Payer List - Professional (CMS1500) & Institutional (UB04)

  Download the full list

 
  • ENR = Pre Enrollment Required
  • TYP = Type/Model
  • C/P - Commercial/Par
  • G/NP - Government/Non-Par
  • ST = State
  • LOB = Line Of Business
  • M = Medical / Professional
  • H = Hospital / Institutional
  • RTE = Real Time Eligibility (270/271)
  • RTS = Real Time Claim Status (276/277)
  • ERA = Electronic Remittance Advice (835)
  • SEC = Secondary (COB)


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Payer IDPayer NameENRTYPSTLOBRTERTSERASECNote
13162 1199 National Benefit Fund N C/P M/H N N Y Y IVR: (888) 819-1199. Customer Service: (646) 473-7160. Pre-Enrollment is required for Electronic Remittance Advice.
59069 21st Century Health and Benefits N C/P M/H N N N Y
20413 3P Administrators N C/P M/H N N Y Y Pre-Enrollment required for Electronic Remittance Advice.
4YC01 4 YourChoice EPO/PPO Network N C/P M/H N N Y Y Payer returns ERA's automatically once electronic claim submission begins.
74234 8th District Elec N C/P UT M N N N Y Customer Service: (800) 628-6562
93044 A & I Benefit Plan Administrators N G/NP M/H N N N Y Customer Service: (800) 547-4457
75240 AAG - American Administrative Group N C/P M/H N N N Y Formerly Icon Benefit Admin
75240 AAG Benefit Plan Administrators, Inc. N C/P M/H N N N Y
36273 AARP Hospital Indemnity Plans insured by UnitedHealthcare Insurance Company N C/P M/H N N Y Y Customer Service: (800) 227-7789. Pre-Enrollment is required for Electronic Remittance Advice.
36273 AARP Medicare Supplement Plans insured by UnitedHealthcare Insurance Company N C/P M/H N N Y Y Customer Service: (800) 227-7789. Pre-Enrollment is required for Electronic Remittance Advice.
87726 AARP MedicareComplete insured through UnitedHealthcare (formerly AARP MedicareComplete from SecureHorizons) N C/P M/H N N Y Y Customer Service: (866) 633-2446. Pre-Enrollment is required for Electronic Remittance Advice.
87726 AARP MedicareComplete insured through UnitedHealthcare / Oxford Medicare Network - AARP MedicareComplete N C/P M/H N N N Y Customer Service: (866) 633-2446
87726 AARP MedicareComplete insured through UnitedHealthcare / Oxford Mosaic Network - AARP MedicareComplete Mosaic N C/P M/H N N N Y Customer Service: (866) 633-2446
03443 ABRAZO Advantage Health Plan N C/P M/H N N N Y
68068 Absolute Total Care - Cenpatico N G/NP SC M/H N N Y Y Customer Service: (866) 912-6285. ERA enrollment forms will be listed under Centene Corporation.
68069 Absolute Total Care - Medical N G/NP SC M/H N N Y Y Customer Service: (866) 595-8133. ERA enrollment forms will be listed under Centene Corporation.
AHS01 Access Administrators N G/NP M/H N N N Y
COACC Access Behavioral Care N C/P CO M N N N Y Customer Service: (800) 511-5010
ACC01 Access IPA N C/P CA M/H N N Y Y Payer returns ERA's automatically once electronic claim submission begins.
AMM06 Access Medical Group N C/P CA M/H N N N N
19305 Access Medicare (Cuatro LLC) N G/NP M/H N N Y N Pre-Enrollment is required for Electronic Remittance Advice.
AMM06 Access Santa Monica N C/P CA M/H N N N N
64071 Acclaim N C/P M N N N Y
IP095 Acclaim IPA N C/P CA M/H N N N Y
IP095 Acclaim IPA (MHCAC) N C/P CA M/H N N N Y
MPM24 Accountable Anthem Beverly POD N C/P CA M/H N N N Y Customer Service: (818) 702-0100
MPM23 Accountable HealthCare IPA (MPM) N C/P CA M/H N N N Y Customer Service: (818) 702-0100.
AHIPA Accountable IPA N C/P CA M/H N N N N Customer Service: (562) 435-3333.
72467 ACS Benefit Services, Inc. N G/NP M N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
24585 ACTIN Care Groups / Clