part B of Georgia
Georgia Medicare Part A Jurisdiction J
GAMCR
Professional
Medicare Part B of Illinois
ILMCR
Professional
Medicare Part B of Indiana
INMCR
Professional
Medicare Part B of Iowa
IAMCR
Professional
Medicare Part B of Kansas
KSMCR
Professional
Medicare Part B of Louisiana
LAMCR
Professional
Medicare Part B of Maine
MEMCR
Professional
Medicare Part B of Maryland
00901
Professional
Medicare Part B of Massachusetts
MAMCR
Professional
Medicare Part B of Michigan
Medicare Part B of Michigan (WPS)
Blue Cross Blue Shield Michigan Medicare
MIMCR
Professional
Medicare Part B of Minnesota
MNMCR
Professional
Medicare Part B of Mississippi
MSMCR
Professional
Medicare Part B of Missouri
Medicare Part B of MO (Eastern) (Specialty testing required)
MOMCR
Professional
Medicare Part B of Nebraska
NEMCR
Professional
Medicare Part B of New Hampshire
NHMCR
Professional
Medicare Part B of New Jersey
Medicare Part B of NJ (Specialty testing required)
NJMCR
Professional
Medicare Part B of New Mexico
NMMCR
Professional
Medicare Part B of New York (Empire)
NYMCR
Professional
Medicare Part B of North Carolina
North Carolina Medicare Part A Jurisdiction M
NCMCR
Professional
Medicare Part B of Oklahoma
OKMCR
Professional
Medicare Part B of Pennsylvania
PAMCR
Professional
Medicare Part B of Rhode Island
RIMCR
Professional
Medicare Part B of South Carolina
SCMCR
Professional
Medicare Part B of Tennessee
TNMCR
Professional
Medicare Part B of Texas
TXMCR
Professional
Medicare Part B of Upstate NY
N1MCR
Professional
Medicare Part B of Vermont
VTMCR
Professional
Medicare Part B of Virginia
VAMCR
Professional
Medicare Part B of West Virginia
WVMCR
Professional
Medicare Part B of Western MO ( pre-existing providers only)
MWMCR
Professional
Medicare Part B of Wisconsin
WIMCR
Professional
MEDICARE PART B Oregon
02302
Professional
MEDICARE PART B South Dakota
03402
Professional
MEDICARE PART B Southern California
01182
Professional
MEDICARE PART B Utah
03502
Professional
MEDICARE PART B Washington
02402
Professional
MEDICARE PART B Wyoming
03602
Professional
Medicare Part B- N VA Prin George MontFairfax Arlington Cou
Medicare Part B of DC
00903
Professional
Medicare Railroad * (MetraHealth Medicare)
Medicare Railroad (MetraHealth Medicare)
RRWMC
Professional
Medicare Y Mucho Mas
L0210
Professional
Medico Insurance
Medico Insurance Company
23160
Professional
Medigold
Mt. Carmel
95655
Professional
Mediture IPA
AMM11
Professional
MedPartners (PHCS Repricing)
MedPartners (PHCS RepricingPO Box 10240 Fort Wayne
In 46857
441MP
Professional
Medpartners
MedPartners Admin Services
412MP
Professional
MedSolutions
Inc
MedSolutions
Inc.
62160
Professional
Medstar Family Choice DC
RP062
Professional
Medstar Family Choice Maryland Healthchoice
RP063
Professional
Medstar Physician Partners
Helix Family Choice
00243
Professional
Medstar Select
251MS
Professional
Memorial Clinical Associates
MCA11
Professional
Memorial Hermann Bundle Program
MHB123
Professional
Memorial Hermann Health Network I Par Plus
Memorial Hermann Health Network
MHHNP
Professional
Memorial Integrated Healthcare
59064
Professional
MemorialCare Medical Foundation
MMFMC
Professional
Mental Health Consultants Inc
37050
Professional
Merchants Benefit Administration
INC
86087
Professional
Mercy Care
39114
Professional
Mercy Care Plan of Arizona
Mercy Health Plan (AHCCCS)
Mercy Health Plan of AZ
86052
Professional
Mercy Maricopa Integrated Care
33628
Professional
Mercy Provider Network
43185
Professional
Meridian Health Plan of Illinois
MeridianTotal (Meridian Complete
Illinois Complete
YouthCare and Ambetter Payer ID effective 01-01- 2021)
MeridianTotal (Meridian Complete
Illinois Complete
YouthCare and Ambetter Payer ID effective 01-01-2021)
MHPIL
Professional
MeridianComplete (Ambetter from Michigan
Meridian Complete
Michigan Complete) Payer ID effective 01-01-20
MeridianComplete (Ambetter from Michigan
Meridian Complete
Michigan Complete) Payer ID effective 01-01-2021
MHPMI
Professional
MeridianHealth Illinois
Meridian Health Plan Illinois Complete (Meridian Health Plan Illinois Medicaid effective until 12/31/20)
13189
Professional
Meritain Health (Formerly know as North American Administrators)
Meritain Health (North American Health Plan.)
North American Administrators
Inc.
64157
Professional
Metcare Health Plan
65113
Professional
Metro Plus Health Plan
13265
Professional
Metropolitan Health Plan
10850
Professional
MHCC Luminare Health
35189
Professional
MI Blue Care HMO (BCN of MI-835s returned MIBLS)
Michigan Blue Care HMO (BCN of Michigan)
Blue Cross MI Blue Care Complete
MIBCN
Professional
Miami Behavioral Health
92579
Professional
Miami Children’s Health Plan
82832
Professional
Michigan Medicare PlusBlue (835s returned under MIBLS)
Michigan Medicare PlusBlue
MIMPB
Professional
Micron Tech
96598
Professional
MID Rogue Oregon Health Plan
MD Rogue Oregon Health Plan
MRIPA
Professional
Mid-American Benefits
22823
Professional
Mid-West Behavioral Health Network
MVBCN
Professional
Midlands Choice
Midlands Health Partners
47080
Professional
Midwest Group Benefits
61146
Professional
Midwest Health Partners
76079
Professional
Midwest Health Plan
Midwest Health Plans
INC.
MHP77
Professional
Midwest Physician Administrative Services
TH088
Professional
Mills Peninsula Medical Group
MPMG1
Professional
MINNESOTA DEPARTMENT OF HEALTH- SAGE PROGRAMS
MNDH1
Professional
MISS SELECT HLTH CARE/SELECT ADMN SERVICE
MS Select Healthcare (Mississippi Select Health Care)
64088
Professional
Mission Community IPA Med Grp
MPM07
Professional
Mississippi Medicaid
SKMS0
Professional
Mississippi Medicaid Medicare Advantage Crossovers
SKMS1
Professional
Mississippi Physician Care Network
Mississippi Physicians Care Network
64084
Professional
Missoula County Medical Benefits
37275
Professional
Missouri Medicaid
Medicaid of Missouri
MOMCD
Professional
ML Healthcare
26097
Professional
MMM - Medicare y mucho Mas
88600
Professional
Moda Health (ODS Health Plan)
ODS Health Plan
13350
Professional
Molina Complete Care AZ
Molina Complete Care DSNP
MCC02
Professional
Molina Health Care of South Carolina
Molina Healthcare of South Carolina
46299
Professional
Molina Healthcare Arizona
A4353
Professional
Molina Healthcare Mississippi
77010
Professional
Molina Healthcare Nebraksa
Molina Healthcare of Nebraska INC
MLNNE
Professional
Molina Healthcare of CA - Encounters only.
33373
Professional
Molina Healthcare of California (Rendering provider must use Medi-Cal ID number or State License Number. Billing provider should use Federal TaxID only.)
Molina Healthcare of California
38333
Professional
Molina Healthcare of Florida
51062
Professional
Molina Healthcare of Idaho
61799
Professional
Molina Healthcare of Illinois
Molina Illinois
20934
Professional
Molina Healthcare of Iowa
MLNIA
Professional
Molina Healthcare of Michigan
38334
Professional
Molina Healthcare of Nevada
Molina Healthcare Nevada
A6106
Professional
Molina Healthcare of New Mexico
NM505
Professional
Molina Healthcare of New Mexico - SCI
Molina Healcare of New Mexico - SCI
04423
Professional
Molina Healthcare of New Mexico Salud
Lovelace Salud (Older PID of SX159 is no longer valid)
Molina Healthcare of New Mexico - Salud
09824
Professional
Molina Healthcare of Ohio
20149
Professional
Molina Healthcare of Texas
20554
Professional
MOLINA HEALTHCARE OF UTAH
SX109
Professional
Molina Healthcare of Washington (Rendering providers use DSHS Medicaid ID or State Licence Number.)
Molina Healthcare of Washington I Par Plus
38336
Professional
Molina Healthcare of Washington ENCOUNTERS ONLY
43174
Professional
Molina Healthcare of Wisconsin
Abri Healthplan (Now known as Molina Health Care of WI)
Abri Healthplan
ABRI1
Professional
Molina Ohio Medicaid
07316
Professional
Monarch Healthcare IPA (Rendering provider ID# required on all claims.)
Monarch IPA
IP095
Professional
Monitor Life
Monitor Life (secondary claims only
Medicare cannot be prim
01759
Professional
Montana Blue Cross Blue Shield
Blue Shield of Montana
MTBLS
Professional
Montana Medicaid
Medicaid of Montana
MTMCD
Professional
Montefiore Contract Management Organization (Provider ID required
call 914- 377-4400 for ID prior to first claims submissions.)
Montefiore Contract Management Organization
13174
Professional
Montefiore HMO
46161
Professional
Monterey Bay IPA
MBIPA
Professional
Monumental Life
Monumental Life Ins Co.
MMLIC
Professional
Morris Associates aka HealthScope Benefits
MORRIS ASSOCIATES
35092
Professional
Mosaic IPA Medical Group (Providers please contact Brandi Guinn @ 559-735-3892 x233 for authorization.)
IP083
Professional
Motion Picture Ind Health Plan ( processed by Anthem BC CA)
MPI01
Professional
MotivHealth Insurance Company
U7632
Professional
Mountain Health CO-OP
MHC01
Professional
Mountain States Administrators (COLORADO ONLY)
MTNST
Professional
MPEEBT(MISSISSIPPI PUBLIC ENTITY)
MPE Employee Benefit Services
37233
Professional
MPM Prospect
MPM16
Professional
MPMBA
IHS23
Professional
MPOWER Bundle
STXB99
Professional
MRIPA Allcare CCO (Medicaid Payer)
MRIPA Allcare CCO
26161
Professional
MS BCBS State Employees
SB731
Professional
MSA Care Guide
MSA CARE GUARD
20572
Professional
Multicare Connected Care
RP036
Professional
Multicare INC
Multicare Pace
R3457
Professional
Multnomah County
MLTOT
Professional
Municipal Health Benefits Fund
Municipal Health Benefit Program
Municipal Health Benefit Fund
81883
Professional
Muskegon Care
A1681
Professional
Mutual of Omaha Insurance Company
Mutually Preferred
National Rural Letter Carrier Association (Policy Number GMG1846)
United of Omaha
71412
Professional
Mutual of Omaha Medicare Advantage
82275
Professional
MVP Health Plan of NY
14165
Professional
My Family Medical Group
33020
Professional
MyNexus
Inc.
32043
Professional
NAA (North Americal Administrators
LP - Nashville
TN.)
NAA (North America Administrators)
65085
Professional
NAHGA Claim Services
National Accident & Health General Agency Inc.
67788
Professional
NaphCare
Inc
Naphcare Inc
58182
Professional
Nascentia Health Plan (Medicare line of business)
45529
Professional
National Allied Workers Union Local 831
National Allied Workers Union Local 831 Insurance Trust
CB148
Professional
National Capital Preferred Provider Organization (NCPPO) (To obtain your provider ID number
please call the NCPPO Customer Service Department at (800) 272-5911
HEALTHLINK PPO
90001
Professional
National Foundation Life Insurance Company
Anerican Founders Life Ins Co (NFL Plans only)
Life & Health Ins Co of America (NFL Plan only)
98205
Professional
National General
ASHC1
Professional
National Health Benefit
88057
Professional
National Healthcare Corp Advantage
NHC01
Professional
National Teachers Association (NTA)
NTA11
Professional
National Telecommunications Cooperative Association (NTCA)
National Telecommunications Cooperative Associations
52103
Professional
National Telecommunications Cooperative Association (NTCS Staff)
National Telecommunications Cooperative Associations (NTCS Staff)
52104
Professional
National Telecommunications Cooperative Association
National Telecom Association (NTCA)
52120
Professional
National Vision
NVADM
Professional
NCAS - Fairfax
VA
75190
Professional
NCAS-CHARLOTTE
NCAS - Charlotte
VA
75191
Professional
Nebraska Blue Cross Blue Shield
Blue Shield of Nebraska
NEBLS
Professional
Nebraska Medicaid
SKNE0
Professional
Nebraska Medicaid
Medicaid of Nebraska
NEMCD
Professional
Neighborhood Health of Plan Rhonde Island
Neighborhood Health Partnership
Neighborhood Health Plan of Rhode Island (Contact NHPRI 401-459-6030 to verify provider and vendor number.)
05047
Professional
Neighborhood Health Plan RI
Neighborhood Health Plan RI - Exchange
Unity
Integrity
Neighborhood Health Plan RI- Exchange
Unity
Integrity
96240
Professional
Neighborhood Healthcare Pace
R3456
Professional
Neskia Health Group
Shasta Administrative Services
Nesika Health Group (Old payerID of 37255 is no longer valid.)
75280
Professional
Netcare Life and Health Insurance
66055
Professional
Network Health
04332
Professional
Network Health Insurance Corp - Medicare
Network Health Insurance Corp- Medicare
Network Health Insurance Medicare
77076
Professional
Network Health Plan of Wisconsin
Inc.(Prior to initial claims submission
please contact Network Health Plan EDI specialist at 920-720-1506.)
Network Health of WI
Network Healthplan of Wisconsin
39144
Professional
Network Solutions IPA
NSIPA
Professional
Neuehealth
NEUEH
Professional
Nevada Anthem Blue Cross Blue Shield
Blue Shield of Nevada
Anthem of Nevada
Nevada Anthem Blue Cross and Blue Shield
NVBLS
Professional
Nevada Blue Shield
Blue Cross of Nevada
00265
Professional
Nevada Medicaid
SKNV0
Professional
New Avenues Inc.
New Avenues
Inc.
95998
Professional
New Century Health
NCHCA
Professional
New Century Health - Vista Cardiology
NCH09
Professional
New Century Health Arizona Integrated Physicians
NCHOR
Professional
New Century Health Urology
NCH03
Professional
New Era Life Insurance Company
98798
Professional
New Hampshire Anthem Blue Cross Blue Shield
Blue Shield of New Hampshire
New Hampshire Anthem Blue Cross and Blue Shield
NHBLS
Professional
New Jersey Medicaid
SKNJ0
Professional
New Mexico Blue Cross Blue Shield
Blue Shield of New Mexico
Lovelace Sandia Health Plan (Acquired by Blue Shield of NM)
NMBLS
Professional
New Mexico Blue Cross Community Centennial
New Mexico Blue Cross Community Centennial (MemberIDs start with "YIP")
MC721
Professional
New Mexico Health Connections
45129
Professional
New Mexico Medicaid
SKNM0
Professional
New Mexico Public Schools Insurance Authority
85036
Professional
New York Blue Cross Blue Shield (Empire)
Blue Shield of New York (Empire)
NYBLS
Professional
New York Hotel Trade Council
7707C
Professional
New York Life - Long Term Care I Par Plus
New York Life - Long Term Care
NYL11
Professional
New York Medical Indemnity Fund
NYDFS
Professional
New York Network Management
11334
Professional
Next Level Health Partners (FKA 69821)
81085
Professional
NextBlue
55892
Professional
NHI Billing
14043
Professional
Nippon Life Insurance Company
Nippon Life Insurance Company (Dental)
Nippon Life Insurance Company of America
81264
Professional
North American Benefits
North American Benefits Network (NABN)
34159
Professional
North American Med
North American Medical Management Northern California
E3510
Professional
North Carolina Blue Cross Blue Shield
Blue Shield of North Carolina
NCBLS
Professional
North Dakota Blue Cross Blue Shield
Blue Shield of North Dakota
NDBLS
Professional
North Dakota Medicaid
SKND0
Professional
North Shore - LIJ (Healthfirst)
17516
Professional
North West Life
Northwestern National Life
RELIASTAR (Formerly NWNL)
PH018
Professional
Northcoast Healthcare
A2790
Professional
Northern California Advantage Medical Group
NCA01
Professional
Northern Illinois Health Plan
36347
Professional
Northwest Community Health Partners
NWCHP
Professional
Northwest Diagnostic Clinic I Par Plus (Old PayerID of NWDC1 is no longer valid.)
NW Diagnostic Clinic/SelectCare of Texas (NWDC)
62119
Professional
Northwest Physicians Network (For claims with a DOS of 01/21/2021 and greater use payer ID LIFE1)
NPN11
Professional
Northwest Suburban IPA (IL)
Northwest Suburban IPA Illinois
36346
Professional
Northwestern Medicine Phys Network
Northwestern Medicine Physcians Network
NWEST
Professional
Northwood Healthcare
NWOOD
Professional
Nova Healthcare Administrators
Inc. (Grand Island
NY)
NOVA Healthcare Administrators NY
16644
Professional
Novant Health Direct to Employers
HLSTA
Professional
NX Health Network
44412
Professional
NY Central FEP (Federal Employee Program) Blue Shield
N2FEP
Professional
Nyhart
37299
Professional
NYS Department of Health
14142
Professional
Oak Street Health
OAKST
Professional
Oak West Physician Association
Oak West Primary Physician Association
36400
Professional
Oak West Primary Physician Association
NAOAK
Professional
Occhsner Health Plan
Ochsner Health Plan
A5236
Professional
Occular Benefits
L0140
Professional
Ohio Anthem Blue Cross Blue Shield
Blue Shield of Ohio
Ohio Anthem Blue Cross and Blue Shield
OHBLS
Professional
Ohio Health Choice PPO
Ohio Health Choice
PPO
34189
Professional
Ohio Medicare Part A Jurisdiction 15
Medicare Part B of Ohio
OHMCR
Professional
Ohio PPO Connect
74431
Professional
OhioHealthy
Florida Hospital Waterman
48116
Professional
Oklahoma Blue Cross Blue Shield
Blue Shield of Oklahoma
OKBLS
Professional
OLOLRMC Uninsured Patient Services Program
OLRMC
Professional
Olympus Management Health Care
Olympus Managed Health Care
65074
Professional
OMNI IPA
36090
Professional
OmniCare (For claims with Dates of Service after 10/01/04)
OMNICARE- Coventry Health Plan of MI
25150
Professional
Omnicare IPA
OMN02
Professional
Oncology Network of Orange County.
ONOCI
Professional
One Call Medical
22321
Professional
One Health Plan GA
OSF Healthcare East
95569
Professional
One Health Plan of California
One Health Plan CA
95379
Professional
One Health Plan of Colorado
95412
Professional
One Health Plan of Georgia
One Health Plan of Illinois
One Health Plan IL
95388
Professional
OPEIU Locals 30 & 537
BPA01
Professional
Opticare Eye Health Network
Opticare Eye Health Network (Envolve Benefit Option)
56190
Professional
Opticare of Utah
OPCAU
Professional
Optima Health Plan
Optima Insurance Company
Sentara Family Plan
Sentara Health Management
54154
Professional
Optimed Health
96277
Professional
Optimum Healthcare
Inc.
Optimum Healthcare Inc
20133
Professional
Optum – Complex Medical Conditions (CMC) (formerly OptumHealth Care Solutions and United Resource Networks) former payer id 52190
OptumHealth (OptumHealth Care Solutions)
formerly United Resources Networks
former payer ID 52190
OptumHealth Complex Medical Conditions (CMC) (formerly OptumHealth Care Solutions and United Resource Networks) (Former payerID 52190)
41194
Professional
Optum Care Network of Connecticut
E3287
Professional
Optum Health - Physical Health (Includes Oxford)
formerly ACN
former payer IDs 41159
41160
ACN01
OptumHealth Physical Health - includes Oxford (former payer id 41159
41160)
41161
Professional
Optum Maryland Behavioral Health
OMDBH
Professional
Optum Medical Network (previously Lifeprint)
OptumCare / AZ
NV
UT (formerly Optum Medical Network & Lifeprint Network))
OptumCare / AZ
UT (formerly Lifeprint Network)
LIFE1
Professional
Optum RX
ORXM1
Professional
Optum San Diego Public Sector
OSDPS
Professional
Oregon Blue Cross Blue Shield (Regence)
Blue Shield of Oregon
ORBLS
Professional
Oregon Health Mgmt OHMS aka Primary Health of Josephine
OHMSP
Professional
Oregon Medicaid
SKOR0
Professional
Oregon's Health CO-OP
45332
Professional
Orthonet-Aetna
Orthonet - AETNA
13383
Professional
Oscar Health
OSCAR
Professional
OSF Health Plans
HUMANA
Claims only
Group Health Insurance - DE
ARCADIAN MGMT SERVICE
Humana Care Plan
Humana Group Health Plan
Arcadian Management Services
Inc (Group number should be entered if available. )
Humana Health Chicago
Humana Health Chicago Insurance Company
Humana Health Plan
Humana Insurance Agency
Humana Insurance Company
Humana Medical Plan - CA
Humana Medical Plan - KY
Humana Wisconsin Health Organization
IBA Health & Life Assurance Co.
OSF Healthcare East
OSF HealthPlans
Services
61101
Professional
OSG-Michael Reese
37127
Professional
Oxford Health Plans
UnitedHealthcare / Oxford
06111
Professional
P3 Health Partners -Arizona
58375
Professional
P3 Health Partners Nevada
P3HNV
Professional
P5 Health
87068
Professional
Pace Central Iowa
72436
Professional
PACE CNY
70454
Professional
Pace Nebraska
35416
Professional
Pace of Southeast Michigan
Pace Southeast Michigan
86711
Professional
Pace of Southwest Iowa
Pace Southwest Iowa
53534
Professional
Pace of Southwest Michigan Inc.
45114
Professional
Pacific Administrators
PCFAD
Professional
Pacific Southwest Administrators (PSWA)
Pacific Southwest Administrators
75309
Professional
PacificSource Administrators
Select Benefit Administrators
Inc.
93031
Professional
PacificSource Commercial
93029
Professional
PacificSource Community Solutions
20416
Professional
Pacificsource Medicare
20377
Professional
Pacificsource OHP
COIHS
Professional
Palo Alto Medical Foundation
IP132
Professional
Pan American Life Insurance
04218
Professional
Parallon RCPS
PARLN
Professional
Paramount
Paramount Health
SX158
Professional
Parkland Community Health Plan
66917
Professional
Partners Behavioral Health
13141
Professional
Partners Health Plan
14966
Professional
Partners in Health
PARTH
Professional
Partners Insurance Company
RP099
Professional
Partnership Health Plan contact OptumInsight Enrollments Dep
Partnership Health Plan of CA
PHP02
Professional
Passport Advantage ** (Effective 7-1- 18 new PID 66008
former payer ID 97652)
Passport Advantage (Effective 7- 1-18 new PID 66008
former payer ID 97652)
66008
Professional
Passport Health Plan
61325
Professional
Path Administrators (DH Evans)
D H Evans & Associates reg required call 410-349-3222
25172
Professional
Patient Access
PAN01
Professional
Patient Advocates
Patient Advocate
55489
Professional
Patient Physician Cooperative
20510
Professional
PATIENTPAY
26335
Professional
Payer Fusion
27048
Professional
payer ID 84223)
Keystone VIP Choice (formerly payer ID 84223)
77741
Professional
Peak Health
PEAK0
Professional
Peak Pace Solutions
27034
Professional
Pediatric Associates of Broward
Pediatric Associated Health Plan
20472
Professional
PEF Clinic
PEF01
Professional
Penn Behavioral Health
53226
Professional
Pennsylvania Blue Cross Blue Shield (Highmark)
Blue Shield of Pennsylvania
PABLS
Professional
Pennsylvania Keystone Health Plan East (encounters only)
Keystone Health Plan East - Encounters
PA Keystone Health Plan E(encounters only-835s return PAKEY)
PEBLS
Professional
Pennsylvania Life Insurance
23130
Professional
Pennsylvania Pace
20172
Professional
Pennsylvania Preferred Health Network (PPHN)
Americaid CC Tampa
06161
Professional
People 1st Health Strategies
IHS03
Professional
People One Health
IHS01
Professional
Peoples Health Network (Tenet) (Network ID must be on claim. Contact phn.provider@tenethealth.com)
Peoples Health Network
72126
Professional
Perennial Advantage of Colorado
PAC01
Professional
Perennial Advantage of Ohio
PAOH1
Professional
Personal Insurance Administrators
Inc.
Personal Insurance Administrators
PIA
95397
Professional
PHCS Savility (ONLY for Savility card members.)
13306
Professional
Phifer Wire Insurance (Per request from Payer
claims are printed and mailed.)
PHIF4
Professional
Phoenix Choice
55649
Professional
Phoenix Health Plan
03440
Professional
PHP of Northern Indiana
Physicians Health Plan of Northern Indiana
12399
Professional
Phy Choice Med Grp San Luis ObispoSan Luis Obispo Select IPA
SLOS1
Professional
Physician Health Coop/SRRIPA Stones River Reg IPA Humana 837
57549
Professional
Physicians Care Network (Rockford
IL Only) PayerID valid only for claims with billing submission name
city and state of Physicians Care Network
Rockford
IL.
Physicians Care Network (Rockford IL only)
36345
Professional
Physicians Care Network/The Polyclinic
PCN12
Professional
Physicians Choice Medical Group of Santa Maria
MCI01
Professional
Physicians Corporation of America (Florida Plan Only)
65018
Professional
Physicians Health Association
Physicians Health Association of Illinois
37136
Professional
PHYSICIANS HEALTH COLLABORATIVE
20398
Professional
Physicians Health Network
MHCM2
Professional
Physicians Health Plan
Physicians Health Plan (For behavioral Health claims processing
see documents sent to your office from the payer.)
37330
Professional
Physicians Health Plan (PHP-SC)
09173
Professional
Physicians Healthways IPA
PHIPA
Professional
Physicians Mutual
Physicians Mutual Insurance Company
47027
Professional
Physicians of Southwest Washington
91171
Professional
Physicians Plus Insurance Corp.
Physicians Plus Insurance Corporation
39156
Professional
PHYSMETRICS
48008
Professional
Piedmont WellStar Health Plan
251PD
Professional
PIH Health (Formerly Bright Health Plan)
Bright Health Physicians
BHP01
Professional
Pinnacle Medical Group
95271
Professional
Pinnacol Assurance
CCIA1
Professional
Pioneer Provider Network
PPNZZ
Professional
Pittman Crossover
00156
Professional
Pittsburgh Care Partnership
23283
Professional
Planned Administrator
Planned Administrators
Inc. (PAI)
37287
Professional
PMG of San Jose
PMGSJ
Professional
PodAmerica
RP106
Professional
Podiatry First INC
POD1S
POD1ST
Professional
Podiatry Network FL
59324
Professional
Point Comfort Underwriters
PCU01
PCU02
Professional
Pomona Valley Medical Group (PVMG) ProMed
IP057
Professional
Pool Administrators Primary
PAI01
Professional
Pool Administrators Secondary
PAI02
Professional
PPO Plus
LLC
72148
Professional
Prairie States Enterprises
Inc.
Prairie States Enterprises
36373
Professional
Preferred Administrator I Par Plus
Preferred Admin (Provider Relations @ (915)532-2778
x1068)
EPF10
Professional
Preferred Care Partners / FL
65088
Professional
Preferred Health Care (PHC)
Preferred HealthCare Lancas
33898
Professional
Preferred Health Plan (Louisville
KY previous payer ID 61106 )
Healthsmart Benefit Solutions (Wells Fargo TPA
formerly Acordia National)
Preferred Health Plan (Louisville
KY)
Preferred Health Professionals (PHP Kansas City previous ID 61106)
87815
Professional
Preferred Health Plan of Carolinas (PHPC)
CB404
Professional
Preferred Health Professionals
31478
Professional
Preferred Health Professionals Kansas City
00036
Professional
Preferred Health Systems Insurance Co (PPO)
PREFERRED BEN ADMIN
61665
Professional
Preferred Health Systems
Inc.
Preferred Health System
60110
Professional
Preferred IPA
PFIPA
Professional
Preferred Med Grp
AKA Vantage
AmeriWest
Cal Care
LAMC
Vantage Medical Group Use Payer ID PPM01 for claims with DOS prior to 08.01.2020
Desert Family Practice Association
PPM01
Professional
Preferred Medicare
L0250
Professional
Preferred Network Access
36401
Professional
Preferred One
41147
Professional
Premera Blue Cross (WA)
Premera Blue Cross WA
00430
Professional
Premier Administrative Solutions
65415
Professional
Premier Eye Care
65054
Professional
Premier Healthcare Exchange
88051
Professional
Premier HealthCare Exchange (Cypress)
88056
Professional
Presbyterian Health Plan (Commercial) (Provider ID is required. Contact (888) 923-5757 6 then 2 to obtain ID. New Mexico Providers only.)
Presbyterian Health Plan
PREHP
Professional
Presbyterian Salud
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
Professional
Presbyterian(NM)
Presbyterian (NM)
05003
Professional
Presence ERC
46311
Professional
Prestige Health Choice (Payer is effective 5/1/2014 Managed Medicaid Plan. For EDI Support
please email edi.phc@amerihealthcaritas.com or call 800-617-5727)
Prestige Health Choice
77003
Professional
Prevea Health Insurance Plan
Arise Health Plan (Formerly Prevea Health)
Arise Health Plan
Prevea Health Plan
39185
Professional
Prevea360
41822P
Professional
Prevea360 Health Plan
Children's Community Health Plan
Chorus Community Health Plans (WI Medicaid)
Wellfirst Health
Care4Kids (WI Medicaid)
Care4Kids (WI Medicaid plans)
Dean Health Plan
39113
Professional
Prezzo
CB531
Professional
Prezzo
A2314
Professional
Primary Care CA
Primary Care Assoc of CA (Customer Service877-602-1563)
PCACZ
Professional
Primary Care of Joliet
PCJOL
Professional
Primary Delivery Systems
VENCOR
73288
Professional
Primary Health Network
82048
Professional
Primary PhysicianCare
Inc.(Now known as HealthGram)
Healthgram
Primary PhysicianCare
Inc.
56144
Professional
Prime Community Care Central Valley
Prime Community Care of Central Valley(837I & 837P)
MVCV1
Professional
Prime West Health Plan
61604
Professional
PrimeCare Health Plan
IP079
Professional
Princeton Premier IPA
PRI01
Professional
Principal Financial Group (Vision Claims only.)
Principle Financial Group
61271
Professional
Priority Health (Please contact Priority Health EDI Dept at 616- 464-8686 or email EDISETUP@Priority-Health.com)
Priority Health
38217
Professional
Prism Health Networks (Now known as Palladian Muscular Skeletal Health )
Palladian Muscular Skeletal Health (Formerly Prism Health Networks)
37268
Professional
Prism Univera
Prism-Universa
37315
Professional
ProCare Health Plan Medicaid Use payer ID 38224 DOS 01-01-20 and greater
70259
Professional
ProCare Texas
PTX01
Professional
Prodegi
U8151
Professional
Productive Processing Inc.
13396
Professional
Professional Benefit Administrators
Inc. (Oak Brook
IL)
Professional Benefit Administrators
Inc (Oak Brook
IL)
36331
Professional
Professional Claims Management (Canton OH)
Professional Claims Management
37242
Professional
Professional Claims Manangement
56001
Professional
Progressive Benefit Services Inc
HSHS Medical Group IPA
37137
Professional
PROGYNY
PROGY
Professional
Prominence Administrative Services
88022
Professional
Prominence Health Plan Encounters
St. Marys Health Plan Encounters
St.. Mary's Health Plan Encounters
88082
Professional
Prominence Health Plan of Florida
Prominence HealthFirst of Florida Inc
83352
Professional
Prominence Health Plan of Nevada
93082
Professional
Prominence Health Plan of Texas
80095
Professional
Prominence Health Plan
ST MARYS HEATLH PLAN
Saint Marys Health Plan
88029
Professional
Protective Life Insurance Company
37309
Professional
Providence Facility Claims
PROV1
Professional
Providence Health Plan
SX133
Professional
Providence Insurance & Administrative Services
Providence Administrative Services
PAS01
Professional
Providence Preferred (PPO) (ProviderID & Enrollment required
PHP00
Professional
Provident Life & Accident Insurance Company
Provident Life & Accident Insurance Company of America
Provident Life & Casualty Insurance Company
Healthpoint Corporation
Healthsource Provident (CIGNA)
Healthsource Provident Ins. Co.
68195
Professional
Provider Network of America
MPJVL
Professional
Provider Partners Health Plan Illinois
31401
Professional
Provider Partners Health Plan of Texas
Provider Partners Health Plan Texas
31405
Professional
Provider Partners Health Plan Pennsylvania
31400
Professional
ProviDRs Care Network
48100
Professional
PruCare HMO (Encounters Only)
Prudential Encounters
HM015
Professional
Prudent Medical Group
MPM25
Professional
Pruitt Health Premier
PH001
Professional
Pruitt Health Premier (NC
SC)
PHPC1
Professional
Psychealth Care Management LLC
Psychealth Care Management Assoc
A2797
Professional
PUBLIC EMPLOYEES HEALTH PROGRAM
PEHP
SX106
Professional
Puerto Rico Medicare Part B (J9 - First Coast)
SMPR0
Professional
Quad City Community Healthcare (QCCH)
40437
Professional
Qualcare Arkansas
Qualchoice Arkansas
35174
Professional
Qualcare IPA
QCP01
Professional
Quality Care Partners
Quality Care Partners (QCP)
89461
Professional
QuantumCare (We Care Health Plan)
QCTPA
Professional
Quartz Administrative Services Organization (ASO)
46571
Professional
Quest Behavioral Health
44219
Professional
Questcare Medical (USC)
84562
Professional
QuikTrip
Quicktrip Corporation
73067
Professional
QVI Risk Solutions
Inc.
57117
Professional
Rady Children's Network
Rady Children's Health Network
RCHN1
Professional
Ravenswood Phys Assoc
Ravenswood Physician Assoc
RPAWC
Professional
RBMS
LLC
91176
Professional
Redirect Health Administration
86145
Professional
Redlands IPA (Synermed)
SYMED
Professional
Redlands Yucaipa Medical Group
18247
Professional
Regal Med Group
Regal Medical Group
REGAL
Professional
Regence BCBS Idaho
Regence BS Idaho
00611
Professional
Regence BCBS Utah
00910
Professional
REGENCE BLUE CROSS BLUE SHIELD OF UTAH (Includes FEP)
U1100
Professional
Regence Group Administrators
RGA01
Professional
Regency Empolyee Benefits
38221
Professional
Regional Care INC
Regional Care
Inc.
47076
Professional
Rehn and Associates
REHNA
Professional
Relation Insurance Services of Florida
59299
Professional
Reliance Health Plan
RHP01
Professional
Renaissance Physicians Organization
76066
Professional
Reserve National Insurance
Reserve National Insurance (For Claims rejections
please contact Reserve national Customer Service at (405)848-7931.)
73066
Professional
Resolve Health Plan Ad (Auth # required: begins w5 &13len
Innovative Payer 1
20481
Professional
Resolve Health Plan Administrators
LLC
RHA01
Professional
RESURRECTION HEALTH CARE PREFERRED
Family Medical Network
36396
Professional
Resurrection Physicians Group I Par Plus
Resurrection Physician Provider Group
RPPG1
Professional
RevClaims
RVC01
Professional
Rhode Island Blue Cross Blue Shield
Blue Shield of Rhode Island
RIBLS
Professional
Rhode Island Medicaid
SKRI0
Professional
Right Care from Scott & White
74205
Professional
RightChoice Benefits Administrators
37331
Professional
Rios Southwest Medical Group
RIOS1
Professional
River City Medical Group
RCMG1
Professional
Riverside Health Inc
Riverside Health
Inc
45281
Professional
Riverspring Health Plans
05178
Professional
RMSCO
INC.
RMSCO
Inc.
16117
Professional
Rocky Mountain Health Plan Grand Junction
SX141
Professional
Rocky Mountain HMO
RMHMO
Professional
Rocky Mountain Pace
93142
Professional
Rubicon Health Group
IHS18
Professional
Rush Prudential Health Plans (HMO Only)
36389
Professional
S & S Healthcare Strategies
31441
Professional
Sagamore Health Network
Sagamore Health Network
Inc.
35164
Professional
Saint Anthony PHO
STA01
Professional
SALT LAKE COUNTY BEHAVIORAL HEALTH SERVICES
HT007488-001
Professional
Salvasen Health
CB122
Professional
Samaritan Advantage
SAMAD
Professional
Samaritan Choice Plan
SAMCP
Professional
Samaritan Employer Group Plan
SAM00
Professional
Samaritan Health Plans
CP001
Professional
Samera Health
Mint Health Plans/Samera Health
U8053
Professional
San Bernardino Medical Group
SBMED
Professional
San Diego County Medical Services (CMS)
San Diego County Medical Services
MSO11
Professional
San Diego County Physician Emergency Services
MSO22
Professional
San Diego County Ryan White Primary Care Program
MSO33
Professional
San Diego County Sheriffs Department
MSO55
Professional
San Diego PACE
96400
Professional
San Francisco Health Plan
SFHP1
Professional
San Luis Obispo Select IPA
San Louis Obispo Select
33072
Professional
San Mateo Health Commission dba Health Plan of San Mateo
SX174
Professional
Sana Benefits
50114
Professional
Sandhills Center
SHC30
Professional
Sanford Health Plan
MNSHP
Professional
Santa Clara County IPA
SCACO
Professional
Santa Clara Family Health Plans
24077
Professional
Santa Clara IPA HMO
10378
Professional
Sante Community Physicians Medical Group Corp.
Sante Health System Medi-Cal
Sante Health System Medi-C
SNTMC
Professional
Sante Health Systems
Sante Health System
77038
Professional
Satellite Health Plan
Inc (Satellite Health Plan is a MA ESRD C-SNP effective 1/1/14. First Time submitters
please fax a W9 to 650-625-6083)
Satellite Health Plan Inc
45552
Professional
Saudi Health Mission
SHM01
Professional
SC BCBS Companion Health
SC922
Professional
SC BCBS State Employee Health Plan
SC400
Professional
SC FEP Blue Cross
SC402
Professional
Scan CA
Scan Health Plan CA
SCAN1
Professional
SCAN Encounters (Diversified Data Design (DDD))
SCAN Encounters
99157
Professional
Scan Health Plan Arizona
SCAN2
Professional
Scan Health Plan AZ
73172
Professional
SCAN Long Term Care
20460
Professional
Schaller Anderson CHOC Health Alliance
SCH01
Professional
SCHC Total Care
Total Care of NY (Former payer ID TCARE)
SCHC Total Care Inc
16146
Professional
SCHS Alta Global Medical Care Group
MPM54
Professional
Scott & White I Par Plus
Scott & White Health Care
88030
Professional
Scripps Health Plan MSO
SHPM1
Professional
Scripps Health Plan Services
SHPS1
Professional
Seaside Health Plan (Starting with DOS 9/1/2013)
46187
Professional
Seaview IPA
SVIPA
Professional
Secure Health of Georgia (Claims for this payer id are only accepted with a DOS equal to or after 01/01/2021)
Secure Health Plan of GA ## (Claims for this payer id are only accepted with a DOS equal to or after 01/01/2021)
42561
Professional
Secure Health of Georgia (Claims for this payer id are only accepted with a DOS prior to 12/31/2020)
Secure Health Plan of GA ## (Claims for this payer id are only accepted with a DOS prior to 12/31/2020)
28530
Professional
SecureOne
86242
Professional
Security Administrative Systems
Cornerstone Benefit Administrators
HealthSmart Security Administrative Services
35202
Professional
Security Health Plan
39045
Professional
Sedgwick
Sedgwick CMS
TP097
Professional
SeeChange HealthPlan
SCHP1
Professional
Select Benefit Administrators of America
SELECT BENEFIT ADMIN
37282
Professional
Select Health of South Carolina
23285
Professional
SelectCare of OK - Tribute
SCOK1
Professional
SelectCare of Texas (HPN) Heritage Physicians Network
76045
Professional
SelectCare of TX Beaumont Prov ID Req 713-843-6780 to obta
Golden Triangle Physician Alliance
GTPA1
Professional
SELECTHEALTH
SX107
Professional
Self Insured Benefit Admin FL
Self Insured Benefit Administrators
59111
Professional
Self Insured Plans
Self Insured Plans
LLC
36404
Professional
Self-Funded Plans
Inc (IL
PA
OH)
Self-Funded Plans (IL
PA
OH)
34131
Professional
Selman Company
52214
Professional
Selman Tricare Supplement Plans
TRSEL
Professional
Sendero Health
SCS17
Professional
Sendero IdealCare (For DOS on or after 01-01-2019)
MV440
Professional
Senior Whole Health Care ## (Use payer ID SWHNY for DOS equal to or after 01/01/2021) Use payer ID 83035 for DOS prior to 01/01/2021)
Senior Whole Health (Use payer ID SWHNY for DOS equal to or after 01/01/2021). Use payer ID 83035 for DOS prior to 01/01/2021)
SWHNY
Professional
Senior Whole Health Care ## (Use payer ID 83035 for DOS prior to 01/01/2021. Use new payer ID SWHNY for DOS equal to or after 01/01/2021)
Senior Whole Health (Use payer ID 83035 for DOS prior to 01/01/2021. Use new payer ID SWHNY for DOS equal to or after 01/01/2021)
83035
Professional
Senior Whole Health Massachusetts
SWHMA
Professional
Sentara Mental Health Professional
5415M
Professional
Sentinel Management
Sentinel Management Services
23249
Professional
Sentinel Security Life Insurance
Atlantic Coast Life Insurance
87020
Professional
Seoul Medical Group
AMM07
Professional
Seoul Medical Group
Avalon IPA
Centinela IPA
Freeman IPA
Hollywood Presbyterian
American Family Health Providers
Huntington Park Medical Group
Huntington Park Mission
Pasadena Primary Care Physicians
AMVI
Cap Management Systems
Greater L. A. Health
Mendicina Familiar Medical Group
Greater San Gabriel
Exceptional Care Medical
Noble Community
Family Choice Medical
Family Health Alliance
AKM Medical Group
IP080
Professional
Sequoia Health IPA
ALG01
Professional
Seton CHIP (Provider ID required.)
Seton Health Plan - CHIP I Par Plus
SHPCH
Professional
Seton Employee Plan
Seton Employee Plan I par Plus
SHEBP
Professional
Seton Star
STAR1
Professional
Seven Corners
25404
Professional
SGIC
11789
Professional
Shared Health Mississippi
SHTMS
Professional
Shared Health Mississippi
SHMS1
Professional
Sharp Community Medical Group
SCMG1
Professional
Sharp Health Plan
SHP01
Professional
Sharp Rees-Stealy Med Group
Sharp Rees-Stealy Medical Group
SRS83
Professional
Sheakley Unicomp
10002
Professional
Sheet Metal Workers Local 104 (PayerID valid for submission add of PO Box 1138
San Ramon
CA 94583.)
Sheet Metal Workers Local 104
BeneSys
Inc. (Now known as Sheet Metal Workers Local 104)
38238
Professional
Sieba
LTD.
03699
Professional
Sierra Health and Life (Health Plan of Nevada)
Health Plan of Nevada
Sierra Health and Life
76342
Professional
Sierra Health Services Encounters (Health Plan of Nevada)
Health Plan of Nevada (Encounter claims)
Sierra Health and Life (Encounters)
76343
Professional
Sierra Medical Group (Customer Service 661-480-2047)
SMG01
Professional
SIHO
77153
Professional
Silver Cross Managed Care Organization
NASCR
Professional
Silver Star Pace
97691
Professional
Silverback TPA (previous payer ID 37728) For all dates of services on and after Jan. 1
2019
claims should be submitted WellMed
payer ID WELM2
WellMed (Claims)
Wellmed Medical (Claims) I Par Plus
WELM2
Professional
Simply HealthCare Plans (new payer ID SMPLY as of 12-1-2018)
Simply Healthcare
Simply HealthCare Plans (New PID SMPLY effective 12/1/18)
SMPLY
Professional
Sinclair Health Plan
84076
Professional
SISCO
44827
Professional
Smith Administrators
02057
Professional
Smith Administrators
SMITH
Professional
Smoky Mountain Center
13010
Professional
Snedeker Risk Mangament
Snedeker Risk Management
A7637
Professional
So CA Health Care SystCHS Alta Pod Medpoint &SCHS Alto Pod
MPM20
Professional
Solidarity Healthshare
77721
Professional
Solis Health Plans
SOLIS
Professional
Somos IPA (Emblem Health)
81508
Professional
Sonder Health Plans
Sondor Health Plans
A0339
Professional
Sound Health
First Choice Health Network
Sound Health (now known as First Choice Health Network)
91131
Professional
Soundpath Health
Soundpath Health (Formerly known as Puget Sound Health Partners
Inc.)
42172
Professional
South Atlantic Medical Group
SAMG1
Professional
South Carolina Solutions
42406
Professional
South Central Preferred (SCP)
WellSpan Plus
23266
Professional
South County Health Alliance (previously under Payer ID 41154)
81600
Professional
South Dakota Blue Cross Blue Shield
Blue Shield of South Dakota
SDBLS
Professional
South Dakota Chiropractic (Sanford Health Plan)
Sanford Health Plan
CASD2
Professional
South Dakota Medicaid
SKSD0
Professional
South Florida Common Services
Memorial Integrated Healthcare/South Florida Community Care Network
59065
Professional
South Florida Musculoskeletal Care
06294
Professional
South Indiana Health Options - HMO
SX142
Professional
SouthCare/Healthcare Preferred
Southcare / Healthcare Preferred
25147
Professional
Southeast Michigan Pace
R3460
Professional
Southern Cal Physicians Managed Care Services
SCP01
Professional
Southern Illinois Healthcare
SIHCA
Professional
Southern Illinois Healthcare Assoc
SIH99
Professional
Southland Benefit Solutions
Amerikids-Dallas/Ft. Worth
Amerigroup Houston (Claims and Encounters)
Amerigroup Houston
26374
Professional
Southland IPA
SIPA1
Professional
Southwest Mighigan Behavioral Health Mental Health
Southwest Michigan Behavioral Health Mental Health
A3268
Professional
Southwest Mighigan Behavioral Health Substance Use Disorder
Southwest Michigan Behavioral Health Subtance Use Disorder
A4585
Professional
Southwest Physicians Group
SWPG1
Professional
Southwest Service Administrators
PHX Teamsters UT/MT/ID
PHX Teamsters UT/MT/ID (For Dates of Service after 05/01/16)
CX100
Professional
Southwest Service Life/Galaxy Health
Southwest Service Life
37266
Professional
Southwestern Health Resources Clinically Integrated
Southwestern Health Resources Clinically Integrated (DOS After Dec. 31
2022)
RP085
Professional
Specialty Care Program
IHS17
Professional
Spectrum Administrators
Populytics (formerly Spectrum Administrators)
23253
Professional
Spencer Stuart ARM Ltd.
38416
Professional
St Joseph Health
IP062
Professional
St Mary's IPA
St Mary IPA
SMIPA
Professional
St. Joe High Desert
JOEHD
Professional
St. John's Claims Administration
St. Johns/First Health
37264
Professional
St. Joseph Heritage Healthcare
IP106
Professional
St. Joseph HUMBOLT County
IP059
Professional
St. Therese Physician Association
37116
Professional
Staff Benefits Management Administration
SBMCO
Professional
Standard Life & Accident Insurance Company
73099
Professional
Standard Life and Accident
Standard Life & Accident (Payer accepts secondary claims only
and Medicare cannot be primary payer.)
01758
Professional
State Farm Health
State Farm Homeowners Group Medical Plans (Note that payer requires Insured’s ID of 11 digits and exact structure. Otherwise
claims will reject).
State Farm Workers Compensation Plans (Note that payer requires Insured’s ID of 11 digits and exact structure. Otherwise
claims will reject)
31053
Professional
STATE FARM MUTUAL AUTOMOBILE INSURANCE CO
State Farm (Property & Casualty )
State Farm Casualty & Property Claims
31059
Professional
State of TX Dental
Government Employees Health Association Inc. (GEHA)
Government Employees Health Association
Inc. (GEHA)
57254
Professional
Sterling Medicare Advantage
Sterling Medicare Advantage (Claims containing Dates of service after 4-30-2014
claims should be sent to Wellcare
PayerID 14163)
67829
Professional
Stoner & Associates
31121
Professional
Stones River IPA Amerivantage
57492
Professional
Stones River Regional IPA - The Physicians ACO
28943
Professional
Stones River Regional IPA - Windsor
15752
Professional
Stones River Regional IPA/BCBST
15750
Professional
SummaCare Health Plan
95202
Professional
Summit Administration Services
Inc.
86083
Professional
Summit America Insurance Services
Inc. (Student Accident and Sickness
College Sports and NASCC claims only.)
37301
Professional
Summit Community Care
PASSE
Professional
Sunrise Advantage Plan Pennsylvania
SPA01
Professional
Superier Health
IHG Dirwxr
75274
Professional
Superior Insurance Services
97802
Professional
Superior Vision Services
13305
Professional
Surgery One IPA
SOIPA
Professional
Sutter Conn Sutter Med SMG
SWMG
SIP)800-611-5191 setup&test
Sutter Connect Medical Group
IP092
Professional
Sutter Connect - Delta - Claims
IP100
Professional
Sutter Connect - SIP
SMG
SWMG - Encounters only
HM059
Professional
Sutter Connect - Solano Regional Medical Group - Claims
IP099
Professional
Sutter Connect - Sutter Gould Medical Foundation - Claims
Sutter Connect Gould
IP091
Professional
Sutter Connect East Bay Med Foundation
94269
Professional
Sutter Connect East Bay Med Foundation
East Bay Medical Network
IP130
Professional
Sutter Connect East Bay Medical
HM065
Professional
Sutter Connect-Palo Alto Medical Foundation
SC050
Professional
Sutter East Bay Regional Hosp-Affinity Claims
SC052
Professional
Sutter Health Aetna
60624
Professional
Sutter Med of Redwoods (SMGR)
HM057
Professional
Sutter Medical Group
SC004
Professional
Sutter Senior Care
SC028
Professional
Swedish Covenant Hospital
36411
Professional
Swift Glass Corporation
07040
Professional
TakeCare Insurance Company
98022
Professional
Talbert Medical Group
TALMG
Professional
Tall Tree Administrators
Tall Trees Administrators
88067
Professional
Tattered Cover
Inc.
Amalgamated Transit Union Division 1001 Health & Welfare Fund
CompuSys Incorporated of Colorado
Compusys of Colorado
Glassworkers and Glaziers Health and Welfare Fund Trust
Industrial Machine Specialties
Pipe Industry Health & Welfare Fund of Colorado
Colorado Laborers Health and Welfare Fund
Carpenters' and Millwrights' Health Benefit Trust Fund
Carpet
Linoleum and Resilient Tile Layers Health and Welfare Fund
COMPU
Professional
Taylor Benefits
TAYLR
Professional
Teachers Health Trust
88019
Professional
Team Choice - Alpha Care Gold I Par Plus
Nexcaliber
ADSL1
Professional
Teamcare
Central States Southeast and Southwest Areas Health and Welfare and Pensions Funds
Central States Health & Welfare Funds
Rosemont of Des Plaines
IL
36215
Professional
Tech-Steel
Inc.
Intermountain Ironworkers Trust Fund
Operating Engineers Local No 53
8th Distric Electrical
CompuSys Incorporated (New Mexico)
Utah Carpenters
CompuSys Incorporated of Arizona
Utah Laborers
CompuSys Incorporated of Utah
CompuSys/Erisa Group
Incorporated (AZ)
CompuSys/Erisa Group
Incorporated (NM)
CompuSys/Erisa Group
Incorporated (TX)
Transwestern General Agency
Chapter NECA Health & Welfare Trust
IBEW Western Utilities or Local 57
City of Austin
Erisa Administrative Services Incorporated
Erisa Administrative Services
Inc.
New Mexico District Council of Carpenters
New Mexico Painters and Allied Trades Local No 823
New Mexico-West Texas Multi- Craft (lso known as New Mexico Laborers)
Advanstaff
Inc.
Arizona Pipe Trades Health and Welfare Trust Fund Local Union Nos. 469 & 741 Metal Trades Health Plan
Arizona Pipe Trades Health and Welfare Trust Fund Local Union Nos. 469 & 741 Pipe Trades Health Plan
Utah Pipe Trades
74234
Professional
Teddy Health
TEDDY
Professional
Telamon
22483
Professional
Tennessee Blue Cross Blue Shield
Blue Shield of Tennessee
TNBLS
Professional
Tervist
Speciality Care Program
IHS08
Professional
Tethys Health Ventures
Tehtys Health Ventures
20212
Professional
Texan Plus/Selectcare of TX (Kelsey) I Par Plus
SelectCare of TX-Kelsey-Seybold Prov Requrired 713- 843-6780
KLSY1
Professional
Texas Agricultural Cooperative Trust
TXABA
Professional
Texas Blue Cross Blue Shield
Blue Shield of Texas (includes Blue Cross of Texas)
Blue Shield of Texas
TXBLS
Professional
Texas Children
75228
Professional
Texas Children's Health Plan
76048
Professional
Texas Children's Health Plan (Medicaid) (After 10-08-16
submit claims with payerID TXCSM)
TX Childrens Star Medicaid (Enroll verif calls 800-990-TCHP
TXCSM
Professional
Texas First Health Plans
Texas First Health Plan
TX1ST
Professional
Texas Health Aetna
88221
Professional
Texas HealthSpring
Texas Healthspring I Par Plus
THS01
Professional
Texas Independence Health Plan
31403
Professional
TexasFirst Health Plan
13185
Professional
The Alliance of Wisconsin (Only for ID Cards showing PO Box 44365 Madison WI 53744 as mailing address)
88461
Professional
The Benefit Group
TBGNE
Professional
The Boon Group
BOONG
Professional
The Care Network- Savannah Business Group (TCN)
The Care Network
The Care Network- Savanna
68423
Professional
The Chesterfield Companies
Chesterfield Resources
Inc.
34154
Professional
The City of Amarillo
City of Amarillo Group Health
COA01
Professional
The City of Odessa
75600
Professional
The Colorado Purchase Alliance
TCPA1
Professional
The Health Exchange (Cerner Corporation)
The Health Exchange
20356
Professional
The Health Plan (Form known as Hometown Health Plan of OH)
Hometown Health Plan of Ohio (Now known as The Health Plan)
30757
Professional
The Health Plan of West Virginia Inc
The Health Plan (Upper Ohio Valley)
The Health Plan (Upper Ohio Valley)
34150
Professional
The Health Plan of West Virginia
Inc
95677
Professional
The Healthcare Group (THCG)
Encore Health Network (Note: Group Policy Number in HCFA Box 11 is required.)
Encore Health Network
35206
Professional
The Loomis Company
The Loomis
23223
Professional
The Macaluso Group
82694
Professional
The MEGA Life and Health Insurance Company-OKC (Valid if PO BOX 548801 Oklahoma City OK 73154.)
59227
Professional
The Preferred Healthcare Systems (TPHS)
The Preferred Healthcare System - PPO Altoona
PA
PrimeSource Health Network
04320
Professional
Thomas Cooper (Provider must be enrolled with SC Blue Shield
SC315
Professional
Three Rivers Preferred
MP340
Professional
TLC Advantage in Sioux Falls
TLD Advantage in Sioux Falls
TLC01
Professional
TLC Benefit Solutions
TLC79
Professional
TN (formerly AmeriChoice TN:
UnitedHealthcare Community Plan / TN (formerly AmeriChoice TN: TennCare
Secure Plus Complete)
95378
Professional
Today's Health
Today's Health I Par Plus
WITH1
Professional
Torrance Hospital IPA
THIPA
Professional
Total Care of NY (As of 4-1-18
claims use payer ID 16146)
TCARE
Professional
Total Community Care
InnovAge
InnovAge (Total Community Care)
31182
Professional
Total Plan Concepts
80900
Professional
Total Senior Care
12268
Professional
Touchpoint Solutions CRM
TPS01
Professional
Touchstone Health PSO
23856
Professional
Touchstone Health/Health Net Smart
13402
Professional
TR PAUL INC
TR Paul Inc.
37230
Professional
Transchoice - Key Benefit Admin
TransChoice Key Benefit Administrators
37284
Professional
Transwestern Insurance Administrators
Inc.
TRAN1
Professional
Travis County Healthcare District
Central Health
Travis County MAP - Mediview
Community Care Collaborative
Travis County Hospital District
TCMAP
Professional
Tri-Valley Medical Group
20538
Professional
Triad Healthcare Inc
39181
Professional
Triada Assurance
CB733
Professional
Tribute Health Plan (Formerly Central Benefits National.)
31118
Professional
Tribute Healthcare
Central Benefit National (Now known as Tribute Health Plan.)
61184
Professional
Tricare East (effective 01-01-2018)
Tricare East
Tricare East Effective 1-1-2018
TREST
Professional
Tricare for Life (All Regions 1-12)
Tricare for Life
TDDIR
Professional
Tricare Overseas
FOREN
Professional
TRICARE West / UHC Military & Veterans (formerly TriWest)
TRICARE West (UnitedHealthcare Military & Veterans)
UnitedHealthcare Military & Veterans / TRICARE West
99726
Professional
TriHealth Physician Solutions
31144
Professional
Trilogy Health Network
62777
Professional
Trinity Health Pace
TRNPC
Professional
Trinity Health Solutions Inc - Everpointe
32052
Professional
Triple S
97300
Professional
Triple S Advantage
973MA
Professional
Triple S Incorporated
SB980
Professional
Triplefin
LLC
Triplefin LLC
64300
Professional
TRISTAR Benefit Administrators
Select Benefit Administrators (Des Moines Iowa)
Select Benefit Administrators (PayerID valid for claims submission address of PO Box 8339
Des Moines
IA 50301)
42137
Professional
TriWest Healthcare Alliance (VA CCN Regions 4
5
&6)
TWCCN
Professional
Troy Medicare
TRYMC
Professional
TruBlue
True Blue TPA
83413
Professional
True Health New Mexico
82288
Professional
True Health New Mexico FEHBP
85824
Professional
Truli for Health
TRULI
Professional
Trusteed AKA: TPSC Benefits
91078
Professional
Trustmark Small Business Benefits
Tooling & Manufacturing Assoc.
Benefit Trust Life Insurance Company
Starmark
Tooling & Manufacturing Association
61425
Professional
Tuality Health
THA01
Professional
Tuality Health Select
THASC
Professional
Tufts Health Plan
Tufts Associated Health
04298
Professional
U OF U HEALTH PLANS
SX155
Professional
UC Davis Health Systems
UC Davis Health System
UCDMG
Professional
UC-Davis Health
94603
Professional
UCare Individual & Family Plans
55413
Professional
Ucare of Minnesota (Use payer ID 52629 for DOS in 2018. Use new payer ID 55413 for UCare Individual & Family Plans with DOS in 2019)
Ucare of MN(Use ID 52629 DOS in 2018 UseID 55413 DOS in 2019
52629
Professional
UCLA Medical Group
USMBP
Professional
UCS (Electrical Workers Insurance Fund Local 5800)
93235
Professional
UHA Health Insurance
UHA01
Professional
UHC/SPECTERA VISION NETWORK
Spectera
UnitedHealthcare / Spectera Eyecare Networks
00773
Professional
UHIN Test Payer
HT000346-001
Professional
UHIN Test Payer All Transactions Good
ALLGD
Professional
UICI Administrators - State of Nevada
75245
Professional
Ultimate Health Plan
77022
Professional
Ultra Benefits
Inc.
UltraBenefits
Ultra Benfits Inc.
41206
Professional
UMASS Medical School Health and Criminal Justice Program
UMHCJ
Professional
UMC Health System
UMC Health Plan
75130
Professional
Umpqua Health Alliance
77503
Professional
UMR (UMR Wausau)
UMR
UMR (formerly UMR Wausau)
UnitedHealthcare / UHC Shared Services - UHSS formerly UHIS
UnitedHealthcare / UHIS- UnitedHealthcare Integrated Svcs.
39026
Professional
UMWA Health & Retirement Funds
UMWA Health & Retirement Funds (Dental)
UMWA - UNITED MINE WORKERS ASSOC
52180
Professional
Unified Group Services
35198
Professional
Unified Health Services
62170
Professional
Unified Life Insurance Company
RP064
Professional
Unified Physicians Network
Unified Physicians Network (For Claims rejections
please contact Unified Physicians claim department at 847-763-1700)
34638
Professional
UNION PACIFIC RAILROAD EMPLOYEES HEALTH SYSTEMS
U6844
Professional
Unite Health Share Ministries (UHSM)
83173
Professional
Unite Here
59144
Professional
United Agriculture Benefit Trust
UABT1
Professional
United Benefits
Inc (a Brown & Brown Company)
59069
Professional
United Care Medical Group
ADCUC
Professional
United Claim Solutions
A0047
Professional
United Claim Solutions
United Claims Solutions
20090
Professional
United Claims Solutions Insight Benefit Administrators
United Claims Solutions Insight Benefit Administrator
96436
Professional
United Food & Commercial Workers UFCW Local 1529
21850
Professional
United Healthcare Ohio Medicaid
88337
Professional
United Healthcare Ohio Medicaid Dental
DentaQuest
83244
Professional
United Healthcare Ohio Medicaid Vision
83572
Professional
UNITED HEALTHCARE SERVICES INC(Optum Salt Lake)
OptumHealth SLC
Optum Tooele
U6885
Professional
United Medical Alliance
UCHealth Plan Administrators (As of 8/1/14 CSMED
UMA & Phycor combined)
84132
Professional
UnitedHealthcare (Student Resources )
UnitedHealthcare / StudentResources
74227
Professional
UnitedHealthcare Community Plan / AZ / Children's Rehabilitative Services (CRS) / Long Term Care
UnitedHealthcare Community Plan / Arizona Long Term Care - BH & SNP / Children's Rehabilitative Services (CRS)
UnitedHealthcare Community Plan / AZ (formerly Arizona Physicians IPA and APIPA)
03432
Professional
UnitedHealthcare Community Plan / KanCare
UnitedHealthcare Community Plan / KS - KanCare
96385
Professional
UnitedHealthcare Community Plan / Missouri
UnitedHealthcare Community Plan Missouri
86050
Professional
UnitedHealthcare Community Plan / NJ (formerly AmeriChoice NJ Medicaid
NJ Family Care
NJ Personal Care Plus)
AmeriChoice NJ
Medicaid
NJ Family Care (UnitedHealthcare Community Plan)
UnitedHealthcare Community Plan / NJ (formerly AmeriChoice NJ Medicaid
NJ Family Care
NJ Personal Care Plus) former payer id 86001
86047
Professional
UnitedHealthcare Medicare Solutions / UnitedHealthcare MedicareDirect (formerly SecureHorizons)
UnitedHealthcare West / UnitedHealthcare of CA
OK
OR
TX
WA and PacifiCare of AZ
CO
NV
First Seniority Freedom
UST Healthproof (Effective for claims with a DOS of 2023)
OptumHealth Behavior Solutions FKA United Behavioral Health
OptumHealth (OptumHealth Behavioral Solutions of NM)
MAHP (MD IPA
Optimum Choice and MLH) UnitedHealthcare
AARP MedicareComplete through UHC (formerly from SecureHorizons)
United Healthcare
AARP MedicareComplete UHC/Oxford/former payer id 06111
Arnett Health Plans Former PayerID 95440
Definity Health Plan (UnitedHealthcare)
Harvard Pilgrim Passport Connect
OptumHealth Behavioral Solutions of NM
Tarrant Health Services (previous payer ID 37728) For all dates of service prior to Jan. 1
2019
claims should be submitted to UnitedHealthcare
payer ID 87726
UnitedHealthcare
UnitedHealthcare (Empire Plan)
UnitedHealthcare / UnitedHealthcare of the Mid-Atlantic
MD IP
87726
Professional
UnitedHealthcare West / Encounters (formerly PacifiCare)
UnitedHealthcare West Encounters (formerly known as PacifiCare)
95958
Professional
UnitedHealthOne / UnitedHealthcare Life Ins Co - Golden Rule
UnitedHealthOne / Golden Rule
Rooney Life Ins.
37602
Professional
UnitedHealthOne / UnitedHealthcare Life Insurance Company (formerly American Medical Security)
All Savers Insurance / UnitedHealthcare
UnitedHealthcare / All Savers Alternate Funding
UnitedHealthcare / All Savers Insurance
81400
Professional
Unity Health Insurance
66705
Professional
Unity Health Partners
A1152
Professional
Univera Community Health
15003
Professional
Univera Health Care Plan/ChoiceCare Buffalo
Univera Healthcare
SX087
Professional
Univera Healthcare - CNY
HC001
Professional
Univera Healthcare (SSA)
SX091
Professional
Univera Traditional PPO
Univera PPO
UNINW
Professional
Universal Care - California
Universal Care - California (ProviderID required.)
33001
Professional
University Family Care
09830
Professional
University Family Care - Healthcare Group
University Physicians Healthcare Group
07503
Professional
University Family Care - Maricopa Health Plan
Maricopa Health Plan / Maricopa Care Advantage
09908
Professional
University Health Alliance
99026
Professional
University Health Care Advantage
Essence Healthcare CA
Essence Healthcare - CA
46407
Professional
University Healthcare Marketplace
45437
Professional
University of Illinois
UIC67
Professional
University of Illinois Division of Specialized Care
37601
Professional
University of Maryland Health Advantage
45282
Professional
Upland Medical Group (Customer Service Phone number
(909) 291-4400)
IP056
Professional
UPMC Health Plan
23281
Professional
Upper Peninsula Health Group TPA
Upper Peninsula Heath Group TPA
37324
Professional
Upper Peninsula Health Plan
38337
Professional
US Benefits
HealthSmart US Benefits
HealthSmart US Benefits (Dental)
93092
Professional
US Department Of Labor (837I & 837P)
US Department of Labor
77044
Professional
US Family Health Plan (USFHP)
USFHP
Professional
US Network and Administrative Services
USN01
Professional
US Virgin Islands Medicaid
SKVI0
Professional
USAA (United States Automobile Association)
USAA
74095
Professional
USC Health Services
9047P
Professional
USFHP St Vincent Catholic Med Center NY
Uniformed Service Family Health Plan
13407
Professional
UST Healthproof (Effective for claims with a DOS of 2022)
UST Healthproof (Effective for claims with a DOS of 2022)
83245
Professional
UTAH DEPARTMENT OF HEALTH
Utah Medicaid FFS
SKUT0
Professional
Utah Medicaid Atypical
U4801
Professional
Utah Medicaid Crossover
U4005
Professional
Utica NY FEP (Federal Employee Program) Blue Shield
N4FEP
Professional
VA Patient Centered Community Care Program (VAPCCC) Region 3
VAP33
Professional
VA Patient Centered Community Care Program Region 5A
VA Patient-Centered Community Care Prog (VAPCCC) Region 5A
VAPC3
Professional
VA Patient Centered Community Care Region 5B
VAPCCC Region 5B
55916
Professional
VA Patient Centered Community Care Region 6
VAPC6
Professional
VACCN Community network
VA Community Care Network for Dental Providers Region 2
VA Community Care Network for Dental Providers Region 3
VA Community Care Network Region 1
VA Community Care Network Region 2
VA Community Care Network Region 3
Dental Providers Region 1
VACCN
Professional
Valir Pace (Formerly Via Christi Hope)
Valir Pace
48123
Professional
Valley Care IPA (Customer Service 805-604-3332)
VCIPA
Professional
Valley Health Administrators
VHA11
Professional
VALLEY HEALTH PLAN
VHP03
Professional
VALLEY HEALTH PLAN
VHP01
Professional
VALLEY HEALTH PLAN
Valley Health Plan Medi-CAL
VHP02
Professional
Valley Mental Health
94293
Professional
Valley Presbyterian Hospital Community Family Care
MPM61
Professional
Valley Presbyterian Hospital
Valley Presbyterian Hospital Preferred IPA
MPM53
Professional
Valor Medicare Advantage
Valor Health Pan
43259
Professional
Value Options / MBHP
ValueOptions/MBHP (For claim rejections please contact e- SupportServices@valueoptions.c om or 888-247-9311)
43307
Professional
Value Options Colorado Medicaid
00815
Professional
Value Options Commercial Claims
00813
Professional
Value Options Maryland
00823
Professional
Value Options Pennsylvania Medicaid
00817
Professional
Value Options Texas Northstar
00818
Professional
Vanderbilt University Medical Center
Vanderbilt Univ Med Center
BPSLLC
Professional
Vantage Health Plan
77701
Professional
Vantage Medical Group Use Payer ID PROSP for claims with DOS after 08.01.2020
Prospect Medical Group
Vantage Medical Group
PROSP
Professional
Varipro
72187
Professional
Ventura County Healthcare Plan
VCHCP
Professional
Verity
VMMH1
Professional
Verity Medical Foundation (DCHS Medical Foundation)
VMF01
Professional
Verity National Group
75256
Professional
Verity Plus
VMMH2
Professional
Vermont Medicaid
SKVT0
Professional
VESTACARE
VestaCare / RH Admin
VESTA
Professional
Vibra Health Plan
15976
Professional
VieCare Life Armstrong
25922
Professional
Viida Care (Now known as Amida Care)
Vida Care (Now known as Amida Care.)
Amida Care (Formerly Vida Care.)
24818
Professional
VillageCareMAX
26545
Professional
Virgin Island Medicare Part B (J9 - First Coast)
SMVI0
Professional
Virginia Anthem Blue Cross and Blue Shield
Local Choice
Blue Shield of Virginia
Priority Healthcare
Virginia State Employer Funds
Healthkeeper HMO
Virginia Anthem Blue Cross Blue Shield
Medicare Supplemental
Peninsula Healthcare
COVA (Commonwealth of VA)
Keycare PPO
VA State Employer Funds
Blue Care PPO
VABLS
Professional
Virginia Coordinated Care
84806
Professional
Virginia Premier Health Plans (Effective 02-01-2019 former payer IDs VPEP1 54176 VPELT VPCCP VPHP1VPCCI MAPDI 12K83 MAPDP)
Virginia Premier Health Plans
VAPRM
Professional
Virginia Premier Preferred Gold
251VA
Professional
Vista Oncology New Century Infusion Solutions
NCH08
Professional
VIVA Health
Viva Health Plan
63114
Professional
Vivida Health Plan (Use this ID for dates of service on or after 01/01/21)
A0102
Professional
Vivida Health Plan (Use this ID for dates of service prior to 01/01/21)
45488
Professional
VNA Homecare Options (Medicaid line of business)
31626
Professional
VNS Choice Medicare (Formerly Visiting Nurse Service)
VNS CHOICE Medicare (Formerly Visiting Nurses Service)
77073
Professional
Volusia Health Network
59266
Professional
Vxtra Health
99915
Professional
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.)
Vytra Healthcare
22264
Professional
WA Blue Cross Regence (UMP)
WA Blue Shield Regence
Regence Blue Shield of Washington
00932
Professional
WA State Premera Blue Cross (835s returned under AC032)
Washington State Premera Blue Cross
WABLC
Professional
Wabash Memorial Hosp Association
Wabash Memorial Hospital Association
85256
Professional
Washington County Health and Human Services
WCHHS
Professional
Washington Dept. of Labor & Industries
Washington State Labor and Industry
WALAI
Professional
Waterstone Benefit Administrators
73155
Professional
Watts Healthcare Corp IPA
MPM09
Professional
Weiss Health Providers
36337
Professional
Welbehealth
WBHCA
Professional
Wellcare Health Plan
Inc. (Encounters only)
Wellcare Health Plans
Inc. (Encounters)
59354
Professional
Wellcare of CT
Wellcare of NY
14164
Professional
Wellmark BCBS (Iowa
South Dakota)
Blue Shield of Iowa
Iowa Blue Cross Blue Shield
IABLS
Professional
Wellmark BCBS (Iowa
South Dakota)
Wellmark BCBS (IA
SD)
88848
Professional
WellMed (Encounters)
Wellmed Medical (Encounters) I Par Plus
WELMD
Professional
WellNet Health Plans
25711
Professional
Wells Fargo TPA (Part A and Part B)
00214
Professional
Wellspan Employee Assistance Program
WellSpan Employee Assitance Program
CB457
Professional
WellSystems
LLC
35245
Professional
West Suburban Health Providers
80942
Professional
West Virginia Blue Cross Blue Shield
Blue Shield of West Virginia
WVBLS
Professional
West Virginia Family Health Plan (Payer ID 45276 will remain active only for claims for service dates prior to 7/1/2019. Providers should check member cards to ensure they send claims to the correct WV MCO plan for service dates 7/1/2019 and forward).
45276
Professional
West Virginia Senior Choice
WVS01
Professional
Western Growers Assurance Trust (aka Pinnacle Claims Management) Company
Pinnacle Claims Management
Inc.
Western Grower's Assurance Trust (aka Pinnacle Claims Management)
Western Grower's Insurance Company
Western Growers Assurance Trust (aka Pinnacle Claims Management)
24735
Professional
Western Health Advantage
68039
77225
Professional
Western Life Ins. Benefit Plan (FORTIS)
39065
Professional
WESTERN MUTUAL INS
Western Mutual Insurance
37247
Professional
Western Oregon Advanced Health
DOCSO
WOAHM
Professional
Western Pennsylvania Electrical Employees Insurance Trust Fund
Western Pennsylvania Electric Employees
RP083
Professional
Western Southern Financial Group
WEST & SOUTHERN FINANCIAL GROUP
31048
Professional
WestLake Financial Group
Inc.
90560
Professional
Weyco Inc.
38232
Professional
Willamette Valley Comm Health CCO (Marion Polk Health Plan)
MPCHP
Professional
William C Earhart
William C. Earhart Co
Inc.
HealthSmart William C Earhart
93050
Professional
William J Sutton & Co. Ltd.
98010
Professional
Willow Health
WHLTH
Professional
Wilson McShane
41095
Professional
WIN Healthcare (Woman's Integrated Network
Inc.)
13413
Professional
Wisconsin Anthem Blue Cross and Blue Shield
Blue Shield of Wisconsin
Blue Cross Blue Shield of Wisconsin
Wisconsin Anthem Blue Cross Blue Shield
Anthem Medicaid (WI) (Formerly BadgerCare)
WIBLS
Professional
Wisconsin Dept of Corrections
VEST1
Professional
Wisconsin Medicaid
SKWI2
Professional
Woodman Accident and Life Co (AICT Plans only)
American Insurance Company of TX
81949
Professional
Worksite Benefit Systems
Worksite Benefit Services
20333
Professional
WPP Eldercare Wisconsin
77080
Professional
WPPA-ProviDRs Care Network
WP481
Professional
WPS Commercial
OOWPS
Professional
Wyoming Blue Cross Blue Shield
Blue Shield of Wyoming
WYBLS
Professional
Wyoming Medicaid
SKWY0
Professional
Wyoming School Boards Association Insurance Trust
WYSCH
Professional
Yale University Health Plan
60646
Professional
Yam Hill CCO-PHTech
YAMHL
Professional
Yerington Paiute Tribe
51350
Professional
Yuzu Health
IHS15
Professional
Zebra Health HC
88858
Professional
Zenith American Solutions
89677
Professional
Zing Health
83248
Professional
ZoomCare
ZOOM1
Professional
Zurich Insurance
16535
Professional

Institutional

Payer Name Payer Id Line of Business
(NCHD) Nueces County Hospital District
Christus Health Plan Medicaid
45210
Institutional
1199 SEIU National Benefit Fund
1199 National Benefit Fund
13162
Institutional
2020 Eyecare
2020E
Institutional
3P ADMIN
20413
Institutional
6 Degrees Health Inc.
6 Degrees Health INC
20446
Institutional
A & I Benefit Plan Administrators
93044
Institutional
A.G. Administrators
11370
Institutional
AARP Hospital Indemnity Plans insured by UHC Insurance Co
AARP Medicare Supplement Plans insured by UHC Insurance Co
36273
Institutional
Abrazo Advantage Health Plan
03443
Institutional
Access Administrators
AHS01
Institutional
Access Behavioral Care
Colorado Access (837P & 837)
Colorado Access HMO
COACC
Institutional
Access Medical Group
AMG02
Institutional
Acclaim
64071
Institutional
ACS Benefits Payer Compass
PA331
Institutional
ADMINISTRATIVE CONCEP
Adminstrative Concepts
Inc.
22384
Institutional
Advantage Health Solutions Inc.
35209
Institutional
Advantek Benefit Administrators
Advantek Benefit Admins
83077
Institutional
Advantica Benefits
59374
Institutional
AdventHealth Advantage Plans
RP039
Institutional
AdventHealth Transplant Program
AHTP01
Institutional
AdventHealth Value Based Bundle Management LLC
AdventHealth Value Based Bundle Management
VBBM13
Institutional
ADVENTIST HEALTH SYSTEM
95340
Institutional
Advisory Health Administrators
CB159
Institutional
Advocate Health Centers (AHC)
Advocate Health Centers
36320
Institutional
Advocate Health Partners
Advocate Health Partners (PHO)
65093
Institutional
Aegis Administrative Services
Aegis Andministrative Services
CB637
Institutional
Aegis Administrative Services
Aegis Andministrative Services
BC637
Institutional
Aetna Affordable Health Choices
Aetna Affordable Health Choices (SM) SRC
57604
Institutional
Aetna Better Health CA
Aetna Better Health of California
128CA
Institutional
Aetna Better Health IL Medicaid
Aetna Better Health Medicaid IL
26337
Institutional
Aetna Better Health Nevada
128NV
Institutional
Aetna Better Health NY
34734
Institutional
Aetna Better Health of Illinois INC
68024
Institutional
Aetna Better Health of Kansas
Aetna Better Health Kansas
128KS
Institutional
Aetna Better Health of Kentucky
128KY
Institutional
Aetna Better Health of Louisiana
128LA
Institutional
Aetna Better Health of Maryland
128MD
Institutional
Aetna Better Health of Michigan
128MI
Institutional
Aetna Better Health of New Jersey
46320
Institutional
Aetna Better Health of Ohio
50023
Institutional
Aetna Better Health of Pennsylvania Medicaid
Aetna Better Health - PA Medicaid
23228
Institutional
Aetna Better Health of Virginia
128VA
Institutional
Aetna Better Health of West Virginia
Aetna Better Health West Virginia
128WV
Institutional
Aetna OHIORISE
45221
Institutional
Aetna TX Medicaid & CHIP
AETNA TEXAS MEDICAID
38692
Institutional
Aetna
Primary Choice (Aetna HP- NY/NJ)
Magellan Behavioral Health
Select Choice
Senior Choice (Aetna HP-NY/NJ)
Aetna 60054 (Commercial only)
Aetna Health Plan - PPO
Aetna Life & Casualty Company
60054
Institutional
Affiliated Doctors of Orange County
ADOCS
Institutional
Affiliated Physicians Group
M3CA1
Institutional
Affinity Essentials
AffinityAccess
23334
Institutional
Affinity Health Plan
Affinity Health Plans
13334
Institutional
Affordable Benefit Administrator
Affordable Benefit Administrators
Benefit Plan Administrators
Benefit Plan Administrators of Co Eau Claire WI
Benefit Plan Administrators CO Eau Claire WI
Benefit Plan Administrator
Benefit Plan Administrators WI
39081
Institutional
Agency Services Inc
Meritain Health / Agency Services
64158
Institutional
Ageright Advantage
ARA01
Institutional
Agewell of New York
Agewell New York
AWNY6
Institutional
AHPO (Cleveland
OH)
31138
Institutional
AIDS Healthcare Foundation
Positive Health Care (PHC) California
95422
Institutional
AIG Chartis
19402
Institutional
Aither Health
64884
Institutional
Alabama Blue Shield (Professional)
Blue Shield of Alabama
Blue Cross of Alabama
ALBLS
Institutional
ALAMEDA ALLIANCE
Alameda Alliance for Health (Provider must contact payer to be approved. Contact at Alameda is Anet Quiambao at 510-747-6153 or aquiambao@alamedaalliance.co m)
95327
Institutional
Alaska Childrens Services
Inc
Alaska Laborers Construction Industry Trust
Alaska Pipe Trades Local 375
Alaska United Food & Commercial Workers Health & Welfare Trust
Cement Masons & Plasterers Health & Welfare Trust - Grp#F16
Automotive Machinists Local 289 Health & Welfare Trust - Grp#F32
University of Washington Students & Graduate Appts. - Grp#P67
Operating Engineers Locals 302 & 612 Health & Security Fund - Grp#F12
Welfare and Pension Administration
Hotel Employees & Restaurant Employees Health Trust - Grp#F19
N.W. Ironworkers Health & Security Trust Fund - Grp#F15
N.W. Roofers & Employers Health & Security Trust Fund - Grp#F14
N.W. Textile Processors - Grp#F14
Glassworkers Health & Welfare Fund - Grp# F29
Enstar Natural Gas - Grp# P61
Puget Sound Benefits Trust - Grp#F25
Puget Sound Electrical Workers Trust - Grp#33
West Coast Stationary Engineers Health & Security Trust Fund - Grp#F13
Alaska Children's Services
Inc. - Group # P68
Alaska Laborers Construction Industry Trust - Gro
91136
Institutional
Alaska Medicaid
12K86
Institutional
Albuquerque Public Schools
85600
Institutional
Alexian Brothers Community Services of Tennessee
44423
Institutional
AliCare
Amalgamated Life
13550
Institutional
Align Senior Care California
ASCA1
Institutional
Align Senior Care Michigan
ASMI1
Institutional
Align Senior Care Virginia
ASVA1
Institutional
Alignment Healthcare
Align Senior Care Florida
CCHPC
Institutional
AllCare Pace
ACPCE
Institutional
AllCare PEBB
26158
Institutional
Allegiance Benefit Plan Management
Inc.
81040
Institutional
Alliance Coal Health Plan
93658
Institutional
Alliance Physicians of the High Desert
Alliance Physicians High Desestt
22417
Institutional
Alliant Health Plans of Georgia
58234
Institutional
Allianz Global Assistance
Allianz Global Assistan
50749
Institutional
Allied Benefit Systems
37308
Institutional
Allied Physicians of California IPA
Arroyo Vista Family Health Center
Greater Orange IPA
Greater San Gabriel Valley Physicians IPA
La Salle Medical Associates IPA
Advantage Health Network IPA
Arroyo Viata Family Health Center
NMM01
Institutional
Allina Health Aetna
AMC Plus
54398
Institutional
AllWays Health Plan (prev. Neighborhood Plan
Boston
MA)
04293
Institutional
Alphacare Medical Group
MPM32
Institutional
AltaMed
ALTAM
Institutional
Alternative Opportunities
16089
Institutional
Alterwood Advantage
RP016
Institutional
AM-First Insurance Morgan White
01757
Institutional
AMA Insurance Agency
Inc.
AMAIA
Institutional
Amalgamated Life - PA / Alicare
Amalgamated Life - PA/Alicare
13343
Institutional
AMC Plus
A2740
Institutional
AmeraPlan
ClaimChoice Administrators
38219
Institutional
Ameriben - IEC Group
97661
Institutional
Ameriben Solutions
75137
Institutional
America's Choice NMA
Healthsmart America's Choice
America's Choice Health
20029
Institutional
America's Health Choice
21810
Institutional
America's PPO / America's TPA
HealthEZ
41178
Institutional
Americaid Community Care (Houston)
27515
Institutional
Americaid Community Care (Maryland)
27517
Institutional
Americaid Community Care (New Jersey)
27516
Institutional
American Administrative Group - AAG Form known as UICI Admin
UICI - Administrators
75240
Institutional
American Administrative Group AAG (Gallagher Benefits)
American Administrative Group (formerly Gallagher Benefit)
AAG - American Administrative Group
Cincinnati Financial Corporation
Gallagher
Cinncinnati Financial Corporation
37283
Institutional
American Behavior
American Behavioral
63103
Institutional
American Family (administered by American Republic)
American Family Insurance (Administered by American Republic)
56071
Institutional
American Family Insurance
12T31
Institutional
American Fidelity Assurance Company
60801
Institutional
American General
AMERICAN GENERAL LIFE AND ACCIDENT
62030
Institutional
American Health Advantage of Texas
31155
Institutional
American Health Advantage of Utah
31145
Institutional
American Healthcare Alliance
01066
Institutional
American LIFECARE (Group Number required. Valid only for claims with a billing address of 1100 Poydras ST. #2600
New Orleans
LA 70163)
American Lifecare
72099
Institutional
American NatIonal Insurance (ANICO)
American National Insurance Co
74048
Institutional
American Plan Administrators
95606
Institutional
American Postal Workers Union Healthplan
American Postal Workers Union Health Plan
44444
Institutional
American Republic Insurance Company
42011
Institutional
Americas 1st Choice Health Plans of South Carolina
20553
Institutional
Americas 1st Choice of South Carolina
Inc
Americas 1st Choice of South Carolina
Inc.
55349
Institutional
Amerigroup - Illlinois
Amerigroup
28804
Institutional
Amerigroup Multiple States (Claims and Encounters)
Amerigroup Multiple States
26378
Institutional
Amerigroup New Mexico
Amerigroup DC
Amerigroup Georgia
Amerigroup of Iowa
Amerivantage
Amerigroup Iowa
26375
Institutional
Amerigroup Ohio (Claims and Encounters
Amerigroup Illinois (Claims and Encounters
Amerigroup Illinois
Amerigroup Ohio
27518
Institutional
Amerigroup
Amerigroup/Wellpoint New Jersey
Amerivantage
Amerigroup Wellpoint
Amerigroup Vantage
Amerigroup Wellpoint
Amerigroup/Wellpoint Arizona
Amerigroup/Wellpoint Iowa
Amerigroup/Wellpoint Texas
Amerigroup/Wellpoint Washington
Amerigroup/Wellpoint Tennessee
Wellpoint Maryland
WLPNT
Institutional
Amerihealth Administrators
Inc.
23252
Institutional
Amerihealth Administrators
Inc.
AmeriHealth Administrators
54763
Institutional
AmeriHealth Caritas Healthplan New Hampshire
87716
Institutional
AmeriHealth Caritas Louisiana (Formerly known as LA Care)
AmeriHealth Caritas Louisiana(Formerly known as LA Care)
27357
Institutional
Amerihealth Caritas Next DE
AmeriHealth Caritas Next FL
45408
Institutional
Amerihealth Caritas Next FL
AmeriHealth Caritas Next DE
47073
Institutional
AmeriHealth Caritas Next NC
83148
Institutional
Amerihealth Caritas North Carolina
81671
Institutional
AmeriHealth Caritas Ohio Inc
AmeriHealth Caritas Ohio
Inc
35374
Institutional
AmeriHealth Caritas Ohio Medicaid MCE (Transportation Only)
AmeriHealth Caritas Ohio Medicaid MCE
42435
Institutional
Amerihealth Caritas VIP Care - Florida DSNP
AmeriHealth Caritas VIP Care Florida DSNP
88232
Institutional
AmeriHealth Caritas VIP Care Delaware DSNP
Amerihealth Caritas VIP Care - Delaware DSNP
87406
Institutional
AmeriHealth Caritas VIP Care
AmeriHealth Caritas Pennsylvania Community HealthChoices
77062
Institutional
AmeriHealth Caritus VIP Care Plus (Michigan)
77013
Institutional
Amerihealth Delaware
77799
Institutional
Amerihealth District of Columbia (For EDI Support
please email edi.dc@amerihealthdc.com or call 1-888-656-2383)
Amerihealth DC
77002
Institutional
Amerihealth HMO NJ and DE
Amerihealth HMO NJ and Delaware
95044
Institutional
AmeriHealth Mercy Health Plan (FKA AmeriHealth Caritas Pennsylvania. Claims containing DOS on or after 1/1/21 will need to be sent under this payer ID)
AmeriHealth Caritas Pennsylvania
22248
Institutional
Amerihealth NJ/DE - HMO ** (Must complete enrollment form under payer ID 95044)
23037
Institutional
AmeriHealth NorthEast (Dates of Service on or before Dec. 31
2020
may continue to use the following until Dec. 31
2021. For dates of service 01/01/21 or after use payer ID 22248}
AmeriHealth NorthEast (Dates of Service on or before Dec. 31
2020
may continue to use the following until Dec. 31
2021. For dates of service 01/01/21 or after use payer ID 22248)
77001
Institutional
Amerihealth PPO New Jersey
12X28
Institutional
Amfirst Insurance Company
64090
Institutional
Amida Care Medicare
79966
Institutional
Amtrust North America
J1868
Institutional
Amway Corporation
Activia Benefit Services LLC
Activia Benefit Services LLC (formerly Amway Corp)
Activa Benefits Services
LLC (Formerly Amway Corporation)
38254
Institutional
Anchor Benefit Consulting Inc
Anchor Benefit Consulting
Anchor Benefit (Dental)
53085
Institutional
Anchor Benefit Consulting
Anchor (Claimsbridge)
IHS10
Institutional
Angeles IPA (SynerMed)
75299
Institutional
Angle Insurance Company of Utah
39856
Institutional
Antares Management Services
Mutual Health Services (fka Antares Management Solutions)
Antares Management Solutions
34192
Institutional
Anthem BCBS Georgia
Anthem GA
00601
Institutional
Anthem BCBS Missouri
Anthem BCBS Missouri
00241
Institutional
Anthem BCBS Colorado
00050
Institutional
Anthem BCBS Connecticut
00060
Institutional
Anthem BCBS Maine
00180
Institutional
Anthem BCBS New Hampshire
00270
Institutional
Anthem BCBS Ohio
00834
Institutional
Anthem BCBS Virginia
00423
Institutional
Anthem Blue Cross Blue Shield
02937
Institutional
Anthem Blue Cross of California
California Anthem Blue Cross
California Blue Cross
Blue Cross of California
47198
Institutional
Anthem GA
00101
Institutional
Anthem KY
Blue Cross of Indiana
Blue Cross of Kentucky
00160
Institutional
Anthem Maine Health
00958
Institutional
Anthem NH
Blue Cross of New Hampshire
00770
Institutional
Anthem OH
Blue Cross of Ohio
00332
Institutional
APEX BENEFITS SERVICE
Apex Benefit Services (Claims must contain the rendering provider ID or the claim will reject.)
34196
Institutional
Apex Health
83112
Institutional
Apostrophe
81312
Institutional
APWU Health
Conversion Plan - APWU
55544
Institutional
Arbor Health
52312
Institutional
Arcadia Healthcare Solutions IPG
11081
Institutional
Arcadia Healthcare Solutions NPA
Arcadia Healthcare Solutions - NPA
36364
Institutional
Argus Dental and Vision
ARGUS
Institutional
Arizona Medicaid
SKAZ0
Institutional
Arizona Medicare
Medicare of Arizona
AZMCR
Institutional
Arizona Priority Care Plus
27154
Institutional
Arkansas Best Corporation - Choice Benefits
CIGNA
CIGNA - PPA
CIGNA - PPO
CIGNA Health Plan - HMO
Connecticut General (CIGNA)
EQUICOR
EQUICOR - PPO
Equitable (CIGNA)
HEALTHSOURCE GA
HEALTHSOURCE IN
HEALTHSOURCE KY
HEALTHSOURCE ME
HEALTHSOURCE NH
HEALTHSOURCE OH
HEALTHSOURCE PROVI
HEALTHSOURCE SOUTH
Provident
TYSON FOODS
Arkansas Best Corporation
CIGNA Premier Plus
Arkansas Best Corporation (previous payer ID 75278
new payer ID is effective for claims submitted December 15
2017 and after).
62308
Institutional
Arkansas Medicare Part A Jurisdiction 7
12022
Institutional
ASAGEHA
06603
Institutional
ASC Benefit Services
Inc.
ACS Benefit Services
inc.
72467
Institutional
Ascension Bundle Program
Ascension Bundle Health
ASN99
Institutional
Ascension Living Pace MI
Ascension Living St Vincent Pace INC
R3458
Institutional
Asian American Medical Group
AAMG1
Institutional
Aspire Health Plan
46156
Institutional
Aspirus Medicare Advantage
36483
Institutional
ASR Physicians Care
Physicians Care Network
ASR Corporation
38265
Institutional
ASRM LLC
ASRM Corporation
ASRM
ASRM1
Institutional
Associated Hispanic Physicians Southern California
MPM44
Institutional
Associates for Health Care
Inc. (AHC)
Associates for Healthcare
36326
Institutional
Assurant Health
Assurant Health Self Funded
75068
Institutional
ASSURED BENEFITS ADMI
Assured Benefits Administrators
74240
Institutional
Asuris NW Health
93221
Institutional
Atlantic Medical
Colonial AMI
Atlantic Medical Insurance
22285
Institutional
Atrio Health Plan
Asserta Health
IHS14
Institutional
AultCare
Aultra Administrative Group
PrimeTime Health plan
204951704
AULOH
AULTC
AULTCARE
Institutional
AultCare
Aultra Administrative Group
PrimeTime Health plan
Aultcare
341488123
Institutional
Author by Humana
61108
Institutional
Automated Benefit Services (ABS)
Automated Benefit Services
38259
Institutional
Automated Group Administration
Inc.
Automated Group Administration
37280
Institutional
Auxiant (Nat’l Health Benefit Corp)
National Health Benefits Corportation- NHBC02
National Health Benefits Corporation - NHBC02
88050
Institutional
Avectus Healthcare Solutions (Call 855-AVECTUS)
Avectus Healthcare Solutions
MP001
Institutional
Avera Health Plans
46045
Institutional
AVMED
Avmed Inc.
59274
Institutional
Bakersfield Family Medical Center
BKRFM
Institutional
Bakery & Confectionery Union & Industry International Health
BCTF1
Institutional
Bankers Life and Casualty Company or Washington National Insurance Company
90000
Institutional
Banner Health
12X42
Institutional
Banner Health & Aetna Health Insurance Company
67895
Institutional
Banner Medicare Advantage Plus (HMO)
(HMO) Banner
16664
Institutional
Banner Medicare Advantage Plus (PPO)
16663
Institutional
Banner University Family Care (University of Arizona Health Plans)
Banner University Family Care
66901
Institutional
Baptist Cardiac Program
BSC01
Institutional
Barinet (L&W)
CB369
Institutional
Baycare Select Health Plans Incorp
Baycare Select Health Plans Inc
81079
Institutional
BCBS Arizona
BCBSAZ
Institutional
BCBS Kansas
4716B
Institutional
BCBS Kansas City
47171
Institutional
BCBS Mighigan and Blue Care Network
00210
Institutional
BCBS Minnesota
00222
00722
Institutional
BCBS Minnesota
Blue Cross of Minnesota
00220
Institutional
BCBS Minnesota
Comprehensive Care Services (BCBSMN)
00720
Institutional
BCBS Montana
00751
Institutional
BCBS North Carolina
BCSNC
Institutional
BCBS North Dakota
55891
Institutional
BCBS South Carolina Planned Admin
SC BCBS Planned Administrators
SC886
Institutional
BCBS Texas Medicaid
BCBS Texas Medicaid (Plan effective December 1
2015)
66001
Institutional
BCBS Western NY Medicaid
WNYMD
Institutional
BCBS Wyoming
53767
Institutional
BCBSMN Blue Plus Medicaid
00726
Institutional
Beacon Health Options
BHOVO
Institutional
Beaver Medical Group
45967
Institutional
Behavioral Health Systems
63100
Institutional
Bella Vista Med Grp IPA
Bella Vista Medical Group
MPM10
Institutional
Benebay
Berkshire Health Plans
Berkshire Health Partners
23243
Institutional
BeneFirst
37125
Institutional
Benefit & Risk Management Services
Benefit & Risk Management Services (Commercial Medicare under Med3000)
99320
Institutional
Benefit Coordinators
Benefit Coordinators Corporation
25145
Institutional
Benefit Management Admin (BMA)
BMATP
Institutional
Benefit Management LLC/VBA
88092
Institutional
Benefit Management Services for Charlotte
NC
Benefit Management Services
56139
Institutional
Benefit Management Systems
Inc.
Benefit Management Systems
Inc of Mississippi
37212
Institutional
Benefit Management
Inc. of KS (Only accepts claims for these groups BMI187
BMI219
BMI234
BMI236
BMI214
BMI241
BMI617 BMI246
BMI246.)
Benefit Management
Inc. of KS
48611
Institutional
Benefit Plan Administrators - ClaimsBridge
Benefit Plan Administrators
IHS19
Institutional
Benefit Plan Administrators
Northern Nevada Trust Fund
Northern Nevada Trust Funds (Call 775-826-7200 prior to submitting claims.)
88027
Institutional
Benefit Planners
Inc.
UICI - Administrators - State of Nevada
74223
Institutional
Benefit Systems and Services
Inc.
Benefit Systems & Services
Inc. (BSSI)
36342
Institutional
Berkshire Intergroup
Quest EAP
10956
Institutional
BEST LIFE & HEALTH CO
Best Life & Health Insurance Co.
95604
Institutional
Better Health Plan of Florida (For claims rejections
contact payer at 800-514-4561 and select provider services option.)
Better Health Plan of Florida
20488
Institutional
Beverly Hospital
MPM42
Institutional
BHSF International
67668
Institutional
BIENVIVIR SERVICES
12X40
Institutional
BIND (UHC Choice Plus Multiplan)
Surest Health Plan
25463
Institutional
Blackhawk
Dart Member Care ##
Dart Member Care
CB987
Institutional
Blue Choice Medicaid (for DOS 12/31/23 and prior)
00403
Institutional
Blue Cross Blue Shield of Alabama
12B54
Institutional
Blue Cross Community Options
Blue Cross Community Solutions Effect 12-14-14 payer ID00621
MCDIL
Institutional
Blue Cross Complete of Michigan
LLC
Blue Cross Complete
32002
Institutional
Blue Cross Iowa & South Dakota COB
12B92
Institutional
Blue Cross Medicare Advantage of Montana
Illinois
Texas and Oklahoma
Blue Cross Medicare Advantage (For DOS after 01-01-2017 and for MemberID starting with YDL
YDJ
XOD
XOJ
ZGD
ZGI
ID
YIJ
YUX and UYB only)
66006
Institutional
Blue Cross of Illinois
Blue Cross of Illinois
BLUECROSS BLUESHIELD (BCBS) IL HCSC
00621
Institutional
Blue Cross of Alaska
12B47
Institutional
Blue Cross of Arizona
53589
Institutional
Blue Cross of Arkansas
00520
Institutional
Blue Cross of Colorado
15491
Institutional
Blue Cross of Connecticut
3534I
Institutional
Blue Cross of Florida
Florida Blue
00590
Institutional
Blue Cross of Georgia
3537I
Institutional
Blue Cross of Idaho
12B07
Institutional
Blue Cross of Louisiana
State Employees Group Benefits
12B12
Institutional
Blue Cross of Maine
12B13
Institutional
Blue Cross of Maryland
12011
Institutional
Blue Cross of Massachusetts
00200
Institutional
Blue Cross of Mississippi
12B17
Institutional
Blue Cross of Missouri
12B65
Institutional
Blue Cross of Missouri - Kansas City
Missouri
5569I
Institutional
Blue Cross of Nebraska
00260
Institutional
Blue Cross of New Mexico
BLUECROSS BLUESHIELD (BCBS) NM HCSC
Lovelace Sandia
00790
Institutional
Blue Cross of New York City (Empire)
12B36
Institutional
Blue Cross of New York of Central
12B37
Institutional
Blue Cross of New York of Utica
Watertown
12B38
Institutional
Blue Cross of New York State
12B35
Institutional
Blue Cross of North Carolina
12B23
Institutional
Blue Cross of North Dakota
12B78
Institutional
Blue Cross of Oklahoma
BLUECROSS BLUESHIELD (BCBS) OK HCSC
00840
Institutional
Blue Cross of Oregon Regence
Regence BCBS Oregon
00851
Institutional
Blue Cross of Pennsylvania Capital
12B60
Institutional
Blue Cross of Rhode Island
12B74
Institutional
Blue Cross of South Carolina
12B55
Institutional
Blue Cross of Vermont
12B32
Institutional
Blue Cross of Washington
Blue Cross of Washington (Premera)
00934
Institutional
Blue Cross of West Virginia
12B28
Institutional
Blue Medicare Advantage
00772
Institutional
Blue Shield of California
94036
Institutional
Blue Shield of Kansas City
Blue Cross of Kansas City
Kansas City Blue Cross Blue Shield
KCBLS
Institutional
Blue Shield of Kansas
Blue Cross of Kansas
Kansas Blue Cross Blue Shield
KSBLS
Institutional
Blue Shield of Michigan
Michigan Blue Cross Blue Shield
MIBLS
Institutional
Blue Shield of New Jersey
Horizon BCBSNJ
22099
Institutional
Blue Shield of New York
Western
Blue Cross Blue Shield Of Western New York
Blue Shield of Western New York
N1BLS
Institutional
Blue Shield of Tennessee
Blue Cross of Tennessee
5513I
Institutional
BMC Health Net Plan
Boston Medical Center Healthnet
13337
Institutional
Boilermakers National Health & Welfare Fund
36609
Institutional
Boon-Chapman Benefit Administrators
Inc.
74238
Institutional
Brand New Day (Encounters)
Brand New Day (FFS)
UC002
Institutional
Brand New Day (FFS)
Brand New Day (Encounters)
UC001
Institutional
Braven Health
84367
Institutional
Bravo Health (Now CIGNA HealthSprings.)
CIGNA HealthSprings
Bravo Health
Elder Health HMO of Pennsylvania
52192
Institutional
Breckpoint
BRKPN
Institutional
Bridgespan
BRIDG
Institutional
Bright Health (for DOS after 01/01/2022)
BRGHT
Institutional
Bright Health Plan
CB186
Institutional
BritCay
Colonial BC
22286
Institutional
Brockerage Concepts
Inc (Benefit Concepts)
Benefit Concepts
Healthsmart Brokerage Concepts
Brockerage Concepts
Inc.
51037
Institutional
Broward Regional Health Planning Council
BRHPC
Institutional
Brown & Toland Medical Group
94316
Institutional
Buckeye Ohio Medicaid
04202
Institutional
Butler Benefits
HealthSmart Butler Benefit
HealthSmart Fringe Benefit Coordinators
HealthSmart US Benefits
HealthSmart William C Earhart
42150
Institutional
C&O Employees Hospital Association
C & O Employees Hospital Association
23708
Institutional
C3 Health (fka Access Health Inc.)
A1680
Institutional
Cal-Optima Direct
Caloptima
CALOPTIMA DIRECT
CALOP
Institutional
California Health and Wellness
California Health & Wellness
68047
Institutional
California Home Health and Hospice
12M98
Institutional
California IPA
AMM14
Institutional
California Pacific Medical Center
California Pacific Medical Center
94056
Institutional
Cannon Cochran Management Services
Inc. LA (Claims for Payer address of Metairie
LA only.)
CANNON COCHRAN MANAGEMENT SERVICES INC
71057
Institutional
CANNON COCHRAN MGMT
Arcadia Insurance Company
Sage Technologies (Formerly CCMSI) (Claims for payer address of Rockford
IL ONLY.)
37105
Institutional
CAP Management Systems
CAP Management
95399
Institutional
Capital District Physicians Health Plan
12X03
Institutional
Capital Health Plan
95112
Institutional
Capitol Administrators (Lucent Health)
68011
Institutional
Caprock Health Plan
CapRock HealthPlans
CAPHP
Institutional
Cardiovascular Care Providers
GCVCP
Institutional
Care Access PSN
12K89
Institutional
Care Around the Clock
57721
Institutional
Care First Health Plan of AZ
Care 1st Health Plan of Arizona
57116
Institutional
Care First Health Plan of CA
Care 1st Health Plan of CA
57115
Institutional
Care N Care
Care N' Care
66010
Institutional
Care to Care
41222
Institutional
Care Wisconsin Health Plan (Trizetto)
27004
Institutional
CareCentrix
11345
Institutional
CareCentrix BCBS MI
CareCentrix BCBS Michigan
11349
Institutional
CareCentrix Cigna
11346
Institutional
CareCentrix Florida Blue
11347
Institutional
CareCentrix Horizon
11348
Institutional
CareCentrix Wellcare
11350
Institutional
CareCore Aetna Radiology
CareCore National
LLC (Aetna Radiology Claims)
New York Medical Imaging-MVP
14179
Institutional
CareCore National
Care Core National
14182
Institutional
CareCore Oxford Radiology
CareCore National
LLC (Radiology charges for Oxford)
14180
Institutional
Carefirst BCBS DC National Capital Area
CareFirst BCBS - DC
National Capital Area
SB580
Institutional
Carefirst BCBS NCA
12000
Institutional
Carefirst Medicare Advatange
CareFirst Medicare Advantage
00193
Institutional
Carelon Aetna Home Health
34010
Institutional
Carelon Anthem Home Health
34009
Institutional
CareMore Value Plus (CVP)
Caremore
Caremore IPA
CARMO
Institutional
CareOregon
Inc.
Care Oregon
93975
Institutional
CarePartners of Connecticut
16307
Institutional
CarePlus Health Plan
95092
Institutional
Caresource Georgia
Caresource of Georgia
CareSource of GA
GACS1
Institutional
CareSource Health Plan of Oregon
MRCHP
Institutional
Caresource Indiana
CareSource Marketplace
CareSource IN
INCS1
Institutional
CareSource KY
Caresource Humana
Humana Caresource
CareSource of Kentucky
KYCS1
Institutional
CareSource MI Medicaid
CareSource Michigan Medicaid
MIMCDCS1
Institutional
CareSource North Carolina
CareSource NC
NCCS1
Institutional
CareSource of AR
Caresource AR
ARCS1
Institutional
CareSource OH
31114
Institutional
CareSource Ohio Medicaid
03150
Institutional
Caresource West Virginia
CareSource WV
WVCS1
Institutional
Cariten Commercial
62073
Institutional
Cariten Senior Health
62072
Institutional
Carolina Summit Healthcare
Inc.
Carolina Summit Healthcare
Inc
56195
Institutional
CBHA Carolina Behavioral Health Alliance
Carolina Behavioral Health Alliance
56215
Institutional
CBNHP Health Choices
CBHNP - Health Choices
65391
Institutional
CBSA
CBSA (Corporation Benefit Services of America)
Corporate Benefit Services of America
IBI
Iowa Benefits Inc.
Meritain Health Minneapolis
Iowa Benefits
Inc.
Fortis Self Funded Administrative Services
41124
Institutional
CCOK
Community Care Managed Health Care Plans of Oklahoma
73143
Institutional
CDO Technologies
MBA Benefit Administrators
83028
Institutional
Cedar Valley Community Health Plan
SISCO
Quad Cities Community Health Plan
Lake Region Community Health Plan
Northeast Iowa Community Health Plan
SISCO
Institutional
Cedars-Sinai Medical Network Services Claims
Cedars-Sinai Medical Network Services
95166
Institutional
Cedars-Sinai Medical Network Services Encounters
Cedars-Sinai Medical Network Services
95167
Institutional
Celtic Health Insurance
68063
Institutional
CeltiCare
Cenpatico - Georgia
Iowa Total Care
Centene Advantage Plans (claims for former payer ID 95567 with DOS on or after 1/1/18)
Louisiana Healthcare Connections
Ambetter of Arkansas
Home State Health Plan
Total Carolina Care
Magnolia Mississippi
Bridgeway Arizona
Managed Health Services Indiana
Managed Health Services of Wisconsin (Please contact the payer @ 800-225-2573
ext 25525 to get setup to submit electronic claims.)
Buckeye Community Health
California Health and Wellness
Healthnet Community Solutions
SilverSummit Health Plan
Illinicare Group Health
NebraskaTotal Care
Peach State Health Plan (Behavioral Health)
Peach State Health Plan (Medicaid) (Call 800-225-2573 ext 25525 prior to submitting claims.)
Kentucky Spirit Health Plan
Arkansas Total Care
BRIDGEWAY NETWORK
New Hampshire Healthy Family
California Health & Wellness
Centene Advantage Plans
Western Sky Community Care
Michigan Complete Health
Nebraska Total Care
Novasys Health Network
Peach State Health
68069
Institutional
Cenpatico - Kansas (Prior to submitting claims please call Provider Relations Dept at 866- 896-7293 to verify your provider info is on file in the claim system.)
Cenpatico (For multiple states)
Cenpatico Behavioral Health - Wisconsin (Call 800-225-2573 ext 25525 prior to submitting claims.)
Cenpatico Behavioral Health AZ (Prior to submission
contact 866- 495-6748 to verify provider ID.)
Cenpatico Florida Behavioral Health
Cenpatico Indiana
Cenpatico Massachusetts
Cenpatico Ohio
Illinicare Behavioral Health
Cenpatico
CENPATICO ARIZONA
Cenpatico Behavior Health
CENPATICO GEORGIA
Cenpatico Kansas
CENPATICO TEXAS
GROUP PRACTICE AFFILIATES
IHS Gateway Payer South
Integrated Mental Health Services
68068
Institutional
Center for Elders Independence
94312
Institutional
Center for Healthy Living
CPHL1
Institutional
CenterCare
13357
Institutional
CenterLight Healthcare
13360
Institutional
Centivo
45564
Institutional
Centivo Direct Network Access
IHS04
Institutional
Centra Healthplan
75196
Institutional
Centra Healthplan
Harrington
75243
Institutional
Central California Alliance Call CCA EDI support at 831-430-5510 prior to submitting claims for first time
12K82
Institutional
Central Health Medicare
Central Health MSO
CHCPI
Institutional
Central Mass Heath Care
CMHC
Healthsource CMHC
Healthsource Massachusetts
Inc
Healthsource
MA
02041
Institutional
Central Reserve Life Insurance Company
Loyal American Life
Central Reserve Life
Central Reserve Life Ins.Co. (Formertly Loyal American Life (Medicare Supplement) )
13193
Institutional
Central Valley Medical Group
Sutter Connect - Central Valley Med Group (Claims)
77035
Institutional
Centurion LLC
Centurion
IHS11
Institutional
Centurion of Tennessee
42140
Institutional
Century PHO
36393
Institutional
Chaffey Medical Group
49533
Institutional
CHAMPVA - HAC
Veterans Family Members Program (FKA CHAMPVA-HAC)
84146
Institutional
Children's Community Health Plan Wisconsin
251CC
Institutional
Childrens Medical Center Health Plan
CMCHP
Institutional
Chinese Community Health Plan
Chinese Community Health Plan (Unique Provider ID must be on claim.)
94302
Institutional
Chino Valley Medical Group
CVMC1
Institutional
CHOC Childrens Hosp of Orange Cty Health Alliance
CHOC - Childrens Hospital of Orange County Health Alliance
33065
Institutional
Choice Physicians Network (Nivano Physicians)
CPNNP
Institutional
Choice Physicians Network
Choice Physician Network
CPN01
Institutional
CHP/RPU (FABOH) (Facility physical address required on claim.)
CHP/RPU (FABOH)
39112
Institutional
Christian Brother Services
Christian Brothers Services
38308
Institutional
Christian Care Ministries (Medishare) (Providers should check the member ID card and use the Household ID value as the member ID when submitting claims electron
Christian Care Ministries
59355
Institutional
Christie Student Helath Plan
Christie Student Health Plans
75544
Institutional
Christus Health Medicare Advantage
10629
Institutional
Christus Health Plam -US Family Health Plan
Christus Health Plan - US Family Health Plan
US Family Health Plan
90551
Institutional
Christus Health Plan HIX
Christus Health Plan Health Exchange
52106
Institutional
Christus Spohn Health Network
Spohn Health
SPOHN
Institutional
CIGNA Behavioral Health
CIGNA Behavioral Health (We will also accept PID SX071 for these claims: use of either ID accomplishes the same routing.)
MCC Behavioral Care (We will also accept PID SX071 for these claims: use of either ID accomplishes the same routing.)
MCCBV
Institutional
CIGNA Medicare Advantage
CIGNA Senior
CIGNA Healthcare for Seniors - Arizona Medicare
86033
Institutional
Citrus Valley Physicians Group
Physicians Data Trust
St Vincent Noble Tri Cities IPA
Ximed Medical Group
Citrus Valley Physician's Group
PDT01
Institutional
Claims Choice Administrators LLC
83063
Institutional
ClaimsBridge High Performance Network (HPN)
11752
Institutional
Claimsware Inc. DBA ManageMed
ClaimsWare
Inc. DBA ManageMed
57080
Institutional
Clarian Health Plans
MPLAN
Inc./HealthCare Group
LLC
MPLAN Inc. Healthcare Group
Senior Smart Choice
95444
Institutional
Clear Health Alliance
CLEAR
Institutional
Clear Spring Health Management Services
Family Health Network
85468
Institutional
Clever Care Health Plan
CC168
Institutional
Clinical Specialties INC
Clinical Specialisties INC
CSI001
CSI01
Institutional
Clover Health (FKA Carepoint Health Plan payer ID 77023)
Clover (Formerly Carepoint Health Plan
previous payer ID 77023)
13285
Institutional
CO NM OK TX - Medicare Part A (Mac J4) Legacy WPS
12M88
Institutional
Coachella Medical Group
COMG1
Institutional
Coastal Administrative Services
77052
Institutional
Coastal Care Services Inc
47394
Institutional
Cobalt Benefits Group
LLC dba CBA Blue
Blue Benefit Administrators of Massachusetts
& EBPA
03036
Institutional
Cofinity - Group Resources
42049
Institutional
Colonial CMI
22287
Institutional
Colonial CMI
Colonial Medical
22284
Institutional
Colonial Penn Life Insurance
37077
Institutional
Colorado Access
84129
Institutional
Colorado Community Health Alliance
COCHA
Institutional
Colorado HealthOP
Colorado Health Insurance Cooperative
49718
Institutional
Colorado Medicaid
12K03
Institutional
COMMERCE BENEFITS GRP
Commerce Benefits Group
34181
Institutional
Common Ground Healthcare Cooperative
77170
Institutional
Commonwealth Care Alliance
A2793
Institutional
Commonwealth Care Alliance Medicare Advantage
14316
Institutional
Communicare Advantage
34525
Institutional
Community Care Behavioral Health Organization
Community Care Behavioral Health Org (service prior to 10-1-2007)
25179
Institutional
Community Care BHO
Community Care BHO (For Dates of Service after October 1
2007)
23282
Institutional
Community Care Organization
Community Care Inc. (WI)
39126
Institutional
Community Care PCC
Preferred Community Choice/PCCSelect/CompMed
Preferred Community Choice
73145
Institutional
Community Care Plan(Palm Beach Health District)
PBHD1
Institutional
Community Connect Medicaid
Group Health Cooperative of EauClaire
Group Health Cooperative of Eau Claire
95192
Institutional
Community First I Par Plus
Community First Health Plans
Community First Health Plan
Inc.
COMMF
Institutional
Community Health
60495
Institutional
Community Health Alliance
35193
Institutional
Community Health Allliance TN
Community Health Alliance TN
27905
Institutional
Community Health Choice (Please include TPI Number (Texas Medicaid Number) in Field FA0-23)
Community Health Choice
48145
Institutional
Community Health Electronic Claims/CHEC/webTPA
75261
Institutional
Community Health Group
66170
Institutional
Community Health Plan District of Columbia
L0230
Institutional
Community Health Plan of Washington
CHPWA
Institutional
COMP - Ohio (Austintown
OH)
COMP-Ohio (Austintown
Ohio)
34177
Institutional
Companion Life
American Worker Health Plan
American Worker Health Plan (Dental)
American Worker Health Plus
37322
Institutional
Companion
Forethought
Bankers Reserve/Wellcare
Thrivent
Shenandoah
Combined Insurance Company
Combined Sterling
Liberty Banke
Standard Life
Western Catholic Union
Liberty Bankers
26119
Institutional
CompManagement Health
15243
Institutional
Comprehensive Care Services (BCBSMN For DOS on and after 01-01-2019)
BCBSMN Blue Plus Medicaid
00562
Institutional
ComPsych
U7363
Institutional
Concordia Care Inc
Concordia Care Inc.
33632
Institutional
Connecticare - Medicare
CONNECTICARE MCR
78375
Institutional
Connecticare Comm UB
U6105
Institutional
Connecticare MCR UB
U8375
Institutional
Connecticare
Inc.
ConnectiCare
Inc
06105
Institutional
Connecticut Medicaid
12K04
SKCT0
Institutional
Consociate Group
37135
Institutional
Consolidated Associates Railroad
HealthSmart Consolidated Associates Railroad Employees (CARE)
75284
Institutional
Consolidated Health Plans
Wellfleet Group
LLC
87843
Institutional
Constitution State / Travelers
19046
Institutional
Consumers Choice Health SC
45321
Institutional
Contessa Health
CH201
Institutional
Contessa Health Security Health Plan
CH101
Institutional
Contra Costa Behavioral Health Plan
CCMHP
Institutional
Contra Costa Health Plan
Contra Costa Health Plan
CCHS
Institutional
Contra County Health Plan
CNTRA
Institutional
Cook Childrens Health Plan CHIP
Cook Children's Health Plan
Cook Childrens Health Plan
CCHP1
Institutional
Cook Childrens Health Plan Star
Cook Children's Star Plan
CCHP9
Institutional
Cook Group Health Plan
35149
Institutional
Cook Medical Group
60065
Institutional
Coordinated Benefit Plan
14829
Institutional
Core Management Resouces Group
Core Management Resources Group
Core Administrative Services
58231
Institutional
CoreStar
CoreSource of Illinois
CoreSource of IOWA
CoreSource of Maryland
Luminare Health
CoreSource of Pennsylvania
Luminare Health AZ IL IN MD MN NC PA fka Trustmark Health Benefits
35182
Institutional
Corizon Health
Inc
Corizon Health Inc.(Claims with address of Brentwood
TN should be submitted to this Payer ID.)
CORIZ
Institutional
Cornerstone Hospice and Palliative Care
Inc.
RP111
Institutional
Cornerstone Preferred Resources
CB268
Institutional
Corporate Benefits Service
Inc.
56116
Institutional
Corporate Plan Management Inc.
64270
Institutional
CorrectCare Integrated Health
LADOC
Institutional
CorrectCare Integrated Health (California Prison Healthcare Services)
CorrectCare Integrated Health (CA Prison Health)
CorrectCare Integrated Health (Non -Louisiana Jails Prison Health)
CCIH
Institutional
CorrectCare Integrated Health (Non Louisiana Jails)
CCIHJAIL
Institutional
Correction Health Partners
Physician Health Partners
PHPMC
Institutional
Correctional Medical Services
Corizon
Inc. (fka Correctional Medical Services) Claims with address of St. Louis
MO should be submitted to this Payer ID.
43160
Institutional
CORSOLUTIONS
Employers Direct Health - FI
75235
Institutional
County Care (Behavioral Health and regular claims with a DOS after 4/1/16)
County Care
06541
Institutional
County Care
County Care (Behavioral Health claims with a DOS prior to 4/1/16)
42138
Institutional
County Care
County Care (formerly Centene IPA ) Claims with a DOS prior to 4/1/16)â–¡
42139
Institutional
Covenant Administrators
LLC - 90 Degree
Covenant Administrators LLC - 90 Degree
Guarantee Trust Life Insurance Company
58102
Institutional
Covenant Management System Employee Benefit I Par Plus
Covenant Management Systems Employee Benefit plan
CMSEB
Institutional
Coventry Health Care of Florida
128FL
Institutional
COVID19 HRSA Uninsured Testing and Treatment Fund
95964
Institutional
Cox Health Plan
00119
Institutional
CPR Share Plan
CPR Share Plans
CB695
Institutional
Creative Medical Systems
64068
Institutional
Creative Plan Administrators
37320
Institutional
Crescent Health Solutions
56213
Institutional
Crystal Run Health Plans
46430
Institutional
CSI Network Services
34186
Institutional
CTI Administrators Inc.
CTI Administrators Inc
42141
Institutional
Curative
CURTV
Institutional
Custom Design Benefits
Inc.
Custom Design Benefits Inc.
82056
Institutional
D.H. EVANS & ASSOC.
EBC INC
Employee Benefit Consultants
Health Care District
Health Plan of San Mateo
Healthy Palm Beaches
MERCYCARE WI (Call 608-758- 7739 for PayerID.)
OMMS South Carolina
PA PREFERRED HEALTH
SOUTH CENTRAL PREFERRED
AllCare (Must contact AllCare
800-564-6901 for setup and payerID.)
Blue Medicare of North Carolina (Contracted providers only. Call 888-296-9790)
John Muir Trauma Physicians (Please call 925-947-5288 for Payer ID information.)
EBC Inc. (To obtain the payerID
please call (440) 262-1160)
PA Preferred Health (Call PPHN Claims Operations at 410-349- 3222)
Employee Benefit Consultants (To obtain the payer ID
please call (440) 262-1160.)
Employee Benefit Consultants
Inc. (Call (440) 262-1160 for PayerID.)
Virginia Health Network
Inc (To get the payerID
call payer at (804)320-3837)
Network Health (Before initiating submissions
please call Provider Relations at (617)806-8104 or www.network-health.org for an EDI startup plan.)
Radcon
Inc. (Please contact Kat
CALL
Institutional
DakotaCare
DAK01
Institutional
DC Medicare Part A Jurisdiction 12 - Highmark
12M63
Institutional
DE Medicare Part A Jurisdiction 12 - Highmark
12M76
Institutional
Dean Health Plans
41822
Institutional
Decent Health
DCENT
Institutional
Delaware Medicaid
12K87
SKDE0
Institutional
Dell Children's Health Plan
74272
Institutional
DELTA HEALTH SYSTEMS
94235
Institutional
DENVER HEALTH MED PLN
Denver Health Medical Plan
84135
Institutional
DENVER HEALTH MEDICAID CHOICE
Denver Health and Hospital Authority
84133
Institutional
Department of Labor
J1438
Institutional
Devoted Health
DEVOT
Institutional
DHMN Preferred IPA Hospital Risk
DHM02
Institutional
DHMN Santa Cruz
DHM01
Institutional
Dignity Global
MPM27
Institutional
Dignity HCLA
MPM28
Institutional
Dignity Health - Sacramento Hospital claim shop for Mercy Medical Group
Woodland Clinic Medical Group and Hill Physicians Medical group (hospital risk)
Dignity Health - Sacramento Hosp claim shop-Mercy Med Group
HOSH1
Institutional
Dignity Health Medical Foundation for Mercy Medical Group or Woodland Clinic Medical Group (professional risk)
for Mercy Medical Group or Woodland Clinic Medical Group
Dignity Health Med Found for Mercy Med Gr-Woodland Clin Med
PROH1
Institutional
Dignity Health Medical Group (Inland Empire)
Dignity Health Med Group-Inland Empire (professional risk)
PROH4
Institutional
DIRECT CARE ADMINISTRATORS
DCA62
Institutional
DirectCare
55731
Institutional
District of Columbia Medicaid
12001
Institutional
Diversified Admin Corp
06102
Institutional
DMBA
SX105
Institutional
Doctors Healthcare Plan
DRHCP
Institutional
Dolton Medical Group
DOLMG
Institutional
Downey Select IPA (Applecare Medical Mgmt)
Downey Select IPA (Applecare Medical Mgmt
APP01
Institutional
DPC Core INC
DPC CORE
Inc.
23212
Institutional
Driscoll Childrens Health Plan
Driscoll Childrens Health Plan (CHIP)
74284
Institutional
E.S. Beveridge and Associates
E. S. Beveridge and Associates
E.S. Beveridge
34108
Institutional
E3 Health
Inc (Formerly First Integrated Health)
First Integrated Health
75232
Institutional
Each Care Network- Effective 08/01/2020
88846
Institutional
East Boston Neighborhood Pace
NeighborhoodHealth
25849
Institutional
EAST CAROLINA BEHAVIORAL HEALTH
56089
Institutional
Eastern Main Healthcare Systems (EMHS)
Eastern Main Healthcare Systems (EMHS) Employee Health Plan
16565
Institutional
Eastland Medical Group
EMG11
Institutional
Easy Care MSO LLC
ECMSO
Institutional
Easy Choice HP of NY
Med3000 CMS Title 19 Reform (New PID Effective For DOS After 1/31/19)
Pyramid Life Insurance Company
Wellcare HMO
Inc.
Todays Option (American Progressive and Pyramid Life)
Med3000 CMS Title 19 Reform (New PID Effective For DOS After 1/31/19)
14163
Institutional
Eberle Vivian
EV001
Institutional
EBMS (Employee Benefit Management Services
Inc)
12X44
Institutional
EBMS (Employee Benefit Management Services
Inc)
81039
Institutional
EDS Healthchoice (formerly payer ID 22521 - For dates of service on or after 01/01/2018 )
Healthchoice (formerly payer ID 22521)
HealthChoice
71064
Institutional
El Paso First Health Plans - CHIP
El Paso First - CHIP
El Paso First - CHIP I Par Plus
EPF03
Institutional
Elder Service Plan of the North Shore.
Element Care Incorporated
Elder Service Health Plan of the North Shore
04326
Institutional
ELDERPLAN
ElderPlan
Inc. (Elderplan Provider ID necessary on all claims. Contact (718)921-7979 for Provider ID.)
31625
Institutional
Elmcare L.L.C.
Elmcare
NAELM
Institutional
Elmco
37253
Institutional
Emblem Health
81336
Institutional
EmblemHealth Insurance UB
E5247
Institutional
EmblemHealth Plan (HMO) UB
U5531
Institutional
EmblemHealth Plan (HMO)
GHI HMO Select
25531
Institutional
EmblemHealth Plan (MCR) UB
A3551
Institutional
Emerald Health
16755
Institutional
EMI HEALTH
SX110
Institutional
Empire BC Anthem BC NY
00303
Institutional
Employee Benefit Administration & Management (EBA&M)
HealthSmart Employee Benefit Administrators & Management
95288
Institutional
Employee Benefit Concepts
Employee Benefit Concepts MI
38241
Institutional
Employee Benefit Corporation
37215
Institutional
Employee Benefit Management Corp.
Employee Benefit Management Corp. (EBMC)
31074
Institutional
Employee Benefit Services
Key Benefit Administrators (Ft. Mill
SC)
Employee Benefit Systems
Key Benefit Administrators (Ft.Mill
SC)
37216
Institutional
Employee Benefit System
Employee Benefit Systems
42149
Institutional
Employee Logistics
92135
Institutional
Employee Plans
LLC
Employee Plans LLC
35112
Institutional
Employees Mutual (EMC)
21415
Institutional
Employer Health Network
Employers Health Network
IHS07
Institutional
Employer's Direct SF
Employers Direct Health - SF
75233
Institutional
Employers Direct Health
Employers Direct Health - Employee Plan
75236
Institutional
Employers Health Cooperative (EHC)
Employers Coalition On Health (ECOH)
Claimshop- Employers Coalition on Health
27008
Institutional
Employers Mutual
Inc. (Florida Providers only)
Employers Mutual
Inc (FL)
59298
Institutional
Empower Arkansas
12956
Institutional
Enterprise Group Planning
EGPIN
Institutional
Entrust
36878
Institutional
Epic Life Ins. (Wisconsin Physician Services)
Wisconsin Physicians Service Insurance Corporation
12X29
Institutional
EPN - Seton Health Plan Exclusive (Provider ID required)
EPN (Seton Health Plan Exclusive PR I Par Plus)
EPNSH
Institutional
Erin Group Administrators
Significa Benefit Services
Inc.
Erin Group Administrators (Now known as Significa Benefit Services
Inc.)
23250
Institutional
Essence Healthcare
20818
Institutional
Essential Health Partner
EHPSC
Institutional
Essential Health Partners
EIPA9
Institutional
Everence
Mennonite Mutual (Now known as Everence)
Mennonite Mutual Aid Association and Affiliates (Now known as Everence)
35605
Institutional
Evolutions Healthcare Systems
Evolutions Healthcare
59313
Institutional
Evry Health
EH001
Institutional
Exceedent LLC
22344
Institutional
Excellus BCBS New York Rochest
Excellus BCBS New York Rochester Area
SB804
Institutional
Exclusive Care
Exclusive Care (ALL providers must contact Exclusive Care prior to submitting claims electronically. Please contact Martha Cuevas at 951-955-8853)
EC999
Institutional
FACS Group
37300
Institutional
Falling Colors
FCC20
Institutional
Fallon (Transplant claims)
Fallon Transplant
FT254
Institutional
Fallon Community Health
Fallon Community Health Plan
22254
Institutional
Family Care
Family Care - Milwaukee WI
60995
Institutional
Family Care Specialists
MPM40
Institutional
Family Practice Medical Group
10145
Institutional
Farm Bureau Health Plans MAPD
RP061
Institutional
FCE BENEFIT ADMINISTRATORS
33033
Institutional
Federal Qualified Hlthcr Cntr via UGS
Federally Qualified Healthcare Clinic
FQHC1
Institutional
Fenix Med Group
60818
Institutional
Fidelis Care New York
11315
Institutional
Firefly Health
FRFLY
Institutional
First Agency
88055
Institutional
First Carolina Care
FCC01
Institutional
First Choice Next A Product of Select Health of South Carolina
Inc.
57103
Institutional
First Choice VIP Care Plus SC #3
First Choice VIP Care Plus SC
77009
Institutional
First Choice VIP Care(SC D SNIP) by Select Health of South Carolina
Inc.
32456
Institutional
First Health Network
PPO Oklahoma (WinterBrook HealthCare Management)
73159
Institutional
FirstCare
94999
Institutional
FirstCare Star Medicaid
94998
Institutional
FirstGuard Health Plan - Kansas
90060
Institutional
FirstGuard Missouri
90061
Institutional
FL MCO PHC/PHP
FL MCO PHC PHP
95411
Institutional
Florida Community Care
FLCCR
Institutional
Florida Complete Care
FLCPC
Institutional
Florida Health Plan
Florida Healthcare
59322
Institutional
Florida Hospital VBR
VB001
Institutional
Florida Medicaid
12K34
Institutional
Florida Pace Centers
FLPAC
Institutional
Flume Health INC
Flume Health Inc.
FH205
Institutional
FMH Benefit Services
Luminare Health KC
Luminare Health KC fka Trustmark Health Benefits
FMH Benefit Services
Inc.
48117
Institutional
Fox Valley Medicine Site 199
FVMCH
Institutional
Fox-Everett
Inc.
Fox Everett
64069
Institutional
Franciscan Purdue
FAIPUR
Institutional
Freedom Health Plan
41212
Institutional
Freedom Life
Freedom Life Insurance Company
62324
Institutional
Fresenius+A1210 Total Health
43197
Institutional
Fresno PACE
99660
Institutional
Friday Health Plan
A2700
Institutional
Fringe Benefit Coordinators
HealthSmart Fringe Benefit Coordinators
HealthSmart Fringe Benefit Coordinators (Dental)
59204
Institutional
FrontPath
FrontPath Health Coalition
34171
Institutional
Galveston County Indigent Health
GALVESTON COUNTY INDIGENT HEALTHCARE
30005
Institutional
Gateway Health Plan - Medicare Assured Ohio
Gateway Health Plan - Medicare Assured OH
91741
Institutional
Gateway Health Plan ((Yellow Card). Check the ID card to verify the Payer ID before submitting)
Assured
60550
Institutional
Gateway Health Plan of Ohio
Inc.
76028
Institutional
Gateway Health Plan
Gateway Health Plan - Medicaid PA
25169
Institutional
GBS Group Benefit
GBS Global Benefit
Group Benefit Services
CB951
Institutional
GBS Group Benefit Services
80241
Institutional
GEHA (Government Employees Health Association)
Government Employees Health Association Inc. (GEHA)
Government Employees Health Association
Inc. (GEHA)
44054
Institutional
Geisinger Health Plan
75273
Institutional
GEMCare (Golden Empire Managed Care System)
Gemcare Golden Empire Managed
MCS01
Institutional
Gemcare Health Plan
MCS03
Institutional
General American Life Insurance Company
General American Life Insirance Company
63665
Institutional
Generations Health
46050
Institutional
Georgia Health Advantage
A2327
Institutional
Georgia Medicaid
SKGA0
Institutional
Gettysburg Health
Gettysburg Health Administrators
Core Value (Part of Gettysburg Health.)
23274
Institutional
GHA Orthopedic Providers INC
GHA Othopedic Providers
GHAOP
Institutional
GHI - Medicare PPFS (Private Fee for Service)
22937
Institutional
GHI - New York (Group Health Inc.)
EmblemHealth Plan (MCR)
Group Health Incorporated (GHI) (New York)
13551
Institutional
Global Care Inc
HealthSmart Global Care INC
Global Care
07689
Institutional
Global Care Med Grp IPA
MPM05
Institutional
Global Excel Management
GEM01
Institutional
Global Health
GHOKC
Institutional
Global Health of TX
GHTX0
Institutional
Global Healthcare Alliance
GHAHSS
Institutional
Global One Ventures
GLOBA
Institutional
Global Repricing Solutions
Innovative Healthware Payer 6
IHS06
Institutional
Global TBSP
MPM64
Institutional
Global Women's Health Plan
Global Womens Health Providers
GHAWH
Institutional
Gloria Gates
IHS20
Institutional
GMMI CC
GMICC
Institutional
GMR HEALTHCARE
85664
Institutional
GMS
Inc.
GMS INC
HealthSmart GMS Inc
47083
Institutional
Gold Coast
77160
Institutional
Gold Coast MSO
GCMSO
Institutional
Gold Kidney Health Plan
Gold Kidney Healthcare
A6865
Institutional
Golden Shore Medical Group (GSMG)
NMM03
Institutional
Golden State Medical Group
Nivano Physicians IPD
Nivano Physicians IPA
MBA01
Institutional
Gonzaba Medical Group
GMGSA
Institutional
Good Shepherd Hospice
76923
Institutional
Gravie
GRV01
Institutional
Great Lakes Health Plan (UnitedHealthcare Community Plan / MI)
Great Lakes Health Plan (UnitedHealthcare Community Plan)
UnitedHealthcare Community Plan / MI (formerly Great Lakes Health Plan)
95467
Institutional
Great Lakes PACE
39640
Institutional
Great-West Life
80705
Institutional
Greater Newport Physicians Medical Group
33010
Institutional
Group Administrators Ltd
Group Administrators Ltd.
36338
Institutional
Group and Pension Administrators
48143
Institutional
Group Health Cooperative of South Central Wisconsin Claims
Family Health Systems - WI/Group Health Cooperative
Group Health Cooperative
39167
Institutional
Group Insurance Service Center
Inc.
Group Insurance Service Center
INC
37276
Institutional
Group Marketing Services INC.
Group Marketing Services INC
66701
Institutional
Group Resources PHCS
28680
Institutional
Guardian Life Insurance Company of America
64246
Institutional
Gulf South
60389
Institutional
Gulf South Risk Services
60652
Institutional
GulfStream- General Dynamics/CoreSource
CB624
Institutional
Gundersen Lutheran Health Plan
Gundersen Lutheran Health Care
39180
Institutional
H.E.R.E.I.U Welfare Pension Funds
Unite Here Health
H.E.R.E.I.U. Welfare Pension Funds
37114
Institutional
HAA Preferred Partners
65101
Institutional
Halcyon Behavioral Health
HALCY
Institutional
Hamaspik Choice
Inc.
Hamaspik Choice Inc.
47738
Institutional
HAP Caresource
MIMCDS1
Institutional
HAP Caresource MI Dual
MIMCRCS1
Institutional
Harmony Health Plan of Illinios
Harmony Health Plan of Illinois (Wellcare Provider ID required
call (800) 960-2530 opt. 2 then 5)
36406
Institutional
Harmony Health Plan of Indiana
Harmony Health Plan of IA ( claims for Hoosier Healthwise me
36405
Institutional
Harrington Health - Kansas ((Formerly known as Fiserv Health-Kansas)
Harrington Health - Kansas
Willis Administrative Services Corporation (Now known as UMR Kansas.)
62061
Institutional
Harrington Health BPO
Harrington Health
59143
Institutional
Harvard Community Health Plan
04245
Institutional
Harvard Pilgrim Healthcare
Harvard Pilgrim
04271
Institutional
Hawaii Mainland Administrators PHCS HMA Employees PMO
86070
Institutional
Hawaii Medical Assurance Association (HMAA)
Hawaii Western Management (HWMG)
99208
Institutional
Hawaii Medical Services Association (HMSA)
SB971
Institutional
Hawaii Medicare
Medicare Part B of Northern Mariana Islands
Medicare Part B of Guam
Medicare Part B of Hawaii
HIMCR
Institutional
HCH Administration
37111
Institutional
HCP Nevada
20501
Institutional
Health 2 Business
55213
Institutional
Health Alliance Medical Plans of Illinois
Health Alliance Medical Plans Illinois
77950
Institutional
Health Alliance Plan of Michigan (Use payer ID 38224 for claims with a date of service 01-01-20 and greater. For dates of service 12-31-19 and prior please use payer ID 70259)
Medical Value Plan - Ohio (MVP)
HEALTH ALLIANCE P (Use payer ID 38224 for claims with a date of service 01-01-20 and
MVP - Ohio (Previous payer ID MHP77; Use payer ID 38224 for claims with a date of service 07-01- 19 and greater)
38224
Institutional
Health Care District of Palm Beach
HCDPB
Institutional
Health Care LA IPA (HCLA)
Healthcare LA
IPA
MPM06
Institutional
Health Care Network of Wisconsin (HCN)
42102
Institutional
Health Care Partners AZ
Health Care Partners of AZ
Health Care Partners -AZ (Dates of Service of 5-01-13&later)
HCP02
Institutional
Health Choice Generations
62180
Institutional
Health Choice Generations
Health Choice Utah
45399
Institutional
Health Cost Solutions
Health Coast Solutions
62111
Institutional
Health Design Plus
Contigo Health
Health Design
34158
Institutional
Health EZ
America's PPO (Formerly known as ARAZ.)
America's PPO (Formerly ARAZ)
ARAZ (Now known as America's PPO.)
16120
Institutional
Health First-Tyler
TX
Health First - Tyler
TX
75234
Institutional
Health First
Health First Health Plans
95019
Institutional
Health IN Tech
IHS09
Institutional
Health Management Admin
12T11
Institutional
Health Management Associates (HMA
servicing Southeastern and Southwestern Regions) (Provider ID Required)
HMA Hawaii
86066
Institutional
Health Net - California (Encounters only.)
95568
Institutional
Health Net (California Encounters Only.)
Health Net of California (for claims with DOS prior to 12/31/17. For claims with DOS on or after 1/1/18
please use payer ID 68069 )
Health Net - California
95567
Institutional
Health New England
04286
Institutional
Health Options of Illinois I Par Plus
Health Options of Illinois
NAHOI
Institutional
Health Partners
07003
Institutional
Health Partners
PA
80142
Institutional
Health Payment Systems
Health Payments Systems
Inc.
20270
Institutional
Health Plan of Michigan (Now known as Meridian Health Plan)
Meridian Health Plan Michigan (Meridian Health Plan Michigan Complete and Meridian Health Plan Michigan Medicaid) effective until 12/31/20
MeridianHealth Michigan
Meridian Health Plan Michigan
52563
Institutional
Health Plan of San Joaquin
68035
Institutional
Health Plan Services
Tampa Office
American Benefits Plan Administrators (Las Vegas
NV)
Consolidated Group
HEALTH PLAN SERVICES
Culinary Health & Welfare Fund (Las Vegas
NV)
59140
Institutional
Health Plans Inc.
Health Plans
Inc.
44273
Institutional
Health Plus of Michigan
U8216
Institutional
Health Plus Physicians Organization
63363
Institutional
Health Services for Children with Special Needs (HSCSN)
Health Services for Children with Special Needs
37290
Institutional
Health Services Preferred (HSP) by Emerald Health
Health Srv Pref. (HSP) Emerald Hlth
Integrated Care Network (ICN) by Emerald Health
Health Srv Pref (HSP) Emerald Hlth
PPO Business)
Emerald Health Network
Emerald Health Network
Inc. (All HMO Business)
34167
Institutional
Health Systems Inc
11889
Institutional
HEALTH WEST ADMINISTRATORS
U7876
Institutional
HealthBridge
74853
Institutional
Healthcare Highways Health Plan
HCHHP
Institutional
Healthcare Options I Par Plus
EL Paso First Health Plan HCO Healthcare Options
EPF37
Institutional
Healthcare Partners
Physician Associates of Greater San Gabriel Valley
Arta Health Network
Northridge Medical Group
OCN01
Institutional
HealthCare Partners
IPA (Formerly Heritage New York Medical Group)
Healthcare Partners
IPA
Liberty Health Advantage
11328
Institutional
Healthcare Resources NW
56731
Institutional
HEALTHCARE SOLUTIONS
HealthSmart HealthCare Solutions Group
HealthCare Solutions Group
73147
Institutional
Healthcare Strategic Initiatives
HSICS
Institutional
Healthcare USA
Coventry Health Care (Coventry old Legacy Payer ID's are still accepted)
Coventry Health Care (Coventry old Legacy Payer ID's are still accepted.)
25133
Institutional
HealthChoice Dept of Corrections & Rehab
71065
Institutional
Healthchoice Select
71070
Institutional
HealthComp
85279
Institutional
HealthComp
HEALTHCOMP INC
85729
Institutional
HealthComp
Benefit Administrative Systems
BENEFIT ADMIN. SYSTEM
36149
Institutional
HealthComp
Gilsbar
Inc
HealthPlus of Louisiana (Old PayerID of 95009 is no longer valid)
360 Alliance PPO Gilsbar
360 Alliance Gilsbar
Gilsbar
Health Plus of LA
07205
Institutional
Healthease
Wellcare of FL
59608
Institutional
HEALTHEOS
Multiplan Wisconsin Preferred Provider Network
34080
Institutional
Healthfirst TPA - Austin
Healthfirst of Austin TPA
75289
Institutional
Healthfirst
Inc. (NY)
Healthfirst of NY
80141
Institutional
Healthgram
Ingham Health Plan Corp.
Ingham Health Plan Corp
38343
Institutional
HealthHelp Network
Inc. (HHNI)
59087
Institutional
Healthnet of AZ
Healthnet of Arizona
Inc.
38309
Institutional
Healthnow BCBS New York Western
12B39
Institutional
Healthpartners of MN
HealthPartners of Minnesota
55764
Institutional
Healthplus Amerigroup
Americaid Community Care (Dallas/Ft. Worth)
27514
Institutional
Healthscope
40026
Institutional
HealthSCOPE Benefits EHC Repricing
HealthScope Benefits EHC Repricing
52429
Institutional
HealthSCOPE Benefits
INC
CNA Health Partners
HealthScope Benefits
71063
Institutional
Healthsmart Accel
75237
Institutional
HealthSmart Farm Family Life
14140
Institutional
Healthsmart Management Services Organization Inc
Healthsmart Mgmt Services Org Inc
A0067
Institutional
HealthSmart Medcom
MedCom
59231
Institutional
HealthSmart MFC & HealthPlus Peoria
Methodist First Choice
Midland Management/MFC
23550
Institutional
Healthsmart MyDecision
18840
Institutional
HealthSmart NAMCI Global Care
NAMCI/Global Care
L0110
Institutional
HealthSmart OKC
73140
Institutional
HealthSmart Preferred Benefit Administrators
Preferred Benefit Administrators
53476
Institutional
HealthSmart Preferred Care
HSPC1
Institutional
HealthSmart Preferred Care
North Texas Healthcare Network
North Texas Healthcare Network (Effective 01-01-2019)
75250
Institutional
HealthSmart University Medical Center
11149
Institutional
Healthsource Kentucky - Claims must contain Healthsource specific Vendor ID & specific Rendering Provider ID
Healthsource
KY
61127
Institutional
HEALTHSOURCE MSO
HSMSO
Institutional
Healthsource
AR (Med) (CIGNA)
71075
Institutional
Healthsource
GA (CIGNA)
58210
Institutional
Healthsource
Inc
HS001
Institutional
Healthsource
ME (CIGNA)
Healthsource Maine - Claims must contain Healthsource specific Vendor ID & specific Rendering Provider ID
01041
Institutional
Healthsource
NC (CIGNA)
56147
Institutional
Healthsource
OH
31141
Institutional
Healthsource
SC (claims)
Healthsource
SC (Encounters)
06119
Institutional
Healthsource
TN (CIGNA)
62129
Institutional
HealthSpan Integrated Care accept claims DOS to 1-31-2017
HealthSpan Integrated Care
RH007
Institutional
Healthspring HMO/Medicare + Choice
The Oath - Health Partners of Alabama (Now known as HealthSpring HMO/HealthSpring Medicare+Choice)
HealthSpring HMO/HealthSpring Medicare+Choice
63092
Institutional
HealthSun
HESUN
Institutional
Healthteam Advantage
88250
Institutional
Healthteam Advantage HMO Diabetes and Heart Plan
88350
Institutional
Healthy Blue (MO)
00541
Institutional
Healthy Blue (NE)
00544
Institutional
Healthy Blue Dual Advantage Louisiana
00551
Institutional
Healthy Blue Louisiana
00661
Institutional
Healthy Blue SC (for DOS on or after 1/1/24)
00403R
Institutional
Healthy Kids I Par Plus
M3FL3
Institutional
Healthy San Francisco
HSF01
Institutional
Healthy Texas
68064
Institutional
Healthy Valley Provider Network
HVPNI
Institutional
Healthy York Network
22251
Institutional
Heath Choice AZ
Health Choice of AZ
BCBSAZ ACA Standard Health with Health Choice
62179
Institutional
Hemet Community Med Group ( 951-791-1111 prior to submitting
Hemet Community Medical Group
HCMG1
Institutional
Hennepin Health / Northstar Advantage
60058
Institutional
Heritag+A601e Physician Network I Par Plus
SelectCare of TX (Houston) (Provider ID Required - Contact (713) 843-6780 to obtain ID.)
Texas Plus
HPN11
Institutional
Heritage IPA
HER01
Institutional
HFN Healthease I Par Plus
M3FL5
Institutional
HFN
Inc.
Arkansas Managed Care Organization
Inc. (AMCO)
HFN
Inc
36335
Institutional
High Desert Medical Group
95393
Institutional
High Desert Primary Care
HDPC Premier Healthcare
Mission HospitalAffiliates
STJOE
Institutional
Highline Medical Services MOLINA
91164
Institutional
Highmark BCBS (NY) Medicaid and CHP
Highmark BCBSD NY - Medicaid and CHP
00246
Institutional
Highmark BCBSD Health Options.
Highmark BCBSD
47181
Institutional
Highmark Senior Health Company (PA Blue Shield Medicare Plan)
15460
Institutional
Hill Physicians Aetna PPO
HLPAE
Institutional
Hill Physicians Blue Shield PPO
HLPBS
Institutional
Hill Physicians Health Net PPO
HLPHN
Institutional
Hill Physicians Medical Group
00046
Institutional
Hill Physicians United Healthcare PPO
HLPUH
Institutional
Hillsborough County Health Care
Administrative Services
Administrative Services
Inc.
59141
Institutional
HIP - Health Insurance Plan of Greater New York
HIP-Health Insurance Plan of Greater NY
55247
Institutional
HMC Healthworks aka Health Management Co.
HMC Healthworks aka Health Management Co
75318
Institutional
HMO Louisiana Blue Advantage (For claims with DOS 2020
for claims with DOS on or after 01/01/21 use payer ID 72107)
HMO Louisiana Blue Advantage (For claims with DOS 2020
for claims with DOS 01/01/21 use payer ID 72107)
84555
Institutional
HMO Louisiana Blue Advantage (Use this claim for DOS on or after 01/01/21)
HMO Louisiana Blue Advantage (Use payer ID 72107 for claims with a DOS on or after 01/01/21)
72107
Institutional
Hollywood Presby Medical Center
MPM29
Institutional
Hollywood Presbyterian Medical Center
AMM18
Institutional
Holy Cross Health Partners
NAHLX
Institutional
Home Health Hospice Jurisdiction 15
15404
Institutional
Home Health Hospice Jurisdiction M
11001
Institutional
Homelink
30750
Institutional
Hometown Health Plan Nevada
Hometown Health of NV
88023
Institutional
Hopkins Health Advantage
66003
Institutional
Horace Mann Life Insurance
HealthSmart Horace Mann Life Insurance Company
HMLIC
Institutional
Horizon Healthcare of New York
5526I
Institutional
Horizon Pace
Mercy Health Plan of New Jersey (Provider ID Required in Box33a - Contact (800) 682-9091 to obtain ID)
Horizon NJ Health
22326
Institutional
HPMS (Send claims to payerID listed on patient's Insurance card.)
CARD
Institutional
HRSA COVID-19 Coverage Assistance Fund – 99999-0AQS
90AQS
Institutional
HSBS Memphis
Pittman & Associates (Now known as HSBS Memphis)
HSBS Memphis (Formerly Pittman and Associates)
37224
Institutional
HSBS Oklahoma City
Mutual Assurance (Now known as HSBS Oklahoma City)
HSBS Oklahoma Cityi (Formerly Mutual Assurance Administrators)
37256
Institutional
Humana Health Plan of Ohio
Inc
Humana Health Plan of Ohio Inc
61103
Institutional
Humana Long Term Care
Humana Long Term Care
61115
Institutional
Humboldt Del Norte Foundation IPA
HDNFC
Institutional
Hylton Payroll (Benefit Plan Administrators)
19753
Institutional
I. E. Shaffer
I E SHAFFER
22175
Institutional
IBC Personal Choice
12X26
Institutional
IBG Administrators
LLC
IBG Administrators
81810
Institutional
iCARE (Independent Care Health Plan)
11695
Institutional
ICARE Health Options TPA
iCircle Health Solutions
26054
Institutional
iCircle Care
ICRCL
Institutional
Idaho Medicaid
SKID0
Institutional
Idaho Medicare
IDMCR
Institutional
IHPlans
Imperial Health Plan of California Incorporated
IHP01
Institutional
IHS Gateway Payer South
CB711
Institutional
Illinois Health Plan (IHP)
Boncura Health (Dupage Medical Group)
Boncura Health Solutions (Dupage Medical Group)
DMG01
Institutional
Illinois Medicaid
SKIL0
Institutional
Illinois Physician Alliance IPA
Illinicare Physicians Alliance IPA
IPA99
Institutional
IMCARE
41600
Institutional
Immigration Services
Homeland Security (ATTN: Deportation)
INS Health Services
VAICE
Institutional
Imperial Health Holdings Medical Group
IHHMG
Institutional
INDECS Corporation
40585
Institutional
Independence Administrators
TA720
Institutional
Independence American Insurance Comp
Independence American Insurance
Independence American Ins. Co.
CB231
Institutional
Independent Blues of PA
Personal Choice PPO of PA (Also know as Independent BLC)
Independent BLC of PA (Also known as Personal Choice PPO of Pennsylvania.)
54704
Institutional
Independent Living Systems
45048
Institutional
Indian Health Services
00290
Institutional
Indiana Department of Health Children's Health
35600
Institutional
INDIANA PROHEALTH
Indiana ProHealth Network
35161
Institutional
Indiana University
IUHPL
Institutional
INETICO
INC.
43471
Institutional
InforMed
LLC
52196
Institutional
Ingalls Provider Group (New PID for DOS 1-1-19 & after only)
Ingalls Provider Group
66727
Institutional
Inland Empire Health Plan.
Inland Empire Health Plan
IEHP1
Institutional
Inland Faculty Medical Group
MVMM1
Institutional
INNOV_OSF Healthcare Center
Innov_OSF Healthcare Central
OSFC9
Institutional
Innovante Benefit Admin/ (HSBS WTC) (Effective 3-1-17)
World Trade Center Health Program (WTCHP)
Innovante Benefit Administrators (HSBS WTC)+A174
31172
Institutional
Innovation Health
40025
Institutional
Innovative Healthware Payer 12
IHS12
Institutional
Innovative Healthware Payer 13
IHS13
Institutional
Innovative Healthware Payer 16
IHS16
Institutional
Innovative Healthware Payer 21
NextPA
IHS21
Institutional
Innovative Healthware Payer 22
IHS22
Institutional
Innovative Healthware Payer 25
IHS25
Institutional
Innovative Healthware Services Payer 5
IHS05
Institutional
Innovista Health
INDPM
Institutional
Insurance Administrators of America
Insurance Administrator of America
37279
Institutional
Insurance Design Administrators
13315
Institutional
Insurance Management Services (Amarillo TX)
Insurance Management Services
(Amarillo TX)(This payerID is only valid for claims submission address of PO Box 15688 Amarillo
TX 79105)
15688
Institutional
Insurance Management Services of Texas
Insurance Management Services
IMSMS
Institutional
Insurance Service of Lubbock
Insurance Services of Lubbock
ISL11
Institutional
Insurers Administrative Corporation I Par Plus
Insurers Administrative Corp. (Please visit website prior to submitting claims: edihelp.iacusa.com)
86304
Institutional
Integra Administrative Group
Integra Administrative Group (Seafor d
DE)
INTEGRA Administrative Group
Inc.
51020
Institutional
Integra Group
Integra Group (Also known as Rehab Provider Network
but not the same as Colorado payer of same name.)
31127
Institutional
Integra Managed Long Term Care
45302
Institutional
Integranet I Par Plus
Integranet
INET1
Institutional
Integrated Homecare Services
IHCS1
Institutional
Integrated Medical Solutions
20050
Institutional
Integrated Veterans Care (formerly known as VA FEE Basis Program)
Veterans Administration Fee Basis Programs
VA Fee Basis Programs
12115
Institutional
Integrity Administrators (Champion Chevrolet)
99795
Institutional
INTER UNION OF OPER15
International Union Operating Engineers
37269
Institutional
Interactive Medical Systems
56132
Institutional
Interface EAP
HealthSmart Interface EAP (IEAP)
Interface EAP -IEAP
60280
Institutional
Intergroup Services Corporation
Western Pennsylvania Electrical Employees Insurance Trust Fund
Western Growers Assurance Trust (aka Pinnacle Claims Management)
23287
Institutional
International Benefit Administration
International Benefit Administrator
11329
Institutional
International Funding Inc.
Insurance TPA.CLM LLC
39182
Institutional
International Medical Group
INC
International Medical Group
Inc. I Par Plus
IMGIN
Institutional
Interwest Health
InterWest Health PPO (Montana)
84137
Institutional
Intl Brotherhood Boilermakers EMPL Health Care Plan IBBEHC
International Brotherhood of Boilermakers Employee Health Care Plan(IBBEHC)
48603
Institutional
Iowa Medicaid
12K10
Institutional
Iowa Medicaid
SKIA0
Institutional
Island Home Insurance Company
Island Hone Health Insurance Company
85502
Institutional
IU Health Transplant Evaluation Program
47262
Institutional
J1 MAC Medicare Part A California
12M64
Institutional
J1 Mutual of Omaha
CA
HI
NV (Legacy)
01911
Institutional
J12 Medicare Part A Legacy WPS (DC DE MD NJ PA)
12901
Institutional
J5 National Part A
05901
Institutional
JAI Medical Systems
JAI Medical
JAI01
Institutional
Jericho Share
IHS02
Institutional
JI Sepcialty Services
Inc. I Par Plus
JISSP
Institutional
John Hopkins Healthcare (EHP/PP) (Submit Billing NPI and Rendering/Servicing NPI)
Johns Hopkins (USFHP)
52189
Institutional
John Muir Mt. Diablo Health System
John Muir Mt Diablo Hlth System
68036
Institutional
Johns Hopkins (USFHP) (New submitter should send in their Billing NPI & Rendering servicing NPI)
Johns Hopkins Medical Service
52123
Institutional
Joplin Claims
43178
Institutional
JP Farley Corporation
34136
Institutional
JSL Administrators AKA Wells Fargo Third Party Administrators aka Healthsmart Benefits Solutions
Healthsmart Benefit Solutions.
JSL Administrators AKA Wells Fargo Third Party Aministrators
Wells Fargo Third Party Aministrators AKA Healthsmart Benefit Solutions.
37272
Institutional
JVHL Health Alliance Plan (Fee for Service Contracts)
JHJVL
Institutional
JVHL Priority Health
JZJVL
Institutional
JVHL United Healthcare (Golden Rule Members)
KRJVL
Institutional
JVHL United Healthcare Community Plan (Great Lakes Health Plan)
JRJVL
Institutional
JVHL WellCare
MMJVL
Institutional
JVHL Aetna Better Health Premier Plan
M5JVL
Institutional
JVHL Aetna U.S. Healthcare
J1JVL
Institutional
JVHL AmeriHealth Caritas VIP Care Plus
MDJVL
Institutional
JVHL BCBSM Medicare Plus Blue PPO
KCJVL
Institutional
JVHL Blue Care Network (BCN Commercial Labs)
JVHL Blue Care Network* (BCN Commercial Labs)
JJJVL
Institutional
JVHL Blue Care Network (BCN Reimbursable Labs)
JVHL Blue Care Network* (BCN Reimbursable Labs)
JQJVL
Institutional
JVHL Blue Care Network* (Critical Access / Small Volume Labs)
JVHL Blue Care Network (Critical Access / Small Volume Labs)
MJJVL
Institutional
JVHL Blue Care Network* (JVHL Network)
JVHL Blue Care Network (JVHL Network)
J9JVL
Institutional
JVHL Blue Cross Complete
KPJVL
Institutional
JVHL CIGNA – (Health Partners members only)
KQJVL
Institutional
JVHL CIGNA (Non-HAP and CIGNA- HAP members)
JVHL CIGNA (Non-HAP and CIGNA-HAP members)
KDJVL
Institutional
JVHL Community Care Associates (Healthchoice)
JWJVL
Institutional
JVHL CoventryCares - Aetna Better Health of MI
J8JVL
Institutional
JVHL Genesee County Health Plan
MBJVL
Institutional
JVHL HAP Empowered (Midwest) Health Plan
JBJVL
Institutional
JVHL Health Alliance Plan (Capitated Contracts)
JGJVL
Institutional
JVHL Humana
KVJVL
Institutional
JVHL McLaren Health Plan
K7JVL
Institutional
JVHL Meridian Health Plan of MI (Health Plan of Michigan)
J2JVL
Institutional
JVHL Molina Healthcare of Michigan
JIJVL
Institutional
JVHL Physicians Health Plan
MNJVL
Institutional
JVHL Reliance HMO
MKJVL
Institutional
JVHL United Healthcare (non- Golden Rule Members)
JVHL United Healthcare (non-Golden Rule Members)
J5JVL
Institutional
JVHL VA Community Care Network
MSJVL
Institutional
Kaiser Foundation Health Plan
21313
Institutional
Kaiser Foundation Health Plan of CO (Remits returned KAISR)
Kaiser Foundation Health Plan of Colorado
COKSR
Institutional
Kaiser Foundation Health Plan of GA(835 returned under KAISR
Kaiser Foundation Health Plan of Georgia
NG010
Institutional
Kaiser Foundation Health Plan of Mid-Atlantic St(835 KAISR
Kaiser Foundation Health Plan of the Mid-Atlantic
Kaiser Foundation Health Plan of the Mid Atlantic
NG008
Institutional
Kaiser Foundation Health Plan of Northern CA
Kaiser Foundation Health Plan of Northern CA Region
94135
Institutional
Kaiser Foundation Health Plan of Washington (Formerly Group Health Cooperative of WA)
Kaiser Foundation Health Plan of Washington
Group Health Northwest (Old PayerID of 91121 is being retired. Now use payerID of 91051)
Group Health Options (Formerly KPS Health Plans)
91051
Institutional
Kaiser Foundation Health Plan PPO
Kaiser Self Funded (also known as KPIC Self-Funded Claims and Kaiser Self Funded Plan Harrington) Hawaii
Kaiser Self Funded (also known as KPIC Self-Funded Claims and Kaiser Self Funded Plan Harrington)
94320
Institutional
Kaiser Foundation Northwest
Kaiser Foundation of the Northwest
93079
Institutional
Kaiser Foundation Southern California
Kaiser Foundation Health Plan of Southern CA
94134
Institutional
Kaiser Permanente Health Plan Hawaii
94123
Institutional
Kalos Gold Health Plan
61185
Institutional
Kalos Health
Kane County IPA
40137
Institutional
Kamg Hospital
GSH02
Institutional
Kane County IPA
KCIPA
Institutional
KBA
14503
Institutional
Keenan Associates
95279
Institutional
Kelsey Seybold - Institutional Claims I Par Plus
KELSI
Institutional
Kemper Benefits
61453
Institutional
Kempton Company
Kempton Group Administrators
Kempton Group
73100
Institutional
Kent County Health Plan
KENT1
Institutional
Kentucky Medicare Part A Jurisdiction 15
Medicare Part B of Kentucky
KYMCR
Institutional
Kern Health Systems
77039
Institutional
Kern Legacy Health Plan
89890
Institutional
Key Benefit Administrators
37217
Institutional
Key Insurance Group
KEYIP
Institutional
KEY SELECT
37321
Institutional
Key Solution
Key Solution (Dental)
37323
Institutional
KeyCare Maryland
KCMD1
Institutional
Keystone First Community Health Choices
42344
Institutional
Keystone Health Plan East
12X25
Institutional
Keystone Health Plan East - Claims
Pennsylvania Keystone Health Plan East (claims only)
PAKeystone Health Plan East (claims(835s returnedPAKEY)
PCBLS
Institutional
Keystone Mercy Health Plan
23284
Institutional
Klais & Company (Part A and Part B)
80089
Institutional
Klais and Company
34145
Institutional
Know The Costs
04430
Institutional
Kopp Billing Agency
RP091
Institutional
Kova Healthcare Incorporated
KOVA1
Institutional
LA Care Health Plan
LACAR
Institutional
LACH HealthNet by MedPoint
MPM19
Institutional
Lake Forest Managed Care Associates
37112
Institutional
Lakeside Medical Group
66125
Institutional
Lancaster General Health
Lancaster General Health (LGH)
16109
Institutional
LaSalle Medical Group IPA
95715
Institutional
Lasso Healthcare MSA
10550
Institutional
Lawndale Christian Health Center
LAWND
Institutional
LBA HealthPlans
LBA Health Plans
52193
Institutional
Leon Health Plans
A3565
Institutional
LEON Medical Center Health Plan I Par plus
Leon Med Center
65055
Institutional
Liberty Advantage
LIB01
Institutional
Liberty Union
Life Assurance Company
Mid-America Associates Inc.
Mid-America Associates
37281
Institutional
Lien On Me
LM005
Institutional
Life St Mary (Trinity Health Pace)
76184
Institutional
LIFE TRAC
41136
Institutional
LifeCircles PACE
71498
Institutional
LifePath Hospice Inc.
LifePath Hospice Inc
76870
Institutional
Lifewise A Premier Health Plan
Lifewise Health Plan of Oregon A Premier Health Plan
LifeWise Assurance Company
LifeWise HealthPlan of Oregon
93093
Institutional
Lifewise Health Plan of Washington
LifeWise HealthPlan of Washington
93094
Institutional
Lifeworks Advantage
LWA01
Institutional
Little Company of Mary
LCM1
Institutional
Live Beaver County
Life Beaver County
25924
Institutional
Local 137 Operating Engineers Welfare Fund
84041
Institutional
Lockard & Williams
CB752
Institutional
Loma Linda University Health Care
Loma Linda University Health Plan
33036
Institutional
Loma Linda University Medical Center
95352
Institutional
Lone Star TPA
45289
Institutional
Longevity Health Plan of NY
LNY01
Institutional
Longevity Illinois
LIL01
Institutional
Longevity Michigan
LMI01
Institutional
Longevity NJ
LNJ01
Institutional
Longevity of North Carolina
LNC01
Institutional
Louisiana Medicaid
SKLA0
Institutional
Louisiana Medicare Part A Jurisdiction H
12M12
Institutional
Lovelace Senior Options (LSO)
62310
Institutional
Luminare Health Detroit
NGS Coresource
Luminare Health Detroit fka Trustmark Health Benefits
38225
Institutional
Luminare Health Internal
CoreSource
CoreSource Internal #3
35187
Institutional
Luminare Health Little Rock
CoreSource Little Rock
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)
Luminare Health Little Rock fka Trustmark Health Benefits
75136
Institutional
Luminare Health OH
Coresource of OH
CORESOURCE OH
Luther Care (CoreSource)
Luminare Health OH fka Trustmark Health Benefits
35183
Institutional
Luther Care (CoreSource)
CB212
Institutional
MacNeal Health Providers - CHS (Contact 708-783-7100 prior to first submission.)
Macneal Hlth Providers-CHSZ
36334
Institutional
Magellan Complete Care AZ
Magellan Complete Care Of AZ
Molina Complete Care of Arizona
MCC01
Institutional
Magellan Complete Care Of VA
MCCVA
Institutional
Magellan Health Services
Magellan Behavioral Health - UNUSABLE/MUST SEND PAPER CLAIM (Payer Address required on all claims)
Magellan Complete Care FL
01260
Institutional
MagnaCare Administrative
Brighton Health Plan Solutions (for DOS prior to 01/01/2022)
Brighton Health Plan Solutions (formerly MAGNACARE)
MagnaCare Administrative Services
11303
Institutional
Magnolia
U8062
Institutional
Maine Community Health Options
45341
Institutional
Maine Medicaid
12K13
12K44
Institutional
Maksin Management Corporation (Now known as AIG Educational Markets)
Maksin Management Corporation
AIG Educational Markets (Formerly Maksin Management Corporation)
22195
Institutional
Managed Care Network
Managed Health Networks (MHN)
22771
Institutional
Managed Care Services
LLC
35162
Institutional
Managed Health Services Wisconsin
39187
Institutional
March Vision Health Plan
52461
Institutional
Marin Headlands Medical Group
Sutter Medical Group Of The Redwoods
Sutter Pacific Medical Foundation
Sutter West Bay Medical Group
77304
Institutional
Marin IPA
IP097
Institutional
Marrick Medical Finance
LLC
Marrick Mement Finance
20805
Institutional
Marrick WRx
Aspirion
46478
Institutional
Martins Point Health Care
53275
Institutional
Martins Point Health Care
Martin's Point Health Care USFHP/Generations Advantage
MPHC2
Institutional
Mary Washington Health Plan
83269
Institutional
Maryland Medicare Part A
12010
Institutional
Maryland Physicians Care
22348
Institutional
Maryland Physicians Care (MPC)
Maryland Physicians Care (MCP)
76498
Institutional
Mashantucket Pequot Tribal Nation
Pequot Pharmaceutical Network
Bluebonnet Administrators
37121
Institutional
Massachusetts Behavioral Health (BHO)
Massachusetts Behavioral Health (BHO) (BHO)
BHOMA
Institutional
Massachusetts Medicaid
12K14
Institutional
Massachusetts Mutual also known as Mass Mutual
Unicare Life & Health Insurance Company
UNICARE Major Accounts
80314
Institutional
Masters
Mates and Pilots Plan
Masters
Mates and Pilots Program
MMPHB
Institutional
Mayo Clinic FL/GA
88090
Institutional
MBA Benefit Administrators
MBA of Wyoming
87065
Institutional
MBACLM
IHS24
Institutional
McCreary Corporation
Employers Mutual Inc Stuart FL
59331
Institutional
McLaren Health Advantage
3833A
Institutional
McLaren Health Plan
McLaren
38338
Institutional
McLaren Medicaid
3833C
Institutional
McLaren Medicare Supplement
3833S
Institutional
McLaren State of Michigan
3833M
Institutional
McLarenAdvantage SNP
3833R
Institutional
MD Anderson Physician Network
MDAPN
Institutional
MDsave
MDSV
Institutional
MDwise Healthy Indiana Plan
MDwise Health Indiana Plan
3135M
Institutional
MDwise Hoosier Healthwise
3519M
Institutional
MDwise Medicare Advantage
MDADV
Institutional
MDwise Select Health Network
MWSHN
Institutional
MDwise
Inc. (formerly IU Health)
12K81
Institutional
MDX Hawaii
MDXHI
Institutional
Med Pay
Med Pay (For claims repriced by Premier Health Care Exchange)
88058
Institutional
Med-Pay
Anthem IN
00130
Institutional
MedAdmin Solutions
Network TPA
JIPA Network
Podicare
58204
Institutional
MedAdmin Solutions
Network TPA
JIPA Network
Podicare
Advanced Data Solutions
58202
Institutional
Medcore HP
31057
Institutional
MedCost
56162
Institutional
MedCost /Liberty Healthshare
MedCost / Liberty Health Share
90753
Institutional
MEDCOST BENEFIT SVCS
MedCost Benefit Services
56205
Institutional
MedCost Virginia
54138
Institutional
Medica
94265
Institutional
Medica Government Programs
MEDM1
Institutional
Medica Health Plan Solutions
71890
Institutional
Medica HealthCare Plans / FL
Medica Health Plan of Florida
78857
Institutional
Medica2
12422
Institutional
Medicaid - TX Premier Plan I Par Plus
Medicaid - TX Premier Plan (enroll at (915)-532-3778 x1507)
EPF02
Institutional
Medicaid of Alabama
75254
Institutional
Medicaid of Arizona (AHCCCS)
Arizona Medicaid (AHCCCS)
Medicaid of Arizona (AHCCCS)
Medicaid of Arizona (AHCCCS)(837I & 837P)
AZMCD
Institutional
Medicaid of Arkansas
12023
Institutional
Medicaid of Arkansas
Arkansas Medicaid
ARMCD
Institutional
Medicaid of California (MediCal)
MediCal of California
MDCAL
Institutional
Medicaid of Colorado
1548I
Institutional
Medicaid of CT
06127
Institutional
Medicaid of Flori
77027
Institutional
Medicaid of Georgia
12K05
Institutional
Medicaid of Idaho
12K07
Institutional
Medicaid of Illinois
IL621
Institutional
Medicaid of Indiana
3501I
Institutional
Medicaid of Iowa
18049
Institutional
Medicaid of Iowa
Iowa Medicaid
IAMCD
Institutional
Medicaid of Kansas
47163
Institutional
Medicaid of Kentucky
12K11
Institutional
Medicaid of Louisiana
12K12
Institutional
Medicaid of MA
SKMA0
Institutional
Medicaid of Maryland
12007
Institutional
Medicaid of Massachusetts
5529I
Institutional
Medicaid of Medicaid South Carolina
SCMED
Institutional
Medicaid of Michigan
12K37
Institutional
Medicaid of Michigan BCCCP
SKMI1
Institutional
Medicaid of Minnesota
12K16
Institutional
Medicaid of Mississippi
77032
Institutional
Medicaid of Missouri
12K15
Institutional
Medicaid of Missouri
70029
Institutional
Medicaid of Montana
12K77
Institutional
Medicaid of NC
SKNC0
Institutional
Medicaid of Nebraska
1520I
Institutional
Medicaid of Nevada
NVMMI
Institutional
Medicaid of New Jersey
12006
Institutional
Medicaid of New Mexico
12K22
Institutional
Medicaid of New York
12K35
Institutional
Medicaid of North Dakota
NDDHS
Institutional
Medicaid of North Dakota
North Dakota Medicaid
NDMCD
Institutional
Medicaid of Ohio
3509I
MMISODJFS
Institutional
Medicaid of Ohio
Medicaid of Idaho
AIDID
Institutional
Medicaid of Oklahoma
12K25
Institutional
Medicaid of Pennsylvania
12008
Institutional
Medicaid of Pennsylvania
236003113
Institutional
Medicaid of SC
SKSC0
Institutional
Medicaid of Tennessee
12K46
Institutional
Medicaid of Texas
TX Medicaid Direct
86916
Institutional
Medicaid of US Virgin Islands
12K39
Institutional
Medicaid of Virginia
5538I
Institutional
Medicaid of West Virginia
12K28
Institutional
Medicaid of Wisconsin
Wisconsin Medicaid
WIMCD
Institutional
Medicaid of Wyoming
12K30
Institutional
Medical Associates Health Plan
MAHP1
Institutional
Medical Benefits Mutual
MedBen (Newark
OH)
Medical Benefits Administrators
Inc. (Newark
OH)
Medical Benefits Companies (Newark
OH)
Medical Benefits Mutual (Newark
OH)
Medical Benefits
74323
Institutional
Medical Mutual of Ohio (Payer requires a 12 digit rendering provider ID#
which needs to be obtained from payer by calling 800-321-7223)
Health Span of Ohio (Payer has ceased operations using payerID 31434. claims should now be sent to Medical Mutual of Ohio
PayerID 29076_
Carolina Care Plan
Medical Mutual of Ohio
Carolina Care Plan (Part of the Medical Mutual Family of companies. Former payerID was 57105.)
29076
Institutional
MEDICAL MUTUAL OF OHIO CAREWORKS
Careworks of Ohio
10010
Institutional
Medical Reimbursement Associates
Medical Reimbursements of America
62177
Institutional
Medical Services Initiative
12057
Institutional
Medicare & Much More Florida Incorporated
Medicare & Much More Florida Incorporated (Effective 1/1/19)
MMMFL
Institutional
Medicare Advantage Physicians Health Plan Michigan
Physicians Health Plan of Michigan Medicare
Medicare Advantage PHP Michigan
83276
Institutional
Medicare Florida Blue
FBM01
Institutional
Medicare Hawaii
01211
Institutional
Medicare Louisiana
07201
Institutional
Medicare Nevada
01311
Institutional
Medicare of Alaska
AKMCR
Institutional
Medicare of California
01111
Institutional
Medicare of Colorado
04111
Institutional
Medicare of Connecticut
3533I
Institutional
Medicare of Florida
3518I
Institutional
Medicare of Georgia
3536I
Institutional
Medicare of Illinois
06101
Institutional
Medicare of Indiana
12M09
Institutional
Medicare of Iowa
05101
Institutional
Medicare of Kansas
05201
Institutional
Medicare of Kentucky
15101
Institutional
Medicare of Maine
3547I
Institutional
Medicare of Maryland
5554I
Institutional
Medicare of Massachusetts
5527I
Institutional
Medicare of Michigan
08201
Institutional
Medicare of Minnesota
06201
Institutional
Medicare of Missouri J5
05301
Institutional
Medicare of Nebraska
05401
Institutional
Medicare of New Jersey
12401
Institutional
Medicare of New York
13201
Institutional
Medicare of Oklahoma
04311
Institutional
Medicare of Pennsylvania
12501
Institutional
Medicare of South Carolina
12M55
Institutional
Medicare of Tennessee
12M53
Institutional
Medicare of Texas
04411
Institutional
Medicare of Virginia
Virginia Medicare Part A
11003
Institutional
Medicare of Washington (Noridian)
12M45
Institutional
Medicare of Wisconsin
00450
Institutional
MEDICARE PART A Utah
03501
Institutional
Medicare Part B of Alabama
Alabama Medicare Part A Jurisdiction J
ALMCR
Institutional
Medicare Part B of Georgia
Georgia Medicare Part A Jurisdiction J
GAMCR
Institutional
Medicare Part B of North Carolina
North Carolina Medicare Part A Jurisdiction M
NCMCR
Institutional
Medicare Y Mucho Mas
L0210
Institutional
Medico Insurance
Medico Insurance Company
23160
Institutional
Medigold
Mt. Carmel
95655
Institutional
Mediture IPA
AMM11
Institutional
Mediview Sendero Idealcare
MV400
Institutional
MedPartners (PHCS Repricing)
MedPartners (PHCS RepricingPO Box 10240 Fort Wayne
In 46857
441MP
Institutional
Medpartners
MedPartners Admin Services
412MP
Institutional
MedSolutions
Inc
MedSolutions
Inc.
62160
Institutional
Medstar Family Choice DC
RP062
Institutional
Medstar Family Choice Maryland Healthchoice
RP063
Institutional
Medstar Select
251MS
Institutional
Memorial Clinical Associates/ SelectCare of Texas
62181
Institutional
Memorial Hermann Bundle Program
MHB123
Institutional
Memorial Hermann Health Network I Par Plus
Memorial Hermann Health Network
MHHNP
Institutional
Memorial Integrated Healthcare
59064
Institutional
Mental Health Consultants Inc
37050
Institutional
Merchants Benefit Administration
INC
86087
Institutional
Mercy Care Plan of Arizona
Mercy Health Plan (AHCCCS)
Mercy Health Plan of AZ
86052
Institutional
Mercy Maricopa Integrated Care
33628
Institutional
Mercy Provider Network
43185
Institutional
Meridian Health Plan of Illinois
MeridianTotal (Meridian Complete
Illinois Complete
YouthCare and Ambetter Payer ID effective 01-01- 2021)
MeridianTotal (Meridian Complete
Illinois Complete
YouthCare and Ambetter Payer ID effective 01-01-2021)
MHPIL
Institutional
MeridianComplete (Ambetter from Michigan
Meridian Complete
Michigan Complete) Payer ID effective 01-01-20
MeridianComplete (Ambetter from Michigan
Meridian Complete
Michigan Complete) Payer ID effective 01-01-2021
MHPMI
Institutional
MeridianHealth Illinois
Meridian Health Plan Illinois Complete (Meridian Health Plan Illinois Medicaid effective until 12/31/20)
13189
Institutional
Meritain Health (Formerly know as North American Administrators)
Meritain Health (North American Health Plan.)
North American Administrators
Inc.
64157
Institutional
Metcare Health Plan
65113
Institutional
Metro Plus Health Plan
13265
Institutional
Metropolitan Health Plan
10850
Institutional
MH Employee Plan
59604
Institutional
MHCC Luminare Health
35189
Institutional
MI Blue Care HMO (BCN of MI-835s returned MIBLS)
Michigan Blue Care HMO (BCN of Michigan)
Blue Cross MI Blue Care Complete
MIBCN
Institutional
MI Blue Care Network
12B58
Institutional
MI Blue Cross PPO
Blue Cross of Michigan
12B18
Institutional
Miami Behavioral Health
92579
Institutional
Miami Children’s Health Plan
82832
Institutional
Michigan Medicare PlusBlue (835s returned under MIBLS)
Michigan Medicare PlusBlue
MIMPB
Institutional
MID Rogue Oregon Health Plan
MD Rogue Oregon Health Plan
MRIPA
Institutional
Mid-American Benefits
22823
Institutional
Midlands Choice
Midlands Health Partners
47080
Institutional
Midwest Health Partners
76079
Institutional
Midwest Health Plan
Midwest Health Plans
INC.
MHP77
Institutional
Midwest Physician Administrative Services
TH088
Institutional
MINNESOTA DEPARTMENT OF HEALTH- SAGE PROGRAMS
MNDH1
Institutional
MISS SELECT HLTH CARE/SELECT ADMN SERVICE
MS Select Healthcare (Mississippi Select Health Care)
64088
Institutional
Mississippi Medicaid
12K17
12K18
Institutional
Mississippi Medicaid
SKMS0
Institutional
Mississippi Medicare Part A Jurisdiction 7
12M17
Institutional
Mississippi Physician Care Network
Mississippi Physicians Care Network
64084
Institutional
Missoula County Medical Benefits
37275
Institutional
Missouri Medicaid
SKMO0
Institutional
ML Healthcare
26097
Institutional
Moda Health (ODS Health Plan)
ODS Health Plan
13350
Institutional
Molina Complete Care AZ
Molina Complete Care DSNP
MCC02
Institutional
Molina Health Care of South Carolina
Molina Healthcare of South Carolina
46299
Institutional
Molina Healthcare Arizona
A4353
Institutional
Molina Healthcare Mississippi
77010
Institutional
Molina Healthcare Nebraksa
Molina Healthcare of Nebraska INC
MLNNE
Institutional
Molina Healthcare of California (Rendering provider must use Medi-Cal ID number or State License Number. Billing provider should use Federal TaxID only.)
Molina Healthcare of California
38333
Institutional
Molina Healthcare of Florida
51062
Institutional
Molina Healthcare of Idaho
61799
Institutional
Molina Healthcare of Illinois
Molina Illinois
20934
Institutional
Molina Healthcare of Iowa
MLNIA
Institutional
Molina Healthcare of Michigan
38334
Institutional
Molina Healthcare of Nevada
MLNNV
Institutional
Molina Healthcare of Nevada
Molina Healthcare Nevada
A6106
Institutional
Molina Healthcare of New Mexico - SCI
Molina Healcare of New Mexico - SCI
04423
Institutional
Molina Healthcare of New Mexico Salud
Lovelace Salud (Older PID of SX159 is no longer valid)
Molina Healthcare of New Mexico - Salud
09824
Institutional
Molina Healthcare of Ohio
20149
Institutional
Molina Healthcare of Texas
20554
Institutional
Molina Healthcare of Utah
12X09
Institutional
MOLINA HEALTHCARE OF UTAH
SX109
Institutional
Molina Healthcare of Washington (Rendering providers use DSHS Medicaid ID or State Licence Number.)
Molina Healthcare of Washington I Par Plus
38336
Institutional
Molina Healthcare of Wisconsin
Abri Healthplan (Now known as Molina Health Care of WI)
Abri Healthplan
ABRI1
Institutional
Molina Ohio Medicaid
73160
Institutional
Molina Ohio Medicaid
07316
Institutional
Molina Ohio Medicaid Vision
7316V
Institutional
Monarch Healthcare IPA (Rendering provider ID# required on all claims.)
Monarch IPA
IP095
Institutional
Monitor Life
Monitor Life (secondary claims only
Medicare cannot be prim
01759
Institutional
Montana Medicare
MTMCR
Institutional
Montefiore Contract Management Organization (Provider ID required
call 914- 377-4400 for ID prior to first claims submissions.)
Montefiore Contract Management Organization
13174
Institutional
Montefiore HMO
46161
Institutional
Monumental Life
Monumental Life Ins Co.
MMLIC
Institutional
Morris Associates aka HealthScope Benefits
MORRIS ASSOCIATES
35092
Institutional
MotivHealth Insurance Company
U7632
Institutional
Mountain Health CO-OP
MHC01
Institutional
Mountain States
86040
Institutional
MPEEBT(MISSISSIPPI PUBLIC ENTITY)
MPE Employee Benefit Services
37233
Institutional
MPMBA
IHS23
Institutional
MPOWER Bundle
STXB99
Institutional
MRIPA Allcare CCO (Medicaid Payer)
MRIPA Allcare CCO
26161
Institutional
MSA Care Guide
MSA CARE GUARD
20572
Institutional
Multicare Connected Care
RP036
Institutional
Multicare INC
Multicare Pace
R3457
Institutional
Municipal Health Benefits Fund
Municipal Health Benefit Program
Municipal Health Benefit Fund
81883
Institutional
Mutual of Omaha Insurance Company
Mutually Preferred
National Rural Letter Carrier Association (Policy Number GMG1846)
United of Omaha
71412
Institutional
MVP Health Plan of NY
14165
Institutional
MyNexus
Inc.
32043
Institutional
NAA (North Americal Administrators
LP - Nashville
TN.)
NAA (North America Administrators)
65085
Institutional
NAHGA Claim Services
National Accident & Health General Agency Inc.
67788
Institutional
NALC/Affordable
National Association of Letter Carriers/NALC
53011
Institutional
NaphCare
Inc
Naphcare Inc
58182
Institutional
Nascentia Health Plan (Medicare line of business)
45529
Institutional
National Allied Workers Union Local 831
National Allied Workers Union Local 831 Insurance Trust
CB148
Institutional
National Capital Preferred Provider Organization (NCPPO) (To obtain your provider ID number
please call the NCPPO Customer Service Department at (800) 272-5911
HEALTHLINK PPO
90001
Institutional
National General
ASHC1
Institutional
National Health Benefit
88057
Institutional
National Healthcare Corp Advantage
NHC01
Institutional
National Telecommunications Cooperative Association (NTCA)
National Telecommunications Cooperative Associations
52103
Institutional
National Telecommunications Cooperative Association (NTCS Staff)
National Telecommunications Cooperative Associations (NTCS Staff)
52104
Institutional
NCAS - Fairfax
VA
75190
Institutional
NCAS-CHARLOTTE
NCAS - Charlotte
VA
75191
Institutional
Nebraska Medicaid
12K19
Institutional
Nebraska Medicaid
SKNE0
Institutional
Neighborhood Health of Plan Rhonde Island
Neighborhood Health Partnership
Neighborhood Health Plan of Rhode Island (Contact NHPRI 401-459-6030 to verify provider and vendor number.)
05047
Institutional
Neighborhood Health Plan RI
Neighborhood Health Plan RI - Exchange
Unity
Integrity
Neighborhood Health Plan RI- Exchange
Unity
Integrity
96240
Institutional
Neighborhood Healthcare Pace
R3456
Institutional
Neskia Health Group
Shasta Administrative Services
Nesika Health Group (Old payerID of 37255 is no longer valid.)
75280
Institutional
Netcare Life and Health Insurance
66055
Institutional
Network Health
04332
Institutional
Network Health Insurance Corp - Medicare
Network Health Insurance Corp- Medicare
Network Health Insurance Medicare
77076
Institutional
Network Health Plan of Wisconsin
Inc.(Prior to initial claims submission
please contact Network Health Plan EDI specialist at 920-720-1506.)
Network Health of WI
Network Healthplan of Wisconsin
39144
Institutional
Network Solutions IPA
NSIPA
Institutional
Neuehealth
NEUEH
Institutional
Nevada Blue Shield
Blue Cross of Nevada
00265
Institutional
Nevada Medicaid
12K20
Institutional
Nevada Medicaid
SKNV0
Institutional
Nevada Medicare
NVMCR
Institutional
New Avenues Inc.
New Avenues
Inc.
95998
Institutional
New Era Life Insurance Company
98798
Institutional
New Mexico Blue Cross Community Centennial
New Mexico Blue Cross Community Centennial (MemberIDs start with "YIP")
MC721
Institutional
New Mexico Health Connections
45129
Institutional
New Mexico Medicare Part A Jurisdiction 4
12M22
Institutional
New York Hotel Trade Council
7707C
Institutional
New York Life - Long Term Care I Par Plus
New York Life - Long Term Care
NYL11
Institutional
New York Medical Indemnity Fund
NYDFS
Institutional
Next Level Health Partners (FKA 69821)
81085
Institutional
NextBlue
55892
Institutional
NHI Billing
14043
Institutional
Nippon Life Insurance Company
Nippon Life Insurance Company (Dental)
Nippon Life Insurance Company of America
81264
Institutional
North American Benefits
North American Benefits Network (NABN)
34159
Institutional
North American Med
North American Medical Management Northern California
E3510
Institutional
North Carolina Medica
12K23
Institutional
North Dakota Medicaid
12K78
Institutional
North Dakota Medicare
NDMCR
Institutional
North Shore - LIJ (Healthfirst)
17516
Institutional
Northcoast Healthcare
A2790
Institutional
Northern Illinois Health Plan
36347
Institutional
Northwest Community Health Partners
NANWC
Institutional
Northwest Community Health Partners
NWCHP
Institutional
Northwest Diagnostic Clinic I Par Plus (Old PayerID of NWDC1 is no longer valid.)
NW Diagnostic Clinic/SelectCare of Texas (NWDC)
62119
Institutional
Northwest Physicians Network (For claims with a DOS of 01/21/2021 and greater use payer ID LIFE1)
NPN11
Institutional
Northwest Suburban IPA (IL)
Northwest Suburban IPA Illinois
36346
Institutional
Northwestern Medicine Phys Network
Northwestern Medicine Physcians Network
NWEST
Institutional
Northwood Healthcare
NWOOD
Institutional
Nova Healthcare Administrators
Inc. (Grand Island
NY)
NOVA Healthcare Administrators NY
16644
Institutional
Novant Health Direct to Employers
HLSTA
Institutional
NX Health Network
44412
Institutional
Nyhart
37299
Institutional
NYS Department of Health
14142
Institutional
Oak Street Health
OAKST
Institutional
Oak West Physician Association
Oak West Primary Physician Association
36400
Institutional
Occhsner Health Plan
Ochsner Health Plan
A5236
Institutional
Ohio Health Choice PPO
Ohio Health Choice
PPO
34189
Institutional
Ohio Medicare Part A Jurisdiction 15
Medicare Part B of Ohio
OHMCR
Institutional
Ohio PPO Connect
74431
Institutional
OhioHealthy
Florida Hospital Waterman
48116
Institutional
Oklahoma Medicaid
SKOK0
Institutional
Oklahoma Medicare Part A
12M37
Institutional
Olympus Management Health Care
Olympus Managed Health Care
65074
Institutional
OmniCare (For claims with Dates of Service after 10/01/04)
OMNICARE- Coventry Health Plan of MI
25150
Institutional
One Call Medical
22321
Institutional
One Health Plan GA
OSF Healthcare East
95569
Institutional
One Health Plan of California
One Health Plan CA
95379
Institutional
One Health Plan of Georgia
One Health Plan of Illinois
One Health Plan IL
95388
Institutional
Optima Health Plan
Optima Insurance Company
Sentara Family Plan
Sentara Health Management
54154
Institutional
Optimed Health
96277
Institutional
Optimum Healthcare
Inc.
Optimum Healthcare Inc
20133
Institutional
Optum – Complex Medical Conditions (CMC) (formerly OptumHealth Care Solutions and United Resource Networks) former payer id 52190
OptumHealth (OptumHealth Care Solutions)
formerly United Resources Networks
former payer ID 52190
OptumHealth Complex Medical Conditions (CMC) (formerly OptumHealth Care Solutions and United Resource Networks) (Former payerID 52190)
41194
Institutional
Optum Care Network of Connecticut
E3287
Institutional
Optum Health - Physical Health (Includes Oxford)
formerly ACN
former payer IDs 41159
41160
ACN01
OptumHealth Physical Health - includes Oxford (former payer id 41159
41160)
41161
Institutional
Optum Maryland Behavioral Health
OMDBH
Institutional
Optum Medical Network (previously Lifeprint)
OptumCare / AZ
NV
UT (formerly Optum Medical Network & Lifeprint Network))
OptumCare / AZ
UT (formerly Lifeprint Network)
LIFE1
Institutional
Oregon Medicaid
12K41
Institutional
Oregon Medicaid
SKOR0
Institutional
Oregon Medicare
ORMCR
Institutional
Orthonet-Aetna
Orthonet - AETNA
13383
Institutional
Oscar Health
OSCAR
Institutional
OSF Health Plans
HUMANA
Claims only
Group Health Insurance - DE
ARCADIAN MGMT SERVICE
Humana Care Plan
Humana Group Health Plan
Arcadian Management Services
Inc (Group number should be entered if available. )
Humana Health Chicago
Humana Health Chicago Insurance Company
Humana Health Plan
Humana Insurance Agency
Humana Insurance Company
Humana Medical Plan - CA
Humana Medical Plan - KY
Humana Wisconsin Health Organization
IBA Health & Life Assurance Co.
OSF Healthcare East
OSF HealthPlans
Services
61101
Institutional
Oxford Health Plans
UnitedHealthcare / Oxford
06111
Institutional
P3 Health Partners -Arizona
58375
Institutional
P3 Health Partners Nevada
P3HNV
Institutional
P5 Health
87068
Institutional
Pace Central Iowa
72436
Institutional
PACE CNY
70454
Institutional
Pace Nebraska
35416
Institutional
Pace of Southeast Michigan
Pace Southeast Michigan
86711
Institutional
Pace of Southwest Iowa
Pace Southwest Iowa
53534
Institutional
Pace of Southwest Michigan Inc.
45114
Institutional
Pacific Administrators
PCFAD
Institutional
Pacific Southwest Administrators (PSWA)
Pacific Southwest Administrators
75309
Institutional
PacifiCare of Colorado
COPHS
Institutional
PacificSource Administrators
Select Benefit Administrators
Inc.
93031
Institutional
PacificSource Commercial
93029
Institutional
Pacificsource Medicare
20377
Institutional
Palo Alto Medical Foundation
94115
Institutional
Pan American Life Insurance
04218
Institutional
Parallon RCPS
PARLN
Institutional
Paramount
Paramount Health
SX158
Institutional
Parkland Community Health Plan
66917
Institutional
Partners Behavioral Health
52613
Institutional
Partners Health Plan
14966
Institutional
Partners in Health
PARTH
Institutional
Partners Insurance Company
RP099
Institutional
Partnership Health Plan CA
12M81
Institutional
Passport Advantage ** (Effective 7-1- 18 new PID 66008
former payer ID 97652)
Passport Advantage (Effective 7- 1-18 new PID 66008
former payer ID 97652)
66008
Institutional
Passport Health Plan
61325
Institutional
Path Administrators (DH Evans)
D H Evans & Associates reg required call 410-349-3222
25172
Institutional
Patient Advocates
Patient Advocate
55489
Institutional
Patient Physician Cooperative
20510
Institutional
Payer Fusion
27048
Institutional
payer ID 84223)
Keystone VIP Choice (formerly payer ID 84223)
77741
Institutional
Peak Health
PEAK0
Institutional
Peak Pace Solutions
27034
Institutional
Pediatric Associates of Broward
Pediatric Associated Health Plan
20472
Institutional
Pedicare Title 21 I Par Plus
M3FL8
Institutional
PEF Clinic
PEF01
Institutional
Penn Behavioral Health
53226
Institutional
Pennsylvania Keystone Health Plan East (encounters only)
Keystone Health Plan East - Encounters
PA Keystone Health Plan E(encounters only-835s return PAKEY)
PEBLS
Institutional
Pennsylvania Medicaid
SKPA0
Institutional
Pennsylvania Medicare Part A Jurisdiction 12
12M60
Institutional
Pennsylvania Pace
20172
Institutional
Pennsylvania Preferred Health Network (PPHN)
Americaid CC Tampa
06161
Institutional
People 1st Health Strategies
IHS03
Institutional
People One Health
IHS01
Institutional
Peoples Health Network (Tenet) (Network ID must be on claim. Contact phn.provider@tenethealth.com)
Peoples Health Network
72126
Institutional
Perennial Advantage of Colorado
PACO1
Institutional
Personal Insurance Administrators
Inc.
Personal Insurance Administrators
PIA
95397
Institutional
Phoenix Health Plan
03440
Institutional
PHP of Northern Indiana
Physicians Health Plan of Northern Indiana
12399
Institutional
Physicians Care Network (Rockford
IL Only) PayerID valid only for claims with billing submission name
city and state of Physicians Care Network
Rockford
IL.
Physicians Care Network (Rockford IL only)
36345
Institutional
Physicians Choice Medical Group of Santa Maria
MCI01
Institutional
Physicians Corporation of America (Florida Plan Only)
65018
Institutional
Physicians Health Association
Physicians Health Association of Illinois
37136
Institutional
PHYSICIANS HEALTH COLLABORATIVE
20398
Institutional
Physicians Health Plan
Physicians Health Plan (For behavioral Health claims processing
see documents sent to your office from the payer.)
37330
Institutional
Physicians Medical Group of San Jose
Physicians Health Plan of Michigan Medicare
EXC01
Institutional
Physicians Mutual
Physicians Mutual Insurance Company
47027
Institutional
Physicians of Southwest Washington
91171
Institutional
Physicians Plus Insurance Corp.
Physicians Plus Insurance Corporation
39156
Institutional
Pinnacle Medical Group
95271
Institutional
Pinnacol Assurance
84109
Institutional
Pittman Crossover
00156
Institutional
Planned Administrator
Planned Administrators
Inc. (PAI)
37287
Institutional
PodAmerica
RP106
Institutional
Podiatry Network FL
59324
Institutional
Point Comfort Underwriters
PCU01
PCU02
Institutional
PPO Plus
LLC
72148
Institutional
Prairie States Enterprises
Inc.
Prairie States Enterprises
36373
Institutional
Preferred Administrator I Par Plus
Preferred Admin (Provider Relations @ (915)532-2778
x1068)
EPF10
Institutional
Preferred Care - NY
12X04
Institutional
Preferred Care Partners / FL
65088
Institutional
Preferred Health Care (PHC)
Preferred HealthCare Lancas
33898
Institutional
Preferred Health Plan (Louisville
KY previous payer ID 61106 )
Healthsmart Benefit Solutions (Wells Fargo TPA
formerly Acordia National)
Preferred Health Plan (Louisville
KY)
Preferred Health Professionals (PHP Kansas City previous ID 61106)
87815
Institutional
Preferred Health Plan of Carolinas (PHPC)
CB404
Institutional
Preferred Health Systems Insurance Co (PPO)
PREFERRED BEN ADMIN
61665
Institutional
Preferred Health Systems
Inc.
Preferred Health System
60110
Institutional
Preferred IPA
PFIPA
Institutional
Preferred Med Grp
AKA Vantage
AmeriWest
Cal Care
LAMC
Vantage Medical Group Use Payer ID PPM01 for claims with DOS prior to 08.01.2020
Desert Family Practice Association
PPM01
Institutional
Preferred Network Access
36401
Institutional
Preferred One
41147
Institutional
Premera Blue Cross (WA)
Premera Blue Cross WA
00430
Institutional
Premier Administrative Solutions
65415
Institutional
Premier Healthcare Exchange
88051
Institutional
Premier HealthCare Exchange (Cypress)
88056
Institutional
Presbyterian Health Plan (Commercial) (Provider ID is required. Contact (888) 923-5757 6 then 2 to obtain ID. New Mexico Providers only.)
Presbyterian Health Plan
PREHP
Institutional
Presbyterian Salud
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
Institutional
Presbyterian(NM)
Presbyterian (NM)
05003
Institutional
Presence ERC
46311
Institutional
Prestige Health Choice (Payer is effective 5/1/2014 Managed Medicaid Plan. For EDI Support
please email edi.phc@amerihealthcaritas.com or call 800-617-5727)
Prestige Health Choice
77003
Institutional
Prevea Health Insurance Plan
Arise Health Plan (Formerly Prevea Health)
Arise Health Plan
Prevea Health Plan
39185
Institutional
Prevea360
41822P
Institutional
Prevea360 Health Plan
Children's Community Health Plan
Chorus Community Health Plans (WI Medicaid)
Wellfirst Health
Care4Kids (WI Medicaid)
Care4Kids (WI Medicaid plans)
Dean Health Plan
39113
Institutional
Prezzo
CB531
Institutional
Prezzo
A2314
Institutional
Primary Care CA
Primary Care Assoc of CA (Customer Service877-602-1563)
PCACZ
Institutional
Primary Care of Joliet
PCJOL
Institutional
Primary Health Network
82048
Institutional
Primary PhysicianCare
Inc.(Now known as HealthGram)
Healthgram
Primary PhysicianCare
Inc.
56144
Institutional
Prime Community Care Central Valley
Prime Community Care of Central Valley(837I & 837P)
MVCV1
Institutional
Prime West Health Plan
61604
Institutional
Priority Health (Please contact Priority Health EDI Dept at 616- 464-8686 or email EDISETUP@Priority-Health.com)
Priority Health
38217
Institutional
Prism Univera
Prism-Universa
37315
Institutional
ProCare Health Plan Medicaid Use payer ID 38224 DOS 01-01-20 and greater
70259
Institutional
ProCare Texas
PTX01
Institutional
Prodegi
U8151
Institutional
Professional Benefit Administrators
Inc. (Oak Brook
IL)
Professional Benefit Administrators
Inc (Oak Brook
IL)
36331
Institutional
Professional Claims Management (Canton OH)
Professional Claims Management
37242
Institutional
Progressive Benefit Services Inc
HSHS Medical Group IPA
37137
Institutional
PROGYNY
PROGY
Institutional
Prominence Administrative Services
88022
Institutional
Prominence Health Plan Encounters
St. Marys Health Plan Encounters
St.. Mary's Health Plan Encounters
88082
Institutional
Prominence Health Plan of Florida
Prominence HealthFirst of Florida Inc
83352
Institutional
Prominence Health Plan of Nevada
93082
Institutional
Prominence Health Plan of Texas
80095
Institutional
Prominence Health Plan
ST MARYS HEATLH PLAN
Saint Marys Health Plan
88029
Institutional
Providence Facility Claims
PROV1
Institutional
Providence Health Assurance
77350
77355
Institutional
Providence Health Plan
PHP01
Institutional
Providence Health Plan
SX133
Institutional
Providence Health PPO
SX187
Institutional
Providence Insurance & Administrative Services
Providence Administrative Services
PAS01
Institutional
Provident Life & Accident Insurance Company
Provident Life & Accident Insurance Company of America
Provident Life & Casualty Insurance Company
Healthpoint Corporation
Healthsource Provident (CIGNA)
Healthsource Provident Ins. Co.
68195
Institutional
Provider Network of America
MPJVL
Institutional
Provider Partners Health Plan Illinois
31401
Institutional
Provider Partners Health Plan of Texas
Provider Partners Health Plan Texas
31405
Institutional
Provider Partners Health Plan Pennsylvania
31400
Institutional
ProviDRs Care Network
48100
Institutional
Pruitt Health Premier
PH001
Institutional
Pruitt Health Premier (NC
SC)
PHPC1
Institutional
Psychealth Care Management LLC
Psychealth Care Management Assoc
A2797
Institutional
PUBLIC EMPLOYEES HEALTH PROGRAM
PEHP
SX106
Institutional
Qualcare Arkansas
Qualchoice Arkansas
35174
Institutional
Qualcare IPA
QCP01
Institutional
Quality Care Partners
Quality Care Partners (QCP)
89461
Institutional
Quartz Administrative Services Organization (ASO)
46571
Institutional
Quest Behavioral Health
44219
Institutional
QuikTrip
Quicktrip Corporation
73067
Institutional
Ravenswood Phys Assoc
Ravenswood Physician Assoc
RPAWC
Institutional
RBMS
LLC
91176
Institutional
Redirect Health Administration
86145
Institutional
Redlands Yucaipa Medical Group
18247
Institutional
Regal Med Group
Regal Medical Group
REGAL
Institutional
Regence BCBS Idaho
Regence BS Idaho
00611
Institutional
Regence BCBS Utah
00910
Institutional
REGENCE BLUE CROSS BLUE SHIELD OF UTAH (Includes FEP)
U1100
Institutional
Regence Group Administrators
RGA01
Institutional
Regency Empolyee Benefits
38221
Institutional
Regional Care INC
Regional Care
Inc.
47076
Institutional
Reliance Health Plan
RHP01
Institutional
Renaissance Physicians Organization
76066
Institutional
Reserve National Insurance
Reserve National Insurance (For Claims rejections
please contact Reserve national Customer Service at (405)848-7931.)
73066
Institutional
Resolve Health Plan Ad (Auth # required: begins w5 &13len
Innovative Payer 1
20481
Institutional
Resolve Health Plan Administrators
LLC
RHA01
Institutional
RESURRECTION HEALTH CARE PREFERRED
Family Medical Network
36396
Institutional
Resurrection Physicians Group I Par Plus
Resurrection Physician Provider Group
RPPG1
Institutional
RevClaims
RVC01
Institutional
Rhode Island Medicaid
12K74
Institutional
Rhode Island Medicaid
SKRI0
Institutional
Right Care from Scott & White
74205
Institutional
RightChoice Benefits Administrators
37331
Institutional
Rios Southwest Medical Group
RIOS1
Institutional
River City Medical Group
RCMG1
Institutional
Riverside Health Inc
Riverside Health
Inc
45281
Institutional
Riverspring Health Plans
05178
Institutional
RMSCO
INC.
RMSCO
Inc.
16117
Institutional
Rocky Mountain Health Plan Grand Junction
84065
Institutional
Rocky Mountain Pace
93142
Institutional
Rubicon Health Group
IHS18
Institutional
Rush Prudential Health Plans (HMO Only)
36389
Institutional
S & S Healthcare Strategies
31441
Institutional
Sagamore Health Network
Sagamore Health Network
Inc.
35164
Institutional
Salvasen Health
CB122
Institutional
Samaritan Health Plans
CP001
Institutional
Samera Health
Mint Health Plans/Samera Health
U8053
Institutional
San Diego County Medical Services (CMS)
San Diego County Medical Services
MSO11
Institutional
San Diego County Physician Emergency Services
MSO22
Institutional
San Diego County Ryan White Primary Care Program
MSO33
Institutional
San Diego County Sheriffs Department
MSO55
Institutional
San Diego PACE
96400
Institutional
San Francisco Health Plan
SFHP1
Institutional
San Luis Obispo Select IPA
San Louis Obispo Select
33072
Institutional
San Mateo Health Commission dba Health Plan of San Mateo
12X74
Institutional
Sana Benefits
50114
Institutional
Sanford Health Plan
MNSHP
Institutional
Santa Clara Family Health Plans
24077
Institutional
Sante Community Physicians Medical Group Corp.
Sante Health System Medi-Cal
Sante Health System Medi-C
SNTMC
Institutional
Sante Health Systems
SANTE
Institutional
Sante Health Systems
Sante Health System
77038
Institutional
Satellite Health Plan
Inc (Satellite Health Plan is a MA ESRD C-SNP effective 1/1/14. First Time submitters
please fax a W9 to 650-625-6083)
Satellite Health Plan Inc
45552
Institutional
Saudi Health Mission
SHM01
Institutional
Scan CA
Scan Health Plan CA
SCAN1
Institutional
SCAN Encounters (Diversified Data Design (DDD))
SCAN Encounters
99157
Institutional
Scan Health Plan Arizona
SCAN2
Institutional
Scan Health Plan AZ
73172
Institutional
SCHC Total Care
Total Care of NY (Former payer ID TCARE)
SCHC Total Care Inc
16146
Institutional
SCHS Alta Global Medical Care Group
MPM54
Institutional
Scott & White I Par Plus
Scott & White Health Care
88030
Institutional
Scripps Health Plan MSO
SHPM1
Institutional
Scripps Health Plan Services
SHPS1
Institutional
Seaview IPA
SVIPA
Institutional
Secure Health of Georgia (Claims for this payer id are only accepted with a DOS equal to or after 01/01/2021)
Secure Health Plan of GA ## (Claims for this payer id are only accepted with a DOS equal to or after 01/01/2021)
42561
Institutional
Secure Health of Georgia (Claims for this payer id are only accepted with a DOS prior to 12/31/2020)
Secure Health Plan of GA ## (Claims for this payer id are only accepted with a DOS prior to 12/31/2020)
28530
Institutional
SecureCare Dental
Merchants Benefit Administration
INC
86057
Institutional
SecureOne
86242
Institutional
Security Administrative Systems
Cornerstone Benefit Administrators
HealthSmart Security Administrative Services
35202
Institutional
Security Health Plan
39045
Institutional
Sedgwick
Sedgwick CMS
TP097
Institutional
Select Benefit Administrators of America
SELECT BENEFIT ADMIN
37282
Institutional
Select Health of South Carolina
23285
Institutional
SelectCare of Texas (HPN) Heritage Physicians Network
76045
Institutional
SelectCare of TX Beaumont Prov ID Req 713-843-6780 to obta
Golden Triangle Physician Alliance
GTPA1
Institutional
SELECTHEALTH
SX107
Institutional
Self Insured Benefit Admin FL
Self Insured Benefit Administrators
59111
Institutional
Self Insured Plans
Self Insured Plans
LLC
36404
Institutional
Self-Funded Plans
Inc (IL
PA
OH)
Self-Funded Plans (IL
PA
OH)
34131
Institutional
Selman Company
52214
Institutional
Selman Tricare Supplement Plans
TRSEL
Institutional
Sendero Health
SCS17
Institutional
Sendero IdealCare
11440
UV440
Institutional
Senior Whole Health Care ## (Use payer ID SWHNY for DOS equal to or after 01/01/2021) Use payer ID 83035 for DOS prior to 01/01/2021)
Senior Whole Health (Use payer ID SWHNY for DOS equal to or after 01/01/2021). Use payer ID 83035 for DOS prior to 01/01/2021)
SWHNY
Institutional
Senior Whole Health Care ## (Use payer ID 83035 for DOS prior to 01/01/2021. Use new payer ID SWHNY for DOS equal to or after 01/01/2021)
Senior Whole Health (Use payer ID 83035 for DOS prior to 01/01/2021. Use new payer ID SWHNY for DOS equal to or after 01/01/2021)
83035
Institutional
Senior Whole Health Massachusetts
SWHMA
Institutional
Sentinel Management
Sentinel Management Services
23249
Institutional
Sentinel Security Life Insurance
Atlantic Coast Life Insurance
87020
Institutional
Seton CHIP (Provider ID required.)
Seton Health Plan - CHIP I Par Plus
SHPCH
Institutional
Seton Employee Plan Care Program I Par Plus
SHCAR
Institutional
Seton Employee Plan
Seton Employee Plan I par Plus
SHEBP
Institutional
Seton Star
STAR1
Institutional
Seven Corners
25404
Institutional
SGIC
11789
Institutional
Shared Health Mississippi
SHTM1
Institutional
Shared Health Mississippi
SHTMS
Institutional
Sharp Health Plan
SHP01
Institutional
Sheet Metal Workers Local 104 (PayerID valid for submission add of PO Box 1138
San Ramon
CA 94583.)
Sheet Metal Workers Local 104
BeneSys
Inc. (Now known as Sheet Metal Workers Local 104)
38238
Institutional
Sierra Health and Life (Health Plan of Nevada)
Health Plan of Nevada
Sierra Health and Life
76342
Institutional
Sierra Health Services Encounters (Health Plan of Nevada)
Health Plan of Nevada (Encounter claims)
Sierra Health and Life (Encounters)
76343
Institutional
SIHO
77153
Institutional
Silver Cross Managed Care Organization
NASCR
Institutional
Silver Star Pace
97691
Institutional
Silverback TPA (previous payer ID 37728) For all dates of services on and after Jan. 1
2019
claims should be submitted WellMed
payer ID WELM2
WellMed (Claims)
Wellmed Medical (Claims) I Par Plus
WELM2
Institutional
Simply HealthCare Plans
27094
Institutional
Simply HealthCare Plans (new payer ID SMPLY as of 12-1-2018)
Simply Healthcare
Simply HealthCare Plans (New PID SMPLY effective 12/1/18)
SMPLY
Institutional
Sinclair Health Plan
84076
Institutional
SISCO
44827
Institutional
Smith Administrators
02057
Institutional
Smoky Mountain Center
13010
Institutional
Snedeker Risk Mangament
Snedeker Risk Management
A7637
Institutional
So CA Health Care SystCHS Alta Pod Medpoint &SCHS Alto Pod
MPM20
Institutional
Solidarity Healthshare
77721
Institutional
Solis Health Plans
SOLIS
Institutional
Somos IPA (Emblem Health)
81508
Institutional
Sonder Health Plans
Sondor Health Plans
A0339
Institutional
Sound Health
First Choice Health Network
Sound Health (now known as First Choice Health Network)
91131
Institutional
Soundpath Health
Soundpath Health (Formerly known as Puget Sound Health Partners
Inc.)
42172
Institutional
South Atlantic Medical Group
SAMG1
Institutional
South Carolina Medicaid
12K55
Institutional
South Central Preferred (SCP)
WellSpan Plus
23266
Institutional
South County Health Alliance (previously under Payer ID 41154)
81600
Institutional
South Dakota Medicaid
12K36
Institutional
South Dakota Medicare
SDMCR
Institutional
South Florida Common Services
Memorial Integrated Healthcare/South Florida Community Care Network
59065
Institutional
South Florida Musculoskeletal Care
06294
Institutional
SouthCare/Healthcare Preferred
Southcare / Healthcare Preferred
25147
Institutional
Southeast Michigan Pace
R3460
Institutional
Southern Illinois Healthcare
UIHCA
Institutional
Southern Illinois Healthcare Assoc
SIH99
Institutional
Southland Benefit Solutions
Amerikids-Dallas/Ft. Worth
Amerigroup Houston (Claims and Encounters)
Amerigroup Houston
26374
Institutional
Southwest Mighigan Behavioral Health Mental Health
Southwest Michigan Behavioral Health Mental Health
A3268
Institutional
Southwest Mighigan Behavioral Health Substance Use Disorder
Southwest Michigan Behavioral Health Subtance Use Disorder
A4585
Institutional
Southwest Physicians Group
SWPG1
Institutional
Southwest Service Administrators
PHX Teamsters UT/MT/ID
PHX Teamsters UT/MT/ID (For Dates of Service after 05/01/16)
CX100
Institutional
Southwest Service Life/Galaxy Health
Southwest Service Life
37266
Institutional
Southwestern Health Resources Clinically Integrated
Southwestern Health Resources Clinically Integrated (DOS After Dec. 31
2022)
RP085
Institutional
Specialty Care Program
IHS17
Institutional
Spectrum Administrators
Populytics (formerly Spectrum Administrators)
23253
Institutional
St Mary's IPA
St Mary IPA
SMIPA
Institutional
St. James PHO
11158
Institutional
St. John's Claims Administration
St. Johns/First Health
37264
Institutional
St. Therese Physician Association
37116
Institutional
Staff Benefits Management Administration
SBMCO
Institutional
Standard Life & Accident Insurance Company
73099
Institutional
Standard Life and Accident
Standard Life & Accident (Payer accepts secondary claims only
and Medicare cannot be primary payer.)
01758
Institutional
State Farm Health
State Farm Homeowners Group Medical Plans (Note that payer requires Insured’s ID of 11 digits and exact structure. Otherwise
claims will reject).
State Farm Workers Compensation Plans (Note that payer requires Insured’s ID of 11 digits and exact structure. Otherwise
claims will reject)
31053
Institutional
STATE FARM MUTUAL AUTOMOBILE INSURANCE CO
State Farm (Property & Casualty )
State Farm Casualty & Property Claims
31059
Institutional
State of TX Dental
Government Employees Health Association Inc. (GEHA)
Government Employees Health Association
Inc. (GEHA)
57254
Institutional
Sterling Medicare Advantage
Sterling Medicare Advantage (Claims containing Dates of service after 4-30-2014
claims should be sent to Wellcare
PayerID 14163)
67829
Institutional
SummaCare Health Plan
95202
Institutional
Summit Community Care
PASSE
Institutional
Summit Healthplan I Par Plus
20197
Institutional
Sunrise Advantage Plan Pennsylvania
SPA01
Institutional
Superier Health
IHG Dirwxr
75274
Institutional
Superior Health/Centene Corp I Par Plus
SHP11
Institutional
Superior Insurance Services
97802
Institutional
Sutter Connect - Sutter Gould Medical Foundation - Claims
Sutter Connect Gould
IP091
Institutional
Sutter Health Aetna
60624
Institutional
Sutter Medical Group
SC004
Institutional
Swedish Covenant
U6411
Institutional
Swedish Covenant Hospital
36411
Institutional
Tall Tree Administrators
Tall Trees Administrators
88067
Institutional
Tarrant Health Services (previous payer ID 37728) For all dates of services on and after Jan. 1
2019
claims should be submitted WellMed
payer ID WELM2
37228
Institutional
Team Choice - Alpha Care Gold I Par Plus
Nexcaliber
ADSL1
Institutional
Team Choice PNS
75133
Institutional
Teamcare
Central States Southeast and Southwest Areas Health and Welfare and Pensions Funds
Central States Health & Welfare Funds
Rosemont of Des Plaines
IL
36215
Institutional
Tech-Steel
Inc.
Intermountain Ironworkers Trust Fund
Operating Engineers Local No 53
8th Distric Electrical
CompuSys Incorporated (New Mexico)
Utah Carpenters
CompuSys Incorporated of Arizona
Utah Laborers
CompuSys Incorporated of Utah
CompuSys/Erisa Group
Incorporated (AZ)
CompuSys/Erisa Group
Incorporated (NM)
CompuSys/Erisa Group
Incorporated (TX)
Transwestern General Agency
Chapter NECA Health & Welfare Trust
IBEW Western Utilities or Local 57
City of Austin
Erisa Administrative Services Incorporated
Erisa Administrative Services
Inc.
New Mexico District Council of Carpenters
New Mexico Painters and Allied Trades Local No 823
New Mexico-West Texas Multi- Craft (lso known as New Mexico Laborers)
Advanstaff
Inc.
Arizona Pipe Trades Health and Welfare Trust Fund Local Union Nos. 469 & 741 Metal Trades Health Plan
Arizona Pipe Trades Health and Welfare Trust Fund Local Union Nos. 469 & 741 Pipe Trades Health Plan
Utah Pipe Trades
74234
Institutional
Teddy Health
TEDDY
Institutional
Telamon
22483
Institutional
Tennessee Medicaid
SKTN0
Institutional
Tervist
Speciality Care Program
IHS08
Institutional
Tethys Health Ventures
Tehtys Health Ventures
20212
Institutional
Texan Plus/Selectcare of TX (Kelsey) I Par Plus
SelectCare of TX-Kelsey-Seybold Prov Requrired 713- 843-6780
KLSY1
Institutional
Texas Children
75228
Institutional
Texas Children's Health Plan
76048
Institutional
Texas Health Aetna
88221
Institutional
Texas HealthSpring
Texas Healthspring I Par Plus
THS01
Institutional
Texas Medicaid
12K64
Institutional
Texas Medicaid Long Term Care
12K96
SKTX1
Institutional
TexasFirst Health Plan
13185
Institutional
The Benefit Group
TBGNE
Institutional
The Boon Group
BOONG
Institutional
The Care Network- Savannah Business Group (TCN)
The Care Network
The Care Network- Savanna
68423
Institutional
The Chesterfield Companies
Chesterfield Resources
Inc.
34154
Institutional
The City of Odessa
75600
Institutional
The Colorado Purchase Alliance
TCPA1
Institutional
The Health Exchange (Cerner Corporation)
The Health Exchange
20356
Institutional
The Health Plan of West Virginia Inc
The Health Plan (Upper Ohio Valley)
The Health Plan (Upper Ohio Valley)
34150
Institutional
The Health Plan of West Virginia
Inc
95677
Institutional
The Healthcare Group (THCG)
Encore Health Network (Note: Group Policy Number in HCFA Box 11 is required.)
Encore Health Network
35206
Institutional
The Loomis Company
The Loomis
23223
Institutional
The Macaluso Group
82694
Institutional
The Preferred Healthcare Systems (TPHS)
The Preferred Healthcare System - PPO Altoona
PA
PrimeSource Health Network
04320
Institutional
TLC Advantage in Sioux Falls
TLD Advantage in Sioux Falls
TLC01
Institutional
TN (formerly AmeriChoice TN:
UnitedHealthcare Community Plan / TN (formerly AmeriChoice TN: TennCare
Secure Plus Complete)
95378
Institutional
Today's Health
Today's Health I Par Plus
WITH1
Institutional
Today's Option I Par Plus
48055
Institutional
Total Community Care
InnovAge
InnovAge (Total Community Care)
31182
Institutional
Total Plan Concepts
80900
Institutional
Total Senior Care
12268
Institutional
Touchstone Health PSO
23856
Institutional
TR PAUL INC
TR Paul Inc.
37230
Institutional
Transchoice - Key Benefit Admin
TransChoice Key Benefit Administrators
37284
Institutional
Travis County Healthcare District
Central Health
Travis County MAP - Mediview
Community Care Collaborative
Travis County Hospital District
TCMAP
Institutional
Travis County Hospital District MAP I Par Plus
TCHD1
Institutional
Travis County MAP - Mediview
UCMAP
Institutional
Tri-Valley Medical Group
20538
Institutional
Triada Assurance
CB733
Institutional
Tribute Healthcare
Central Benefit National (Now known as Tribute Health Plan.)
61184
Institutional
Tricare East (effective 01-01-2018)
Tricare East
Tricare East Effective 1-1-2018
TREST
Institutional
Tricare for Life (All Regions 1-12)
Tricare for Life
TDDIR
Institutional
Tricare Overseas
FOREN
Institutional
TRICARE West / UHC Military & Veterans (formerly TriWest)
TRICARE West (UnitedHealthcare Military & Veterans)
UnitedHealthcare Military & Veterans / TRICARE West
99726
Institutional
TriHealth Physician Solutions
31144
Institutional
Trilogy Health Network
62777
Institutional
Trinity Health Pace
TRNPC
Institutional
Trinity Health Solutions Inc - Everpointe
32052
Institutional
Triplefin
LLC
Triplefin LLC
64300
Institutional
TRISTAR Benefit Administrators
Select Benefit Administrators (Des Moines Iowa)
Select Benefit Administrators (PayerID valid for claims submission address of PO Box 8339
Des Moines
IA 50301)
42137
Institutional
TriWest Healthcare Alliance (VA CCN Regions 4
5
&6)
TWCCN
Institutional
Troy Medicare
TRYMC
Institutional
TruBlue
True Blue TPA
83413
Institutional
True Choice USA - Christus Healthplan I Par Plus
TCUCH
Institutional
True Health New Mexico
82288
Institutional
True Health New Mexico FEHBP
85824
Institutional
Truli for Health
TRULI
Institutional
Trusteed AKA: TPSC Benefits
91078
Institutional
Trustmark Small Business Benefits
Tooling & Manufacturing Assoc.
Benefit Trust Life Insurance Company
Starmark
Tooling & Manufacturing Association
61425
Institutional
Tufts Health Plan
Tufts Associated Health
04298
Institutional
U OF U HEALTH PLANS
SX155
Institutional
UC Davis Health Systems
UC Davis Health System
UCDMG
Institutional
UCare Individual & Family Plans
55413
Institutional
Ucare of Minnesota (Use payer ID 52629 for DOS in 2018. Use new payer ID 55413 for UCare Individual & Family Plans with DOS in 2019)
Ucare of MN(Use ID 52629 DOS in 2018 UseID 55413 DOS in 2019
52629
Institutional
UCS (Electrical Workers Insurance Fund Local 5800)
93235
Institutional
UHA Health Insurance
UHA01
Institutional
UHIN Test Payer All Transactions Good
ALLGD
Institutional
Ultimate Health Plan
77022
Institutional
Ultra Benefits
Inc.
UltraBenefits
Ultra Benfits Inc.
41206
Institutional
UMC Health System
UMC Health Plan
75130
Institutional
Umpqua Health Alliance
77503
Institutional
UMR (UMR Wausau)
UMR
UMR (formerly UMR Wausau)
UnitedHealthcare / UHC Shared Services - UHSS formerly UHIS
UnitedHealthcare / UHIS- UnitedHealthcare Integrated Svcs.
39026
Institutional
UMWA Health & Retirement Funds
UMWA Health & Retirement Funds (Dental)
UMWA - UNITED MINE WORKERS ASSOC
52180
Institutional
Unified Group Services
35198
Institutional
Unified Health Services
62170
Institutional
Unified Physicians Network
Unified Physicians Network (For Claims rejections
please contact Unified Physicians claim department at 847-763-1700)
34638
Institutional
UNION PACIFIC RAILROAD EMPLOYEES HEALTH SYSTEMS
U6844
Institutional
Unite Health Share Ministries (UHSM)
83173
Institutional
Unite Here
59144
Institutional
Unite Here Health
37144
Institutional
United Claim Solutions
A0047
Institutional
United Claim Solutions
United Claims Solutions
20090
Institutional
United Claims Solutions Insight Benefit Administrators
United Claims Solutions Insight Benefit Administrator
96436
Institutional
United Healthcare Ohio Medicaid
88337
Institutional
United Healthcare Ohio Medicaid Dental
DentaQuest
83244
Institutional
United Healthcare Ohio Medicaid Vision
83572
Institutional
UNITED HEALTHCARE SERVICES INC(Optum Salt Lake)
OptumHealth SLC
Optum Tooele
U6885
Institutional
United Medical Alliance
UCHealth Plan Administrators (As of 8/1/14 CSMED
UMA & Phycor combined)
84132
Institutional
UnitedHealthcare (Student Resources )
UnitedHealthcare / StudentResources
74227
Institutional
UnitedHealthcare Community Plan / AZ / Children's Rehabilitative Services (CRS) / Long Term Care
UnitedHealthcare Community Plan / Arizona Long Term Care - BH & SNP / Children's Rehabilitative Services (CRS)
UnitedHealthcare Community Plan / AZ (formerly Arizona Physicians IPA and APIPA)
03432
Institutional
UnitedHealthcare Community Plan / KanCare
UnitedHealthcare Community Plan / KS - KanCare
96385
Institutional
UnitedHealthcare Community Plan / Missouri
UnitedHealthcare Community Plan Missouri
86050
Institutional
UnitedHealthcare Community Plan / NJ (formerly AmeriChoice NJ Medicaid
NJ Family Care
NJ Personal Care Plus)
AmeriChoice NJ
Medicaid
NJ Family Care (UnitedHealthcare Community Plan)
UnitedHealthcare Community Plan / NJ (formerly AmeriChoice NJ Medicaid
NJ Family Care
NJ Personal Care Plus) former payer id 86001
86047
Institutional
UnitedHealthcare Medicare Solutions / UnitedHealthcare MedicareDirect (formerly SecureHorizons)
UnitedHealthcare West / UnitedHealthcare of CA
OK
OR
TX
WA and PacifiCare of AZ
CO
NV
First Seniority Freedom
UST Healthproof (Effective for claims with a DOS of 2023)
OptumHealth Behavior Solutions FKA United Behavioral Health
OptumHealth (OptumHealth Behavioral Solutions of NM)
MAHP (MD IPA
Optimum Choice and MLH) UnitedHealthcare
AARP MedicareComplete through UHC (formerly from SecureHorizons)
United Healthcare
AARP MedicareComplete UHC/Oxford/former payer id 06111
Arnett Health Plans Former PayerID 95440
Definity Health Plan (UnitedHealthcare)
Harvard Pilgrim Passport Connect
OptumHealth Behavioral Solutions of NM
Tarrant Health Services (previous payer ID 37728) For all dates of service prior to Jan. 1
2019
claims should be submitted to UnitedHealthcare
payer ID 87726
UnitedHealthcare
UnitedHealthcare (Empire Plan)
UnitedHealthcare / UnitedHealthcare of the Mid-Atlantic
MD IP
87726
Institutional
UnitedHealthcare West / Encounters (formerly PacifiCare)
UnitedHealthcare West Encounters (formerly known as PacifiCare)
95958
Institutional
UnitedHealthOne / UnitedHealthcare Life Ins Co - Golden Rule
UnitedHealthOne / Golden Rule
Rooney Life Ins.
37602
Institutional
UnitedHealthOne / UnitedHealthcare Life Insurance Company (formerly American Medical Security)
All Savers Insurance / UnitedHealthcare
UnitedHealthcare / All Savers Alternate Funding
UnitedHealthcare / All Savers Insurance
81400
Institutional
Unity Health Insurance
66705
Institutional
Unity Health Partners
A1152
Institutional
Univera Healthcare SSA WNY
PPO
Traditional
12X19
Institutional
Univera Healthcare WNY
12X18
Institutional
Univera Traditional PPO
Univera PPO
UNINW
Institutional
Universal Care - California
Universal Care - California (ProviderID required.)
33001
Institutional
University Family Care
09830
Institutional
University Family Care - Healthcare Group
University Physicians Healthcare Group
07503
Institutional
University Family Care - Maricopa Health Plan
Maricopa Health Plan / Maricopa Care Advantage
09908
Institutional
University Health Alliance
99026
Institutional
University Health Care Advantage
Essence Healthcare CA
Essence Healthcare - CA
46407
Institutional
University Healthcare Marketplace
45437
Institutional
University of Illinois
UIC67
Institutional
University of Maryland Health Advantage
45282
Institutional
UPMC Health Plan
23281
Institutional
Upper Peninsula Health Group TPA
Upper Peninsula Heath Group TPA
37324
Institutional
Upper Peninsula Health Plan
38337
Institutional
US Benefits
HealthSmart US Benefits
HealthSmart US Benefits (Dental)
93092
Institutional
US Department Of Labor (837I & 837P)
US Department of Labor
77044
Institutional
US Network and Administrative Services
USN01
Institutional
USAA (United States Automobile Association)
USAA
74095
Institutional
USFHP St Vincent Catholic Med Center NY
Uniformed Service Family Health Plan
13407
Institutional
UST Healthproof (Effective for claims with a DOS of 2022)
UST Healthproof (Effective for claims with a DOS of 2022)
83245
Institutional
UTAH DEPARTMENT OF HEALTH
Utah Medicaid FFS
SKUT0
Institutional
Utah Medicaid Crossover
U4005
Institutional
VA Affairs Financial Services Center
VAFSC
Institutional
VA Patient Centered Community Care Program Region 5A
VA Patient-Centered Community Care Prog (VAPCCC) Region 5A
VAPC3
Institutional
VA Patient Centered Community Care Reg 3
55912
Institutional
VA Patient Centered Community Care Region 5B
VAPCCC Region 5B
55916
Institutional
VA Premier Complete Care
VPCCI
Institutional
VACCN Community network
VA Community Care Network for Dental Providers Region 2
VA Community Care Network for Dental Providers Region 3
VA Community Care Network Region 1
VA Community Care Network Region 2
VA Community Care Network Region 3
Dental Providers Region 1
VACCN
Institutional
Valir Pace (Formerly Via Christi Hope)
Valir Pace
48123
Institutional
VALLEY HEALTH PLAN
VHP03
Institutional
VALLEY HEALTH PLAN
VHP01
Institutional
VALLEY HEALTH PLAN
Valley Health Plan Medi-CAL
VHP02
Institutional
Valley Presbyterian Hospital Community Family Care
MPM61
Institutional
Valley Presbyterian Hospital Preferred IPA
MPM60
Institutional
Valley Presbyterian Hospital
Valley Presbyterian Hospital Preferred IPA
MPM53
Institutional
Valor Medicare Advantage
Valor Health Pan
43259
Institutional
Value Options / MBHP
ValueOptions/MBHP (For claim rejections please contact e- SupportServices@valueoptions.c om or 888-247-9311)
43307
Institutional
Value Options Marland Mental Hygiene
22322
Institutional
Vanderbilt University Medical Center
Vanderbilt Univ Med Center
BPSLLC
Institutional
Vantage Health Plan
77701
Institutional
Vantage Medical Group Use Payer ID PROSP for claims with DOS after 08.01.2020
Prospect Medical Group
Vantage Medical Group
PROSP
Institutional
Varipro
72187
Institutional
Ventura County Healthcare Plan
VCHCP
Institutional
Verity National Group
75256
Institutional
VESTACARE
VestaCare / RH Admin
VESTA
Institutional
Vibra Health Plan
15976
Institutional
VieCare Life Armstrong
25922
Institutional
Viida Care (Now known as Amida Care)
Vida Care (Now known as Amida Care.)
Amida Care (Formerly Vida Care.)
24818
Institutional
VillageCareMAX
26545
Institutional
Virgin Islands Medicare
12M52
Institutional
Virginia Premier Elite Plus
VPEP1
Institutional
Virginia Premier Health Plans (Effective 02-01-2019 former payer IDs VPEP1 54176 VPELT VPCCP VPHP1VPCCI MAPDI 12K83 MAPDP)
Virginia Premier Health Plans
VAPRM
Institutional
Virginia Premier Preferred Gold
251VA
Institutional
VIVA Health
Viva Health Plan
63114
Institutional
Vivida Health Plan (Use this ID for dates of service on or after 01/01/21)
A0102
Institutional
Vivida Health Plan (Use this ID for dates of service prior to 01/01/21)
45488
Institutional
VNA Homecare Options (Medicaid line of business)
31626
Institutional
VNS Choice Medicare (Formerly Visiting Nurse Service)
VNS CHOICE Medicare (Formerly Visiting Nurses Service)
77073
Institutional
Volusia Health Network
59266
Institutional
Vxtra Health
99915
Institutional
Vytra Health UB
E2264
Institutional
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.)
Vytra Healthcare
22264
Institutional
WA Blue Cross Regence (UMP)
WA Blue Shield Regence
Regence Blue Shield of Washington
00932
Institutional
Wabash Memorial Hosp Association
Wabash Memorial Hospital Association
85256
Institutional
Washington Medicaid
SKWA0
Institutional
Washington Medicare
WAMCR
Institutional
Waterstone Benefit Administrators
73155
Institutional
Weiss Health Providers
36337
Institutional
Welbehealth
WBHCA
Institutional
Wellcare Choice I Par Plus
M3FL4
Institutional
Wellcare Health Plan
Inc. (Encounters only)
Wellcare Health Plans
Inc. (Encounters)
59354
Institutional
Wellcare of CT
Wellcare of NY
14164
Institutional
Wellmark BCBS (Iowa
South Dakota)
Blue Shield of Iowa
Iowa Blue Cross Blue Shield
IABLS
Institutional
Wellmark BCBS (Iowa
South Dakota)
Wellmark BCBS (IA
SD)
88848
Institutional
WellMed (Encounters)
Wellmed Medical (Encounters) I Par Plus
WELMD
Institutional
WellNet Health Plans
25711
Institutional
Wells Fargo TPA (Part A and Part B)
00214
Institutional
Wellspace Nexus
NEXUS
Institutional
Wellspan Employee Assistance Program
WellSpan Employee Assitance Program
CB457
Institutional
West Suburban Health Providers
80942
Institutional
West Virginia Senior Choice
WVS01
Institutional
Western Growers Assurance Trust (aka Pinnacle Claims Management) Company
Pinnacle Claims Management
Inc.
Western Grower's Assurance Trust (aka Pinnacle Claims Management)
Western Grower's Insurance Company
Western Growers Assurance Trust (aka Pinnacle Claims Management)
24735
Institutional
Western Health Advantage
68039
77225
Institutional
WESTERN MUTUAL INS
Western Mutual Insurance
37247
Institutional
Western Pennsylvania Electrical Employees Insurance Trust Fund
Western Pennsylvania Electric Employees
RP083
Institutional
Western Southern Financial Group
WEST & SOUTHERN FINANCIAL GROUP
31048
Institutional
WestLake Financial Group
Inc.
90560
Institutional
WHO PHO
WASH1
Institutional
William C Earhart
William C. Earhart Co
Inc.
HealthSmart William C Earhart
93050
Institutional
Willow Health
WHLTH
Institutional
Wilson McShane
41095
Institutional
Wisconsin Anthem Blue Cross and Blue Shield
Blue Shield of Wisconsin
Blue Cross Blue Shield of Wisconsin
Wisconsin Anthem Blue Cross Blue Shield
Anthem Medicaid (WI) (Formerly BadgerCare)
WIBLS
Institutional
Wisconsin Medicaid Long Term Care
WILTC
Institutional
Worksite Benefit Systems
Worksite Benefit Services
20333
Institutional
WPP Eldercare Wisconsin
77080
Institutional
Wyoming Medicaid
SKWY0
Institutional
Wyoming Medicare
WYMCR
Institutional
Yam Hill CCO-PHTech
YAMHL
Institutional
Yerington Paiute Tribe
51350
Institutional
Yuzu Health
IHS15
Institutional
Zebra Health HC
88858
Institutional
Zenith American Solutions
89677
Institutional
Zing Health
83248
Institutional
Zurich Insurance
16535
Institutional

Dental

Payer Name Payer Id Line of Business
6 Degrees Health Inc.
6 Degrees Health INC
20446
Dental
Access Dental Plan
91185
Dental
ADN Administrators
CXADN
Dental
Advantek Benefit Administrators
Advantek Benefit Admins
83077
Dental
Advisory Health Administrators
CB159
Dental
Aegis Administrative Services
Aegis Andministrative Services
CB637
Dental
Aetna Affordable Health Choices
Aetna Affordable Health Choices (SM) SRC
57604
Dental
Aetna Better Health Kansas (Skygen USA)
SCION
Dental
Aetna Better Health of West Virginia
Aetna Better Health West Virginia
128WV
Dental
Aetna Medicare EPO PPO Dental
18014
Dental
Aetna TX Medicaid & CHIP
AETNA TEXAS MEDICAID
38692
Dental
Aetna
Primary Choice (Aetna HP- NY/NJ)
Magellan Behavioral Health
Select Choice
Senior Choice (Aetna HP-NY/NJ)
Aetna 60054 (Commercial only)
Aetna Health Plan - PPO
Aetna Life & Casualty Company
60054
Dental
Affordable Benefit Administrator
Affordable Benefit Administrators
Benefit Plan Administrators
Benefit Plan Administrators of Co Eau Claire WI
Benefit Plan Administrators CO Eau Claire WI
Benefit Plan Administrator
Benefit Plan Administrators WI
39081
Dental
AHF RW
95433
Dental
Alaska Childrens Services
Inc
Alaska Laborers Construction Industry Trust
Alaska Pipe Trades Local 375
Alaska United Food & Commercial Workers Health & Welfare Trust
Cement Masons & Plasterers Health & Welfare Trust - Grp#F16
Automotive Machinists Local 289 Health & Welfare Trust - Grp#F32
University of Washington Students & Graduate Appts. - Grp#P67
Operating Engineers Locals 302 & 612 Health & Security Fund - Grp#F12
Welfare and Pension Administration
Hotel Employees & Restaurant Employees Health Trust - Grp#F19
N.W. Ironworkers Health & Security Trust Fund - Grp#F15
N.W. Roofers & Employers Health & Security Trust Fund - Grp#F14
N.W. Textile Processors - Grp#F14
Glassworkers Health & Welfare Fund - Grp# F29
Enstar Natural Gas - Grp# P61
Puget Sound Benefits Trust - Grp#F25
Puget Sound Electrical Workers Trust - Grp#33
West Coast Stationary Engineers Health & Security Trust Fund - Grp#F13
Alaska Children's Services
Inc. - Group # P68
Alaska Laborers Construction Industry Trust - Gro
91136
Dental
Allied Benefit Systems
37308
Dental
Always Care Benefits
STR01
Dental
American Administrative Group AAG (Gallagher Benefits)
American Administrative Group (formerly Gallagher Benefit)
AAG - American Administrative Group
Cincinnati Financial Corporation
Gallagher
Cinncinnati Financial Corporation
37283
Dental
American Plan Administrators
95606
Dental
American Postal Workers Union Healthplan
American Postal Workers Union Health Plan
44444
Dental
Ameritas
AMLFC
Dental
Ameritas of NY
FANYC
Dental
Anchor Benefit Consulting Inc
Anchor Benefit Consulting
Anchor Benefit (Dental)
53085
Dental
Anchor Benefit Consulting
Anchor (Claimsbridge)
IHS10
Dental
Arkansas Best Corporation - Choice Benefits
CIGNA
CIGNA - PPA
CIGNA - PPO
CIGNA Health Plan - HMO
Connecticut General (CIGNA)
EQUICOR
EQUICOR - PPO
Equitable (CIGNA)
HEALTHSOURCE GA
HEALTHSOURCE IN
HEALTHSOURCE KY
HEALTHSOURCE ME
HEALTHSOURCE NH
HEALTHSOURCE OH
HEALTHSOURCE PROVI
HEALTHSOURCE SOUTH
Provident
TYSON FOODS
Arkansas Best Corporation
CIGNA Premier Plus
Arkansas Best Corporation (previous payer ID 75278
new payer ID is effective for claims submitted December 15
2017 and after).
62308
Dental
Assurant Health
Assurant Health Self Funded
75068
Dental
Atrio Health Plan
Asserta Health
IHS14
Dental
AultCare
Aultra Administrative Group
PrimeTime Health plan
204951704
AULOH
AULTC
AULTCARE
Dental
AultCare
Aultra Administrative Group
PrimeTime Health plan
Aultcare
341488123
Dental
Avesis
86098
Dental
Barinet (L&W)
CB369
Dental
BCBS North Carolina
61473
Dental
BCBS Of Michigan (Dental Claims Only)
BBMDQ
Dental
BCBSAZ Health Choice of AZ
RP105
Dental
Benebay
Berkshire Health Plans
Berkshire Health Partners
23243
Dental
Benefit Plan Administrators - ClaimsBridge
Benefit Plan Administrators
IHS19
Dental
Benefit Plan Administrators
Northern Nevada Trust Fund
Northern Nevada Trust Funds (Call 775-826-7200 prior to submitting claims.)
88027
Dental
Berkshire Intergroup
Quest EAP
10956
Dental
Blackhawk
Dart Member Care ##
Dart Member Care
CB987
Dental
Blue Benefit Administrators of Massachusetts
CBA Blue
EBPA
3036
Dental
Blue Cross and Blue Shield of Kansas
SB650
Dental
Blue Cross and Blue Shield of Kansas City
SB740
Dental
Bright Health Plan
CB186
Dental
Butler Benefits
HealthSmart Butler Benefit
HealthSmart Fringe Benefit Coordinators
HealthSmart US Benefits
HealthSmart William C Earhart
42150
Dental
Carefirst BCBS Maryland Dental
580
Dental
CareSource KY
Caresource Humana
Humana Caresource
CareSource of Kentucky
KYCS1
Dental
Centivo Direct Network Access
IHS04
Dental
Centurion LLC
Centurion
IHS11
Dental
Christian Brother Services
Christian Brothers Services
38308
Dental
ClaimsBridge High Performance Network (HPN)
11752
Dental
Colorado HealthOP
Colorado Health Insurance Cooperative
49718
Dental
Companion Life
American Worker Health Plan
American Worker Health Plan (Dental)
American Worker Health Plus
37322
Dental
Core Management Resouces Group
Core Management Resources Group
Core Administrative Services
58231
Dental
CoreStar
CoreSource of Illinois
CoreSource of IOWA
CoreSource of Maryland
Luminare Health
CoreSource of Pennsylvania
Luminare Health AZ IL IN MD MN NC PA fka Trustmark Health Benefits
35182
Dental
Cornerstone Preferred Resources
CB268
Dental
Covenant Administrators
LLC - 90 Degree
41101
Dental
Covenant Administrators
LLC - 90 Degree
Covenant Administrators LLC - 90 Degree
Guarantee Trust Life Insurance Company
58102
Dental
CPR Share Plan
CPR Share Plans
CB695
Dental
Crescent Health Solutions
56213
Dental
Delta Dental Georgia
DDGA1
Dental
Delta Dental Indiana
CDIN1
Dental
Delta Dental Iowa
CDIA1
Dental
Delta Dental Kansas
CDKS1
Dental
Delta Dental Kentucky
CDKY1
Dental
Delta Dental Massachusetts
4614
Dental
Delta Dental Nebraska
CDNE1
Dental
Delta Dental New Jersey
22189
Dental
Delta Dental New York
11198
Dental
Delta Dental North Carolina
56101
Dental
Delta Dental Northeast (Maine New Hampshire Vermont)
2027
Dental
Delta Dental of Arkansas
DELAR
Dental
Delta Dental of Michigan
46094
Dental
Delta Dental of Missouri
43090
Dental
Delta Dental Ohio
CDOH1
Dental
Delta Dental Oklahoma
CDOK1
Dental
Delta Dental Oregon (Oregon Dental Service)
CDOR1
Dental
Delta Dental Rhode Island
5029
Dental
Delta Dental South Carolina
43091
Dental
Delta Dental Tennessee
CDTN1
Dental
Delta Dental Virginia
CDVA1
Dental
Delta Dental Washington
91062
Dental
Delta Dental Wisconsin
39069
Dental
DeltaCare USA
DDCA2
Dental
DENTAL SELECT
CX093
Dental
Denti-Cal
94146
Dental
DirectCare
55731
Dental
Diversified Admin Corp
CX040
Dental
DMBA
SX105
Dental
DPC Core INC
DPC CORE
Inc.
23212
Dental
E.S. Beveridge and Associates
E. S. Beveridge and Associates
E.S. Beveridge
34108
Dental
East Boston Neighborhood Pace
NeighborhoodHealth
25849
Dental
EDS Healthchoice (formerly payer ID 22521 - For dates of service on or after 01/01/2018 )
Healthchoice (formerly payer ID 22521)
HealthChoice
71064
Dental
Emblem Dental
D3551
Dental
EMI HEALTH
SX110
Dental
Employee Benefit System
Employee Benefit Systems
42149
Dental
Employee Plans
LLC
Employee Plans LLC
35112
Dental
Employer Health Network
Employers Health Network
IHS07
Dental
Envolve Health
46278
Dental
Everence
EV483
Dental
Everence
Mennonite Mutual (Now known as Everence)
Mennonite Mutual Aid Association and Affiliates (Now known as Everence)
35605
Dental
First Continental Life-FCL
CX090
Dental
First RSL(NY)
FRSLC
Dental
FL MCO PHC/PHP
FL MCO PHC PHP
95411
Dental
Flume Health INC
Flume Health Inc.
FH205
Dental
FMH Benefit Services
Luminare Health KC
Luminare Health KC fka Trustmark Health Benefits
FMH Benefit Services
Inc.
48117
Dental
Fox-Everett
Inc.
Fox Everett
64069
Dental
Fringe Benefit Coordinators
HealthSmart Fringe Benefit Coordinators
HealthSmart Fringe Benefit Coordinators (Dental)
59204
Dental
Gaughan South LLC dba South Point Hotel and Casino
35227
Dental
GBS Group Benefit
GBS Global Benefit
Group Benefit Services
CB951
Dental
GEHA (Government Employees Health Association)
Government Employees Health Association Inc. (GEHA)
Government Employees Health Association
Inc. (GEHA)
44054
Dental
Gettysburg Health
Gettysburg Health Administrators
Core Value (Part of Gettysburg Health.)
23274
Dental
Global Repricing Solutions
Innovative Healthware Payer 6
IHS06
Dental
Gloria Gates
IHS20
Dental
Group Administrators Ltd
Group Administrators Ltd.
36338
Dental
Guardian Life Insurance Company of America
64246
Dental
GulfStream- General Dynamics/CoreSource
CB624
Dental
Harrington Health BPO
Harrington Health
59143
Dental
Hawaii Mainland Administrators PHCS HMA Employees PMO
86070
Dental
Health IN Tech
IHS09
Dental
Health Management Associates (HMA
servicing Southeastern and Southwestern Regions) (Provider ID Required)
HMA Hawaii
86066
Dental
Health Plan San Mateo
Health Plan of San Mateo
HPSM1
Dental
HealthChoice Dept of Corrections & Rehab
71065
Dental
HealthComp
7205
Dental
HealthComp
HEALTHCOMP INC
85729
Dental
HealthComp
Benefit Administrative Systems
BENEFIT ADMIN. SYSTEM
36149
Dental
Healthease
Wellcare of FL
59608
Dental
Healthgram
Ingham Health Plan Corp.
Ingham Health Plan Corp
38343
Dental
Healthplex
11271
Dental
Healthplus Amerigroup
Americaid Community Care (Dallas/Ft. Worth)
27514
Dental
Healthy York Network
22251
Dental
Heath Choice AZ
Health Choice of AZ
BCBSAZ ACA Standard Health with Health Choice
62179
Dental
Hillsborough County Health Care
Administrative Services
Administrative Services
Inc.
59141
Dental
IHPlans
Imperial Health Plan of California Incorporated
IHP01
Dental
IHS Gateway Payer South
CB711
Dental
Independence American Insurance Comp
Independence American Insurance
Independence American Ins. Co.
CB231
Dental
INETICO
INC.
43471
Dental
Innovative Healthware Payer 12
IHS12
Dental
Innovative Healthware Payer 13
IHS13
Dental
Innovative Healthware Payer 16
IHS16
Dental
Innovative Healthware Payer 21
NextPA
IHS21
Dental
Innovative Healthware Payer 22
IHS22
Dental
Innovative Healthware Payer 25
IHS25
Dental
Innovative Healthware Services Payer 5
IHS05
Dental
Insurance Administrators of America
Insurance Administrator of America
37279
Dental
Integra Administrative Group
Integra Administrative Group (Seafor d
DE)
INTEGRA Administrative Group
Inc.
51020
Dental
International Benefit Administration
International Benefit Administrator
11329
Dental
Jericho Share
IHS02
Dental
Kentucky Medicaid Dental
CKKY1
Dental
Key Solution
Key Solution (Dental)
37323
Dental
Lancaster General Health
Lancaster General Health (LGH)
16109
Dental
Liberty Union
Life Assurance Company
Mid-America Associates Inc.
Mid-America Associates
37281
Dental
Line Construction Benefit Fund
LCB01
Dental
Lockard & Williams
CB752
Dental
Luminare Health Detroit
NGS Coresource
Luminare Health Detroit fka Trustmark Health Benefits
38225
Dental
Luminare Health Little Rock
CoreSource Little Rock
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)
Luminare Health Little Rock fka Trustmark Health Benefits
75136
Dental
Luminare Health OH
Coresource of OH
CORESOURCE OH
Luther Care (CoreSource)
Luminare Health OH fka Trustmark Health Benefits
35183
Dental
Luther Care (CoreSource)
CB212
Dental
Managed Care of North America (MCNA) Dental
65030
Dental
Mashantucket Pequot Tribal Nation
Pequot Pharmaceutical Network
Bluebonnet Administrators
37121
Dental
MBACLM
IHS24
Dental
Medical Benefits Mutual
MedBen (Newark
OH)
Medical Benefits Administrators
Inc. (Newark
OH)
Medical Benefits Companies (Newark
OH)
Medical Benefits Mutual (Newark
OH)
Medical Benefits
74323
Dental
Merchants Benefit Administration INC
MBAAZ
Dental
METLIFE
65978
Dental
MI Blue Cross PPO
Blue Cross of Michigan
12B18
Dental
Michigan Medicare PlusBlue (835s returned under MIBLS)
Michigan Medicare PlusBlue
MIMPB
Dental
Mid-American Benefits
22823
Dental
MOLINA HEALTHCARE OF UTAH
SX109
Dental
MotivHealth Insurance Company
U7632
Dental
MPMBA
IHS23
Dental
Municipal Health Benefits Fund
Municipal Health Benefit Program
Municipal Health Benefit Fund
81883
Dental
Mutual of Omaha Insurance Company
Mutually Preferred
National Rural Letter Carrier Association (Policy Number GMG1846)
United of Omaha
71412
Dental
NaphCare
Inc
Naphcare Inc
58182
Dental
National Allied Workers Union Local 831
National Allied Workers Union Local 831 Insurance Trust
CB148
Dental
National Elevator
National Elevator Industry Benefit Plan (NEIB)
CX045
Dental
National General
ASHC1
Dental
National Telecommunications Cooperative Association
National Telecom Association (NTCA)
52120
Dental
Netcare Life and Health Insurance
66055
Dental
Nippon Life Insurance Company
Nippon Life Insurance Company (Dental)
Nippon Life Insurance Company of America
81264
Dental
Northern Illinois Health Plan
36347
Dental
NYS Department of Health
14142
Dental
Ohio PPO Connect
74431
Dental
Olympus Management Health Care
Olympus Managed Health Care
65074
Dental
Pan-American Life Insurance Group
4218
Dental
Path Administrators (DH Evans)
D H Evans & Associates reg required call 410-349-3222
25172
Dental
Pennsylvania Preferred Health Network (PPHN)
6161
Dental
People 1st Health Strategies
IHS03
Dental
People One Health
IHS01
Dental
Physicians Mutual
Physician's Mutual (PMIC)
CX068
Dental
Prairie States Enterprises
Inc.
Prairie States Enterprises
36373
Dental
Preferred Health Care (PHC)
Preferred HealthCare Lancas
33898
Dental
Preferred Health Plan of Carolinas (PHPC)
CB404
Dental
Premier Access
CX078
Dental
Premier Access Dental Services
CX110
Dental
Prevea360 Health Plan
Children's Community Health Plan
Chorus Community Health Plans (WI Medicaid)
Wellfirst Health
Care4Kids (WI Medicaid)
Care4Kids (WI Medicaid plans)
Dean Health Plan
39113
Dental
Prezzo
CB531
Dental
Primary PhysicianCare
Inc.(Now known as HealthGram)
Healthgram
Primary PhysicianCare
Inc.
56144
Dental
Principal Financial Group (Vision Claims only.)
Principle Financial Group
61271
Dental
Priority Health (Please contact Priority Health EDI Dept at 616- 464-8686 or email EDISETUP@Priority-Health.com)
Priority Health
38217
Dental
Prodegi
U8151
Dental
Prominence Administrative Services
88022
Dental
Prominence Health Plan Encounters
St. Marys Health Plan Encounters
St.. Mary's Health Plan Encounters
88082
Dental
Prominence Health Plan of Florida
Prominence HealthFirst of Florida Inc
83352
Dental
Prominence Health Plan of Nevada
93082
Dental
Prominence Health Plan of Texas
80095
Dental
Prominence Health Plan
ST MARYS HEATLH PLAN
Saint Marys Health Plan
88029
Dental
PUBLIC EMPLOYEES HEALTH PROGRAM
PEHP
SX106
Dental
Quality Care Partners
Quality Care Partners (QCP)
89461
Dental
Quest Behavioral Health
44219
Dental
REGENCE BLUE CROSS BLUE SHIELD OF UTAH (Includes FEP)
U1100
Dental
Regency Empolyee Benefits
38221
Dental
Resolve Health Plan Ad (Auth # required: begins w5 &13len
Innovative Payer 1
20481
Dental
Resolve Health Plan Administrators
LLC
RHA01
Dental
Rhode Island Medicaid
CKRI1
Dental
RSL
RSLFC
Dental
Rubicon Health Group
IHS18
Dental
Salvasen Health
CB122
Dental
Samera Health
Mint Health Plans/Samera Health
U8053
Dental
Sana Benefits
50114
Dental
SecureCare Dental
Merchants Benefit Administration
INC
86057
Dental
SELECTHEALTH
SX107
Dental
South Central Preferred (SCP)
WellSpan Plus
23266
Dental
Southland Benefit Solutions
Amerikids-Dallas/Ft. Worth
Amerigroup Houston (Claims and Encounters)
Amerigroup Houston
26374
Dental
Southwest Service Administrators
PHX Teamsters UT/MT/ID
PHX Teamsters UT/MT/ID (For Dates of Service after 05/01/16)
CX100
Dental
Specialty Care Program
IHS17
Dental
Spectrum Administrators
Populytics (formerly Spectrum Administrators)
23253
Dental
Standard Insurance
STICC
Dental
Standard of NY
STNYC
Dental
State of TX Dental
Government Employees Health Association Inc. (GEHA)
Government Employees Health Association
Inc. (GEHA)
57254
Dental
Tall Tree Administrators
Tall Trees Administrators
88067
Dental
Teddy Health
TEDDY
Dental
Tervist
Speciality Care Program
IHS08
Dental
The Care Network- Savannah Business Group (TCN)
The Care Network
The Care Network- Savanna
68423
Dental
The Health Plan of West Virginia Inc
The Health Plan (Upper Ohio Valley)
The Health Plan (Upper Ohio Valley)
34150
Dental
The Loomis Company
The Loomis
23223
Dental
The Preferred Healthcare Systems (TPHS)
4320
Dental
Total Community Care
InnovAge
InnovAge (Total Community Care)
31182
Dental
Total Plan Concepts
80900
Dental
Travis County Healthcare District
Central Health
Travis County MAP - Mediview
Community Care Collaborative
Travis County Hospital District
TCMAP
Dental
Triada Assurance
CB733
Dental
Tribute Healthcare
Central Benefit National (Now known as Tribute Health Plan.)
61184
Dental
TRISTAR Benefit Administrators
Select Benefit Administrators (Des Moines Iowa)
Select Benefit Administrators (PayerID valid for claims submission address of PO Box 8339
Des Moines
IA 50301)
42137
Dental
TruBlue
True Blue TPA
83413
Dental
Trusteed AKA: TPSC Benefits
91078
Dental
Trustmark Small Business Benefits
Tooling & Manufacturing Assoc.
Benefit Trust Life Insurance Company
Starmark
Tooling & Manufacturing Association
61425
Dental
U OF U HEALTH PLANS
SX155
Dental
Ultra Benefits
Inc.
UltraBenefits
Ultra Benfits Inc.
41206
Dental
UMC Health System
UMC Health Plan
75130
Dental
UMR (UMR Wausau)
UMR
UMR (formerly UMR Wausau)
UnitedHealthcare / UHC Shared Services - UHSS formerly UHIS
UnitedHealthcare / UHIS- UnitedHealthcare Integrated Svcs.
39026
Dental
UMWA Health & Retirement Funds
UMWA Health & Retirement Funds (Dental)
UMWA - UNITED MINE WORKERS ASSOC
52180
Dental
Unified Group Services
35198
Dental
UNION PACIFIC RAILROAD EMPLOYEES HEALTH SYSTEMS
U6844
Dental
United Claim Solutions
United Claims Solutions
20090
Dental
United Concordia Companies Inc
89070
Dental
United Concordia Dental Plus
CX013
Dental
United Concordia Tricare Dental Plan
UCCTR
Dental
United Healthcare
52133
Dental
United Healthcare Ohio Medicaid Dental
DentaQuest
83244
Dental
US Benefits
HealthSmart US Benefits
HealthSmart US Benefits (Dental)
93092
Dental
US Department Of Labor (837I & 837P)
US Department of Labor
77044
Dental
US Network and Administrative Services
USN01
Dental
UTAH DEPARTMENT OF HEALTH
Utah Medicaid FFS
SKUT0
Dental
VA Family Members Program Dental (VFMP)
84147
Dental
VA Fee Basis Program
VA Integrated Veterans Care (IVC)
12116
Dental
VACCN Community network
VA Community Care Network for Dental Providers Region 2
VA Community Care Network for Dental Providers Region 3
VA Community Care Network Region 1
VA Community Care Network Region 2
VA Community Care Network Region 3
Dental Providers Region 1
VACCN
Dental
VALLEY HEALTH PLAN
VHP01
Dental
WellNet Health Plans
25711
Dental
Wellspan Employee Assistance Program
WellSpan Employee Assitance Program
CB457
Dental
Western Growers Assurance Trust (aka Pinnacle Claims Management) Company
Pinnacle Claims Management
Inc.
Western Grower's Assurance Trust (aka Pinnacle Claims Management)
Western Grower's Insurance Company
Western Growers Assurance Trust (aka Pinnacle Claims Management)
24735
Dental
Western Pennsylvania Electrical Employees Insurance Trust Fund
Western Pennsylvania Electric Employees
RP083
Dental
William C Earhart
William C. Earhart Co
Inc.
HealthSmart William C Earhart
93050
Dental
Yuzu Health
IHS15
Dental

Eligibility

Payer Name Payer Id Line of Business
Affinity Health Plan - Medicare
AFMCR
Eligibility
Alabama Blue Cross (Institutional)
Alabama Blue Shield (Institutional)
ALBLC
Eligibility
Alabama Blue Shield (Professional)
Blue Shield of Alabama
Blue Cross of Alabama
ALBLS
Eligibility
American Postal Workers Union Health Plan
AMPWS
Eligibility
Arise Health Plan
ARISE
Eligibility
Arizona Blue Cross Blue Shield
Blue Shield of Arizona
AZBLS
Eligibility
Blue Cross of Idaho
Idaho Blue Cross
IDBLC
Eligibility
Blue Shield of Arkansas
Arkansas Blue Cross Blue Shield
Blue Advantage of Arkansas
Health Advantage of Arkansas
ARBLS
Eligibility
Blue Shield of Delaware
Delaware Blue Cross Blue Shield
DEBLS
Eligibility
Blue Shield of Florida
Florida Blue Cross Blue Shield
Blue Cross Blue Shield of Florida
Florida Blue Shield
FLBLS
Eligibility
Blue Shield of Georgia (State Health of GA)
Georgia State Health Benefit Plan (Processed by GA BC/BS)
Blue Shield of Georgia
Georgia Anthem Blue Cross Blue Shield
State Merit GA
GABLS
Eligibility
Blue Shield of Hawaii
Hawaii Blue Cross Blue Shield
HIBLS
Eligibility
Blue Shield of Idaho
Idaho Blue Shield (Regence)
Blue Shield of Idaho (Per Provider Testing)
IDBLS
Eligibility
Blue Shield of Illinois
Illinois Blue Cross Blue Shield
ILBLS
Eligibility
Blue Shield of Indiana
Indiana Anthem Blue Cross Blue Shield
Indiana Anthem Blue Cross and Blue Shield
INBLS
Eligibility
Blue Shield of Kansas City
Blue Cross of Kansas City
Kansas City Blue Cross Blue Shield
KCBLS
Eligibility
Blue Shield of Kansas
Blue Cross of Kansas
Kansas Blue Cross Blue Shield
KSBLS
Eligibility
Blue Shield of Kentucky
Kentucky Anthem Blue Cross Blue Shield
KYBLS
Eligibility
Blue Shield of Louisiana
Blue Shield of Lousiana
State Employees Group Benefits
Louisiana Blue Cross Blue Shield
LABLS
Eligibility
Blue Shield of Maine
Maine Anthem Blue Cross and Blue Shield
Maine Anthem Blue Cross Blue Shield
MEBLS
Eligibility
Blue Shield of Michigan
Michigan Blue Cross Blue Shield
MIBLS
Eligibility
Blue Shield of Minnesota
CCS (aka Comprehensive Care Systems)
Minnesota Blue Cross Blue Shield
MNBLS
Eligibility
Blue Shield of Mississippi
Mississippi Blue Cross Blue Shield
MSBLS
Eligibility
Blue Shield of Missouri
Missouri Anthem Blue Cross and Blue Shield
Missouri Anthem Blue Cross Blue Shield
MOBLS
Eligibility
Blue Shield of South Carolina
South Carolina Blue Cross Blue Shield
SC FEP Blue Cross
Medicare Blue Advantage of South Carolina
SCBLS
Eligibility
Boston Medical Center Health Plan
BMCHN
Eligibility
Bravo Health (Cigna Healthspring)
BRAVO
Eligibility
Bridgespan
BRIDG
Eligibility
Cal-Optima Direct
Caloptima
CALOPTIMA DIRECT
CALOP
Eligibility
California Anthem Blue Cross Dental
CABLD
Eligibility
California Blue Shield
CABLS
Eligibility
California Medicaid (Medi-Cal)
CAMCD
Eligibility
Capital Blue Cross of Pennsylvania
PABLC
Eligibility
Carefirst Blue Cross Blue Shield District of Columbia
DCBLS
Eligibility
CareMore Value Plus (CVP)
Caremore
Caremore IPA
CARMO
Eligibility
Caresource Georgia
Caresource of Georgia
CareSource of GA
GACS1
Eligibility
Caresource Indiana
CareSource Marketplace
CareSource IN
INCS1
Eligibility
CareSource KY
Caresource Humana
Humana Caresource
CareSource of Kentucky
KYCS1
Eligibility
Caresource West Virginia
CareSource WV
WVCS1
Eligibility
Clear Health Alliance
CLEAR
Eligibility
Colorado Anthem Blue Cross Blue Shield Dental
Colorado Anthem Blue Cross and Blue Shield Dental
COBLD
Eligibility
Colorado Anthem Blue Cross Blue Shield
Blue Shield of Colorado
Anthem of Colorado
Colorado Anthem Blue Cross and Blue Shield
COBLS
Eligibility
Colorado Community Health Alliance
COCHA
Eligibility
Community First I Par Plus
Community First Health Plans
Community First Health Plan
Inc.
COMMF
Eligibility
Community Health Solutions (Claims now route to Medicaid of Louisiana)
Medicaid of Louisiana (Includes KidMed claims.)
Medicaid of Louisiana (837P
837I & 837D)
Louisiana Medicaid
LAMCD
Eligibility
Connecticut Anthem Blue Cross Blue Shield Dental
Connecticut Anthem Blue Cross and Blue Shield Dental
CTBLD
Eligibility
Connecticut Anthem Blue Cross Blue Shield
Blue Shield of Connecticut
Connecticut Anthem Blue Cross and Blue Shield
CTBLS
Eligibility
Cooperative Benefit Administrators
CBENA
Eligibility
CoreSource (IL
IN
MD
NC & PA)
CRSC1
Eligibility
Delaware Medicaid
Medicaid of Delaware
Medicaid of Delaware
DEMCD
Eligibility
DMBA
SX105
Eligibility
EMI HEALTH
SX110
Eligibility
Federated Mutual Insurance Company
FEDMI
Eligibility
Fidelis (CenterCare)
FIDEL
Eligibility
Gateway Health Plan
GATHP
Eligibility
Georgia Anthem Blue Cross Blue Shield Dental
GABLD
Eligibility
Harvard Pilgrim
HPHCS
Eligibility
Hawaii Medicaid
HIMCD
Eligibility
Health Partners Pennsylvania
HPART
Eligibility
Health Tradition Health Plan
HLTHT
Eligibility
Healthcare Highways
HCH01
Eligibility
HealthFirst of New York
HF1NY
Eligibility
Healthsmart Benefit Solutions
HSBES
Eligibility
Indiana Anthem Blue Cross Blue Shield Dental
Indiana Anthem Blue Cross and Blue Shield Dental
INBLD
Eligibility
Johns Hopkins Health Plan
JHOHP
Eligibility
Kaiser Foundation Colorado
KSFCO
Eligibility
Kaiser Foundation Health Plan of Southern California
Kaiser Permanente Southern CA
KS001
Eligibility
Kaiser Foundation Mid Atlantic
KSFMA
Eligibility
Kaiser Foundation Northwest
KSFNW
Eligibility
Kaiser Foundation of Northern California
Kaiser Foundation Health Plan of Northern California
Kaiser Permanente Northern CA
KS003
Eligibility
Kaiser Foundation Ohio
KSFOH
Eligibility
Kaiser Permanente Georgia
KSPGA
Eligibility
Kentucky Anthem Blue Cross Blue Shield Dental
KYBLD
Eligibility
Keystone Mercy
KEYST
Eligibility
Loomis Company
LOOMS
Eligibility
Maine Anthem Blue Cross and Blue Shield Dental
Maine Anthem Blue Cross Blue Shield Dental
MEBLD
Eligibility
Mass Health (MA Medicaid)
Medicaid of Massachusetts (Mass Health)
Medicaid of Massachusetts
Massachusetts Medicaid
MAMCD
Eligibility
Medicaid of Alabama
Alabama Medicaid
Medicaid of Alabama (for 837P & 837I claims)
ALMCD
Eligibility
Medicaid of Arizona (AHCCCS)
Arizona Medicaid (AHCCCS)
Medicaid of Arizona (AHCCCS)
Medicaid of Arizona (AHCCCS)(837I & 837P)
AZMCD
Eligibility
Medicaid of Arkansas
Arkansas Medicaid
ARMCD
Eligibility
Medicaid of Colorado
Colorado Medicaid
COMCD
Eligibility
Medicaid of Connecticut
Connecticut Medicaid
Medicaid of Connecticut (for 837P & 837I claims)
CTMCD
Eligibility
Medicaid of Florida
Florida Medicaid
Medicaid of Florida (for 837P & 837I claims)
FLMCD
Eligibility
Medicaid of Idaho
Idaho Medicaid
IDMCD
Eligibility
Medicaid of Illinois
Illinois Medicaid
ILMCD
Eligibility
Medicaid of Indiana
Indiana Medicaid
INMCD
Eligibility
Medicaid of Iowa
Iowa Medicaid
IAMCD
Eligibility
Medicaid of Kansas
Kansas Medicaid
KSMCD
Eligibility
Medicaid of Kentucky
Kentucky Medicaid
KYMCD
Eligibility
Medicaid of Maine
Maine Medicaid
MEMCD
Eligibility
Medicaid of Maryland
Maryland Medicaid
MDMCD
Eligibility
Medicaid of Michigan
Michigan Medicaid
MIMCD
Eligibility
Medicaid of Minnesota
Minnesota Medicaid
MNMCD
Eligibility
Medicaid of Mississippi
Medicaid of Mississippi (for 837P & 837I claims)
Mississippi Medicaid
MSMCD
Eligibility
Medicaid of Nevada
Nevada Medicaid
NVMCD
Eligibility
Medicaid of New Hampshire
New Hampshire Medicaid
NHMCD
Eligibility
Medicaid of New Jersey
New Jersey Medicaid
NJMCD
Eligibility
Medicaid of New Mexico
New Mexico Medicaid
NMMCD
Eligibility
Medicaid of New York
New York Medicaid
NYMCD
Eligibility
Medicaid of North Carolina
North Carolina Medicaid
Medicaid of North Carolina (for 837P and 837I claims)
NCMCD
Eligibility
Medicaid of North Dakota
North Dakota Medicaid
NDMCD
Eligibility
Medicaid of Ohio
Ohio Medicaid
OHMCD
Eligibility
Medicaid of Oregon
Oregon Medicaid
ORMCD
Eligibility
Medicaid of Pennsylvania
Pennsylvania Medicaid
Medicaid of Pennsylvania (837P
835s returned under SKPA0)
PAMCD
Eligibility
Medicaid of South Carolina
South Carolina Medicaid
SCMCD
Eligibility
Medicaid of South Dakota
South Dakota Medicaid
SDMCD
Eligibility
Medicaid of Tennessee (TennCare)
TennCare (Medicaid of Tennessee)
Tennessee Medicaid (TennCare)
TNMCD
Eligibility
Medicaid of Texas
Texas Medicaid
TXMCD
Eligibility
Medicaid of Vermont
Vermont Medicaid
VTMCD
Eligibility
Medicaid of Virginia
Virginia Medicaid
VAMCD
Eligibility
Medicaid of Washington DC
District of Columbia Medicaid
Medicaid of DC
DCMCD
Eligibility
Medicaid of Washington State
Washington Medicaid
Medicaid of Washington
WAMCD
Eligibility
Medicaid of West Virginia
West Virginia Medicaid
WVMCD
Eligibility
Medicaid of Wisconsin
Wisconsin Medicaid
WIMCD
Eligibility
Medicaid of Wyoming
Wyoming Medicaid
WYMCD
Eligibility
Michild Michigan
MICHD
Eligibility
Missouri Anthem Blue Cross and Blue Shield Dental
Missouri Anthem Blue Cross Blue Shield Dental
MOBLD
Eligibility
Missouri Medicaid
Medicaid of Missouri
MOMCD
Eligibility
Molina Healthcare California
MOLCA
Eligibility
Montana Blue Cross Blue Shield
Blue Shield of Montana
MTBLS
Eligibility
Montana Medicaid
Medicaid of Montana
MTMCD
Eligibility
MVP Health Plan
MVPHP
Eligibility
Nebraska Blue Cross Blue Shield
Blue Shield of Nebraska
NEBLS
Eligibility
Nebraska Medicaid
Medicaid of Nebraska
NEMCD
Eligibility
Neighborhood Health Plan
NBRHP
Eligibility
Network Health
NETWH
Eligibility
Nevada Anthem Blue Cross Blue Shield Dental
Nevada Anthem Blue Cross and Blue Shield Dental
NVBLD
Eligibility
Nevada Anthem Blue Cross Blue Shield
Blue Shield of Nevada
Anthem of Nevada
Nevada Anthem Blue Cross and Blue Shield
NVBLS
Eligibility
New Hampshire Anthem Blue Cross Blue Shield Dental
New Hampshire Anthem Blue Cross and Blue Shield Dental
NHBLD
Eligibility
New Hampshire Anthem Blue Cross Blue Shield
Blue Shield of New Hampshire
New Hampshire Anthem Blue Cross and Blue Shield
NHBLS
Eligibility
New Mexico Blue Cross Blue Shield
Blue Shield of New Mexico
Lovelace Sandia Health Plan (Acquired by Blue Shield of NM)
NMBLS
Eligibility
New York Blue Cross Blue Shield (Empire)
Blue Shield of New York (Empire)
NYBLS
Eligibility
North Carolina Blue Cross Blue Shield
Blue Shield of North Carolina
NCBLS
Eligibility
North Dakota Blue Cross Blue Shield
Blue Shield of North Dakota
NDBLS
Eligibility
Ohio Anthem Blue Cross Blue Shield Dental
Ohio Anthem Blue Cross and Blue Shield Dental
OHBLD
Eligibility
Ohio Anthem Blue Cross Blue Shield
Blue Shield of Ohio
Ohio Anthem Blue Cross and Blue Shield
OHBLS
Eligibility
Oklahoma Blue Cross Blue Shield
Blue Shield of Oklahoma
OKBLS
Eligibility
Oklahoma Employees Group Insurance
OKSTE
Eligibility
Oklahoma Medicaid
MC030
Eligibility
Optum Medical Network (previously Lifeprint)
OptumCare / AZ
NV
UT (formerly Optum Medical Network & Lifeprint Network))
OptumCare / AZ
UT (formerly Lifeprint Network)
LIFE1
Eligibility
Oregon Blue Cross Blue Shield (Regence)
Blue Shield of Oregon
ORBLS
Eligibility
Pacificare Arizona
PCAAZ
Eligibility
Pacificare Oklahoma
PCAOK
Eligibility
Pacificare Washington
PCAWA
Eligibility
Paramount
Paramount Health
SX158
Eligibility
Passport Health Plan
PPHPC
Eligibility
Pennsylvania Blue Cross Blue Shield (Highmark)
Blue Shield of Pennsylvania
PABLS
Eligibility
PHCS Savility Payers
PHCSS
Eligibility
PHP of Michigan
PHPMI
Eligibility
Physicians Mutual Insurance Company
PMICO
Eligibility
Preferred Health Systems
PREHS
Eligibility
Providence Health Plan
PROHP
Eligibility
PUBLIC EMPLOYEES HEALTH PROGRAM
PEHP
SX106
Eligibility
REGENCE BLUE CROSS BLUE SHIELD OF UTAH (Includes FEP)
U1100
Eligibility
Rhode Island Blue Cross Blue Shield
Blue Shield of Rhode Island
RIBLS
Eligibility
Rocky Mountain Health Plan
RMNHP
Eligibility
Schaller Anderson Integral Quality Care Florida
ICQFL
Eligibility
Schaller Anderson Majestacare Virginia
MACVA
Eligibility
Schaller Anderson Missouri Care
MOCSA
Eligibility
Schaller Anderson Texas Christus
TXCSA
Eligibility
Scott and White Health Care Plan
SCWHP
Eligibility
SELECTHEALTH
SX107
Eligibility
Simply HealthCare Plans (new payer ID SMPLY as of 12-1-2018)
Simply Healthcare
Simply HealthCare Plans (New PID SMPLY effective 12/1/18)
SMPLY
Eligibility
South Dakota Blue Cross Blue Shield
Blue Shield of South Dakota
SDBLS
Eligibility
Star HRG
STARH
Eligibility
Tennessee Blue Cross Blue Shield
Blue Shield of Tennessee
TNBLS
Eligibility
Texas Blue Cross Blue Shield
Blue Shield of Texas (includes Blue Cross of Texas)
Blue Shield of Texas
TXBLS
Eligibility
Tricare for Life
TRLIF
Eligibility
U OF U HEALTH PLANS
SX155
Eligibility
UCare Minnesota
UCARE
Eligibility
University Family Care Arizona
UFCAZ
Eligibility
Utah Blue Cross Blue Shield (Regance)
UTBLS
Eligibility
UTAH DEPARTMENT OF HEALTH
Utah Medicaid FFS
SKUT0
Eligibility
Virginia Anthem Blue Cross and Blue Shield Dental
Virginia Anthem Blue Cross Blue Shield Dental
VABLD
Eligibility
Virginia Anthem Blue Cross and Blue Shield
Local Choice
Blue Shield of Virginia
Priority Healthcare
Virginia State Employer Funds
Healthkeeper HMO
Virginia Anthem Blue Cross Blue Shield
Medicare Supplemental
Peninsula Healthcare
COVA (Commonwealth of VA)
Keycare PPO
VA State Employer Funds
Blue Care PPO
VABLS
Eligibility
Washington Blue Shield (Regence)
WABLS
Eligibility
Wellmark BCBS (Iowa
South Dakota)
Blue Shield of Iowa
Iowa Blue Cross Blue Shield
IABLS
Eligibility
West Virginia Blue Cross Blue Shield
Blue Shield of West Virginia
WVBLS
Eligibility
Western New York Blue Cross Blue Shield
WNYBS
Eligibility
Windsor Health Plan
WNDHP
Eligibility
Wisconsin Anthem Blue Cross and Blue Shield Dental
Wisconsin Anthem Blue Cross Blue Shield Dental
WIBLD
Eligibility
Wisconsin Anthem Blue Cross and Blue Shield
Blue Shield of Wisconsin
Blue Cross Blue Shield of Wisconsin
Wisconsin Anthem Blue Cross Blue Shield
Anthem Medicaid (WI) (Formerly BadgerCare)
WIBLS
Eligibility
Wyoming Blue Cross Blue Shield
Blue Shield of Wyoming
WYBLS
Eligibility
Wyoming Medicare
CMSEL
Eligibility

835s

Payer Name Payer Id Line of Business
Access Behavioral Care
Colorado Access (837P & 837)
Colorado Access HMO
COACC
Payment/Advice
Advantek Benefit Administrators
ADVTK
Payment/Advice
Alabama Blue Shield (Professional)
Blue Shield of Alabama
Blue Cross of Alabama
ALBLS
Payment/Advice
Amerigroup
Amerigroup/Wellpoint New Jersey
Amerivantage
Amerigroup Wellpoint
Amerigroup Vantage
Amerigroup Wellpoint
Amerigroup/Wellpoint Arizona
Amerigroup/Wellpoint Iowa
Amerigroup/Wellpoint Texas
Amerigroup/Wellpoint Washington
Amerigroup/Wellpoint Tennessee
Wellpoint Maryland
WLPNT
Payment/Advice
Amerihealth-NJ (Non-HMO Claims)
AmeriHealth - New Jersey (Non- HMO Claims)
SX075
Payment/Advice
Arizona Blue Cross Blue Shield
Blue Shield of Arizona
AZBLS
Payment/Advice
ASRM LLC
ASRM Corporation
ASRM
ASRM1
Payment/Advice
Auxiant
AUX01
Payment/Advice
Blue Chip of Rhode Island
RICHP
Payment/Advice
Blue Cross Community Options
Blue Cross Community Solutions Effect 12-14-14 payer ID00621
MCDIL
Payment/Advice
Blue Cross of Idaho
Idaho Blue Cross
IDBLC
Payment/Advice
Blue Shield of Alaska
AC032
Payment/Advice
Blue Shield of Arkansas
Arkansas Blue Cross Blue Shield
Blue Advantage of Arkansas
Health Advantage of Arkansas
ARBLS
Payment/Advice
Blue Shield of Delaware
Delaware Blue Cross Blue Shield
DEBLS
Payment/Advice
Blue Shield of Florida
Florida Blue Cross Blue Shield
Blue Cross Blue Shield of Florida
Florida Blue Shield
FLBLS
Payment/Advice
Blue Shield of Georgia (State Health of GA)
Georgia State Health Benefit Plan (Processed by GA BC/BS)
Blue Shield of Georgia
Georgia Anthem Blue Cross Blue Shield
State Merit GA
GABLS
Payment/Advice
Blue Shield of Hawaii
Hawaii Blue Cross Blue Shield
HIBLS
Payment/Advice
Blue Shield of Idaho
Idaho Blue Shield (Regence)
Blue Shield of Idaho (Per Provider Testing)
IDBLS
Payment/Advice
Blue Shield of Illinois
Illinois Blue Cross Blue Shield
ILBLS
Payment/Advice
Blue Shield of Indiana
Indiana Anthem Blue Cross Blue Shield
Indiana Anthem Blue Cross and Blue Shield
INBLS
Payment/Advice
Blue Shield of Kansas City
Blue Cross of Kansas City
Kansas City Blue Cross Blue Shield
KCBLS
Payment/Advice
Blue Shield of Kansas
Blue Cross of Kansas
Kansas Blue Cross Blue Shield
KSBLS
Payment/Advice
Blue Shield of Kentucky
Kentucky Anthem Blue Cross Blue Shield
KYBLS
Payment/Advice
Blue Shield of Louisiana
Blue Shield of Lousiana
State Employees Group Benefits
Louisiana Blue Cross Blue Shield
LABLS
Payment/Advice
Blue Shield of Maine
Maine Anthem Blue Cross and Blue Shield
Maine Anthem Blue Cross Blue Shield
MEBLS
Payment/Advice
Blue Shield of Massachusetts
MABLS
Payment/Advice
Blue Shield of Michigan
Michigan Blue Cross Blue Shield
MIBLS
Payment/Advice
Blue Shield of Minnesota
CCS (aka Comprehensive Care Systems)
Minnesota Blue Cross Blue Shield
MNBLS
Payment/Advice
Blue Shield of Mississippi
Mississippi Blue Cross Blue Shield
MSBLS
Payment/Advice
Blue Shield of Missouri
Missouri Anthem Blue Cross and Blue Shield
Missouri Anthem Blue Cross Blue Shield
MOBLS
Payment/Advice
Blue Shield of New York
Western
Blue Cross Blue Shield Of Western New York
Blue Shield of Western New York
N1BLS
Payment/Advice
Blue Shield of South Carolina
South Carolina Blue Cross Blue Shield
SC FEP Blue Cross
Medicare Blue Advantage of South Carolina
SCBLS
Payment/Advice
Blue Shield of Tennessee
Blue Cross of Tennessee
5513I
Payment/Advice
Cal-Optima Direct
Caloptima
CALOPTIMA DIRECT
CALOP
Payment/Advice
Camp Lejune Family Member Program
CLFM1
Payment/Advice
CARE1ST Health Plan California
C1SCA
Payment/Advice
Caresource Georgia
Caresource of Georgia
CareSource of GA
GACS1
Payment/Advice
Caresource Indiana
CareSource Marketplace
CareSource IN
INCS1
Payment/Advice
CareSource KY
Caresource Humana
Humana Caresource
CareSource of Kentucky
KYCS1
Payment/Advice
Central California Women's Health
Central California Womens Health
WH001
Payment/Advice
Children's Specialists of San Diego
Childrens Specialist of San Diego
CSSD2
Payment/Advice
Colorado Anthem Blue Cross Blue Shield
Blue Shield of Colorado
Anthem of Colorado
Colorado Anthem Blue Cross and Blue Shield
COBLS
Payment/Advice
Community Health Plan Of Washington
SB613
Payment/Advice
Community Health Solutions (Claims now route to Medicaid of Louisiana)
Medicaid of Louisiana (Includes KidMed claims.)
Medicaid of Louisiana (837P
837I & 837D)
Louisiana Medicaid
LAMCD
Payment/Advice
Complementary Healthcare Plan
CHP01
Payment/Advice
Connecticut Anthem Blue Cross Blue Shield
Blue Shield of Connecticut
Connecticut Anthem Blue Cross and Blue Shield
CTBLS
Payment/Advice
Connecticut Bluecare Family Plan (835s returned under CTBLS)
C3BLS
Payment/Advice
Contessa Health
CH201
Payment/Advice
Cook Childrens Health Plan CHIP
Cook Children's Health Plan
Cook Childrens Health Plan
CCHP1
Payment/Advice
Cox Health Plan (Requires Provider ID in Box 33a. Contact Cox Health Plan for ID.)
Cox Health Plan
00019
Payment/Advice
Delaware Medicaid
Medicaid of Delaware
Medicaid of Delaware
DEMCD
Payment/Advice
Dell Childrens Health Plan
DCHPM
Payment/Advice
Delta Health Systems
DHS01
Payment/Advice
Dignity Health - Sacramento Hospital claim shop for Mercy Medical Group
Woodland Clinic Medical Group and Hill Physicians Medical group (hospital risk)
Dignity Health - Sacramento Hosp claim shop-Mercy Med Group
HOSH1
Payment/Advice
Dignity Health Medical Foundation for Mercy Medical Group or Woodland Clinic Medical Group (professional risk)
for Mercy Medical Group or Woodland Clinic Medical Group
Dignity Health Med Found for Mercy Med Gr-Woodland Clin Med
PROH1
Payment/Advice
Dignity Health Medical Group (Inland Empire)
Dignity Health Med Group-Inland Empire (professional risk)
PROH4
Payment/Advice
DMBA
SX105
Payment/Advice
DMERC Region A Testing is required for claims requiring CMNs
DME Region A
DMERA
Payment/Advice
DMERC Region B Testing is required for claims requiring CMNs
DME Region B
DMERB
Payment/Advice
DMERC Region C Testing is required for claims requiring CMNs
DME Region C
DMERC
Payment/Advice
Dupage Medical Group
DUPAG
Payment/Advice
El Paso First Health Plans - CHIP
El Paso First - CHIP
El Paso First - CHIP I Par Plus
EPF03
Payment/Advice
EMI HEALTH
SX110
Payment/Advice
Federal Qualified Hlthcr Cntr via UGS
Federally Qualified Healthcare Clinic
FQHC1
Payment/Advice
Florida Community Care
FLCCR
Payment/Advice
GHI Medicare Part B of New York
Medicare Part B GHI
GHMCR
Payment/Advice
Golden State Medical Group
Nivano Physicians IPD
Nivano Physicians IPA
MBA01
Payment/Advice
Health Care Partners AZ
Health Care Partners of AZ
Health Care Partners -AZ (Dates of Service of 5-01-13&later)
HCP02
Payment/Advice
Health Plan San Mateo
Health Plan of San Mateo
HPSM1
Payment/Advice
Health Services Management
Inc. (NOTE: ANSI submitters can also submit to plans AHP
CMS
ONP
PCI
PHP and VHP with proper value in SBR04.)
Health Services Management
Inc. for AHS
Health Services Management
Inc. for BPA
Health Services Management
Inc. for ECOH
Health Services Management
Inc. for EHC
Health Services Management
Inc. for ENCR
Health Services Management
Inc. for FCM
Health Services Management
Inc. for HF
Health Services Management
Inc. for HT
Health Services Management
Inc. for MMSI
Health Services Management
Inc. for MSHO
Health Services Management
Inc. for PNET
Health Services Management
Inc. for PONE
Health Services Management (HSM)
Health Services Management
Inc. for SC
Health Services Management
Inc. for WEA
HSM01
Payment/Advice
Healthcare Management Administrator
Healthcare Management Administrators
Inc.
HMA01
Payment/Advice
Heritag+A601e Physician Network I Par Plus
SelectCare of TX (Houston) (Provider ID Required - Contact (713) 843-6780 to obtain ID.)
Texas Plus
HPN11
Payment/Advice
Independence Administrators
TA720
Payment/Advice
Kaiser Foundation Health Plan of CO (Remits returned KAISR)
Kaiser Foundation Health Plan of Colorado
COKSR
Payment/Advice
Kaiser Foundation Health Plan of GA(835 returned under KAISR
Kaiser Foundation Health Plan of Georgia
NG010
Payment/Advice
Kaiser Foundation Health Plan of Mid-Atlantic St(835 KAISR
Kaiser Foundation Health Plan of the Mid-Atlantic
Kaiser Foundation Health Plan of the Mid Atlantic
NG008
Payment/Advice
Kaiser Foundation Health Plan of Southern California
Kaiser Permanente Southern CA
KS001
Payment/Advice
Kaiser Foundation Health Plan of the NW (835 ret KAISR)
Kaiser Foundation Health Plan of the NW
NG009
Payment/Advice
Kaiser Foundation of Northern California
Kaiser Foundation Health Plan of Northern California
Kaiser Permanente Northern CA
KS003
Payment/Advice
Kentucky Medicare Part A Jurisdiction 15
Medicare Part B of Kentucky
KYMCR
Payment/Advice
Keystone Health Plan East - Claims
Pennsylvania Keystone Health Plan East (claims only)
PAKeystone Health Plan East (claims(835s returnedPAKEY)
PCBLS
Payment/Advice
Lifetime Benefit Solutions
EBSRM
Payment/Advice
Martins Point Health Care
MPHC1
Payment/Advice
Mass Health (MA Medicaid)
Medicaid of Massachusetts (Mass Health)
Medicaid of Massachusetts
Massachusetts Medicaid
MAMCD
Payment/Advice
MDX Hawaii
MDXHI
Payment/Advice
Med3000 Early Steps
Med3000 CMS Early Steps
EM350
Payment/Advice
Medicaid of Alabama
Alabama Medicaid
Medicaid of Alabama (for 837P & 837I claims)
ALMCD
Payment/Advice
Medicaid of Alaska
AKMCD
Payment/Advice
Medicaid of Arizona (AHCCCS)
Arizona Medicaid (AHCCCS)
Medicaid of Arizona (AHCCCS)
Medicaid of Arizona (AHCCCS)(837I & 837P)
AZMCD
Payment/Advice
Medicaid of Arkansas
Arkansas Medicaid
ARMCD
Payment/Advice
Medicaid of California (MediCal)
MediCal of California
MDCAL
Payment/Advice
Medicaid of Colorado
Colorado Medicaid
COMCD
Payment/Advice
Medicaid of Connecticut
Connecticut Medicaid
Medicaid of Connecticut (for 837P & 837I claims)
CTMCD
Payment/Advice
Medicaid of Florida
Florida Medicaid
Medicaid of Florida (for 837P & 837I claims)
FLMCD
Payment/Advice
Medicaid of Idaho
Idaho Medicaid
IDMCD
Payment/Advice
Medicaid of Indiana
Indiana Medicaid
INMCD
Payment/Advice
Medicaid of Iowa
Iowa Medicaid
IAMCD
Payment/Advice
Medicaid of Kansas
Kansas Medicaid
KSMCD
Payment/Advice
Medicaid of Kentucky
Kentucky Medicaid
KYMCD
Payment/Advice
Medicaid of Louisiana Rehab (Remits returned under LAMCD)
LAREH
Payment/Advice
Medicaid of Maine
Maine Medicaid
MEMCD
Payment/Advice
Medicaid of Maryland
Maryland Medicaid
MDMCD
Payment/Advice
Medicaid of Michigan
Michigan Medicaid
MIMCD
Payment/Advice
Medicaid of Minnesota
Minnesota Medicaid
MNMCD
Payment/Advice
Medicaid of Mississippi
Medicaid of Mississippi (for 837P & 837I claims)
Mississippi Medicaid
MSMCD
Payment/Advice
Medicaid of New Hampshire
New Hampshire Medicaid
NHMCD
Payment/Advice
Medicaid of New Jersey
New Jersey Medicaid
NJMCD
Payment/Advice
Medicaid of New Mexico
New Mexico Medicaid
NMMCD
Payment/Advice
Medicaid of New York
New York Medicaid
NYMCD
Payment/Advice
Medicaid of North Carolina
North Carolina Medicaid
Medicaid of North Carolina (for 837P and 837I claims)
NCMCD
Payment/Advice
Medicaid of North Dakota
North Dakota Medicaid
NDMCD
Payment/Advice
Medicaid of Ohio
Ohio Medicaid
OHMCD
Payment/Advice
Medicaid of Oklahoma
OKMCD
Payment/Advice
Medicaid of Oregon
Oregon Medicaid
ORMCD
Payment/Advice
Medicaid of Pennsylvania
Pennsylvania Medicaid
Medicaid of Pennsylvania (837P
835s returned under SKPA0)
PAMCD
Payment/Advice
Medicaid of Rhode Island
RIMCD
Payment/Advice
Medicaid of South Carolina
South Carolina Medicaid
SCMCD
Payment/Advice
Medicaid of South Dakota
South Dakota Medicaid
SDMCD
Payment/Advice
Medicaid of Tennessee (TennCare)
TennCare (Medicaid of Tennessee)
Tennessee Medicaid (TennCare)
TNMCD
Payment/Advice
Medicaid of Texas
Texas Medicaid
TXMCD
Payment/Advice
Medicaid of Vermont
Vermont Medicaid
VTMCD
Payment/Advice
Medicaid of Virginia
Virginia Medicaid
VAMCD
Payment/Advice
Medicaid of Washington DC
District of Columbia Medicaid
Medicaid of DC
DCMCD
Payment/Advice
Medicaid of Washington State
Washington Medicaid
Medicaid of Washington
WAMCD
Payment/Advice
Medicaid of West Virginia
West Virginia Medicaid
WVMCD
Payment/Advice
Medicaid of Wisconsin
Wisconsin Medicaid
WIMCD
Payment/Advice
Medicaid of Wyoming
Wyoming Medicaid
WYMCD
Payment/Advice
Medical Associates Health Plan
MAHP1
Payment/Advice
Medicare of MO (For pre-existing providers) Eastern & Wests
Medicare Part B of Kansas City (ASK)
KCMCR
Payment/Advice
Medicare Part B of Alabama
Alabama Medicare Part A Jurisdiction J
ALMCR
Payment/Advice
Medicare Part B of Arkansas
ARMCR
Payment/Advice
Medicare Part B of Colorado
SMCO0
Payment/Advice
Medicare Part B of Connecticut
CTMCR
Payment/Advice
Medicare Part B of Florida
FLMCR
Payment/Advice
Medicare Part B of Georgia
Georgia Medicare Part A Jurisdiction J
GAMCR
Payment/Advice
Medicare Part B of Illinois
ILMCR
Payment/Advice
Medicare Part B of Indiana
INMCR
Payment/Advice
Medicare Part B of Iowa
IAMCR
Payment/Advice
Medicare Part B of Kansas
KSMCR
Payment/Advice
Medicare Part B of Louisiana
LAMCR
Payment/Advice
Medicare Part B of Maine
MEMCR
Payment/Advice
Medicare Part B of Massachusetts
MAMCR
Payment/Advice
Medicare Part B of Michigan
Medicare Part B of Michigan (WPS)
Blue Cross Blue Shield Michigan Medicare
MIMCR
Payment/Advice
Medicare Part B of Minnesota
MNMCR
Payment/Advice
Medicare Part B of Missouri
Medicare Part B of MO (Eastern) (Specialty testing required)
MOMCR
Payment/Advice
Medicare Part B of Nebraska
NEMCR
Payment/Advice
Medicare Part B of New Hampshire
NHMCR
Payment/Advice
Medicare Part B of New Jersey
Medicare Part B of NJ (Specialty testing required)
NJMCR
Payment/Advice
Medicare Part B of New Mexico
NMMCR
Payment/Advice
Medicare Part B of New York (Empire)
NYMCR
Payment/Advice
Medicare Part B of North Carolina
North Carolina Medicare Part A Jurisdiction M
NCMCR
Payment/Advice
Medicare Part B of Oklahoma
OKMCR
Payment/Advice
Medicare Part B of Pennsylvania
PAMCR
Payment/Advice
Medicare Part B of Rhode Island
RIMCR
Payment/Advice
Medicare Part B of South Carolina
SCMCR
Payment/Advice
Medicare Part B of Tennessee
TNMCR
Payment/Advice
Medicare Part B of Texas
TXMCR
Payment/Advice
Medicare Part B of Upstate NY
N1MCR
Payment/Advice
Medicare Part B of Vermont
VTMCR
Payment/Advice
Medicare Part B of Virginia
VAMCR
Payment/Advice
Medicare Part B of West Virginia
WVMCR
Payment/Advice
Medicare Part B of Wisconsin
WIMCR
Payment/Advice
Medicare Railroad * (MetraHealth Medicare)
Medicare Railroad (MetraHealth Medicare)
RRWMC
Payment/Advice
Meridian Health Plan of Illinois
MeridianTotal (Meridian Complete
Illinois Complete
YouthCare and Ambetter Payer ID effective 01-01- 2021)
MeridianTotal (Meridian Complete
Illinois Complete
YouthCare and Ambetter Payer ID effective 01-01-2021)
MHPIL
Payment/Advice
MI Blue Care HMO (BCN of MI-835s returned MIBLS)
Michigan Blue Care HMO (BCN of Michigan)
Blue Cross MI Blue Care Complete
MIBCN
Payment/Advice
Michigan Medicare PlusBlue (835s returned under MIBLS)
Michigan Medicare PlusBlue
MIMPB
Payment/Advice
MINNESOTA DEPARTMENT OF HEALTH- SAGE PROGRAMS
MNDH1
Payment/Advice
Missouri Medicaid
Medicaid of Missouri
MOMCD
Payment/Advice
Molina Healthcare of New Mexico
NM505
Payment/Advice
MOLINA HEALTHCARE OF UTAH
SX109
Payment/Advice
Molina Healthcare of Wisconsin
Abri Healthplan (Now known as Molina Health Care of WI)
Abri Healthplan
ABRI1
Payment/Advice
Montana Medicaid
Medicaid of Montana
MTMCD
Payment/Advice
Mountain Health CO-OP
MHC01
Payment/Advice
Mutual of Omaha
MUTOM
Payment/Advice
National Elevator
National Elevator Industry Benefit Plan (NEIB)
CX045
Payment/Advice
Nebraska Blue Cross Blue Shield
Blue Shield of Nebraska
NEBLS
Payment/Advice
Nebraska Medicaid
Medicaid of Nebraska
NEMCD
Payment/Advice
Nevada Anthem Blue Cross Blue Shield
Blue Shield of Nevada
Anthem of Nevada
Nevada Anthem Blue Cross and Blue Shield
NVBLS
Payment/Advice
New Hampshire Anthem Blue Cross Blue Shield
Blue Shield of New Hampshire
New Hampshire Anthem Blue Cross and Blue Shield
NHBLS
Payment/Advice
New Mexico Blue Cross Blue Shield
Blue Shield of New Mexico
Lovelace Sandia Health Plan (Acquired by Blue Shield of NM)
NMBLS
Payment/Advice
New York Blue Cross Blue Shield (Empire)
Blue Shield of New York (Empire)
NYBLS
Payment/Advice
North Carolina Blue Cross Blue Shield
Blue Shield of North Carolina
NCBLS
Payment/Advice
North Dakota Blue Cross Blue Shield
Blue Shield of North Dakota
NDBLS
Payment/Advice
Ohio Anthem Blue Cross Blue Shield
Blue Shield of Ohio
Ohio Anthem Blue Cross and Blue Shield
OHBLS
Payment/Advice
Ohio Medicare Part A Jurisdiction 15
Medicare Part B of Ohio
OHMCR
Payment/Advice
Optum Medical Network (previously Lifeprint)
OptumCare / AZ
NV
UT (formerly Optum Medical Network & Lifeprint Network))
OptumCare / AZ
UT (formerly Lifeprint Network)
LIFE1
Payment/Advice
Oregon Blue Cross Blue Shield (Regence)
Blue Shield of Oregon
ORBLS
Payment/Advice
Pacific Partners Management Services Inc
A0062
Payment/Advice
Partnership Health Plan contact OptumInsight Enrollments Dep
Partnership Health Plan of CA
PHP02
Payment/Advice
Pennsylvania Blue Cross Blue Shield (Highmark)
Blue Shield of Pennsylvania
PABLS
Payment/Advice
Pennsylvania Keystone Health Plan East (encounters only)
Keystone Health Plan East - Encounters
PA Keystone Health Plan E(encounters only-835s return PAKEY)
PEBLS
Payment/Advice
Physician Associates of Greater San Gabriel Valley
PA513
Payment/Advice
Physicians Medical Group of San Jose
Physicians Health Plan of Michigan Medicare
EXC01
Payment/Advice
Presbyterian Health Plan (Commercial) (Provider ID is required. Contact (888) 923-5757 6 then 2 to obtain ID. New Mexico Providers only.)
Presbyterian Health Plan
PREHP
Payment/Advice
Prime Community Care Central Valley
Prime Community Care of Central Valley(837I & 837P)
MVCV1
Payment/Advice
Prodegi
U8151
Payment/Advice
Providence Insurance & Administrative Services
Providence Administrative Services
PAS01
Payment/Advice
PUBLIC EMPLOYEES HEALTH PROGRAM
PEHP
SX106
Payment/Advice
Rady Children's Network
Rady Children's Health Network
RCHN1
Payment/Advice
REGENCE BLUE CROSS BLUE SHIELD OF UTAH (Includes FEP)
U1100
Payment/Advice
Rhode Island Blue Cross Blue Shield
Blue Shield of Rhode Island
RIBLS
Payment/Advice
Rocky Mountain HMO
RMHMO
Payment/Advice
SALT LAKE COUNTY BEHAVIORAL HEALTH SERVICES
HT007488-001
Payment/Advice
Scripps Health Plan Services
SHPS1
Payment/Advice
SELECTHEALTH
SX107
Payment/Advice
Sharp Community Medical Group
SCMG1
Payment/Advice
Sharp Health Plan
SHP01
Payment/Advice
Sharp Rees-Stealy Med Group
Sharp Rees-Stealy Medical Group
SRS83
Payment/Advice
South Dakota Blue Cross Blue Shield
Blue Shield of South Dakota
SDBLS
Payment/Advice
South Dakota Chiropractic (Sanford Health Plan)
Sanford Health Plan
CASD2
Payment/Advice
Stirling Benefits
STL01
Payment/Advice
Sutter Conn Sutter Med SMG
SWMG
SIP)800-611-5191 setup&test
Sutter Connect Medical Group
IP092
Payment/Advice
Sutter Connect Central Valley Medical Group
IP131
Payment/Advice
Tennessee Blue Cross Blue Shield
Blue Shield of Tennessee
TNBLS
Payment/Advice
Texas Blue Cross Blue Shield
Blue Shield of Texas (includes Blue Cross of Texas)
Blue Shield of Texas
TXBLS
Payment/Advice
Texas First Health Plans
Texas First Health Plan
TX1ST
Payment/Advice
TLC Benefit Solutions
TLC79
Payment/Advice
Tricare East (effective 01-01-2018)
Tricare East
Tricare East Effective 1-1-2018
TREST
Payment/Advice
Tricare for Life (All Regions 1-12)
Tricare for Life
TDDIR
Payment/Advice
U OF U HEALTH PLANS
SX155
Payment/Advice
UC Davis Health Systems
UC Davis Health System
UCDMG
Payment/Advice
UNITED HEALTHCARE SERVICES INC(Optum Salt Lake)
OptumHealth SLC
Optum Tooele
U6885
Payment/Advice
Univera Health Care Plan/ChoiceCare Buffalo
Univera Healthcare
SX087
Payment/Advice
USHealth Group
USHA1
Payment/Advice
UTAH DEPARTMENT OF HEALTH
Utah Medicaid FFS
SKUT0
Payment/Advice
VA Patient-Centered Community Care Program (VAPCCC) Reg 5A
VAP5A
Payment/Advice
VALLEY HEALTH PLAN
VHP01
Payment/Advice
Virginia Anthem Blue Cross and Blue Shield
Local Choice
Blue Shield of Virginia
Priority Healthcare
Virginia State Employer Funds
Healthkeeper HMO
Virginia Anthem Blue Cross Blue Shield
Medicare Supplemental
Peninsula Healthcare
COVA (Commonwealth of VA)
Keycare PPO
VA State Employer Funds
Blue Care PPO
VABLS
Payment/Advice
Virginia Premier Elite Plus
VPEP1
Payment/Advice
WA State Premera Blue Cross (835s returned under AC032)
Washington State Premera Blue Cross
WABLC
Payment/Advice
Washington Dept. of Labor & Industries
Washington State Labor and Industry
WALAI
Payment/Advice
Wellmark BCBS (Iowa
South Dakota)
Blue Shield of Iowa
Iowa Blue Cross Blue Shield
IABLS
Payment/Advice
West Virginia Blue Cross Blue Shield
Blue Shield of West Virginia
WVBLS
Payment/Advice
Wisconsin Anthem Blue Cross and Blue Shield
Blue Shield of Wisconsin
Blue Cross Blue Shield of Wisconsin
Wisconsin Anthem Blue Cross Blue Shield
Anthem Medicaid (WI) (Formerly BadgerCare)
WIBLS
Payment/Advice
WPS Commercial
OOWPS
Payment/Advice
Wyoming Blue Cross Blue Shield
Blue Shield of Wyoming
WYBLS
Payment/Advice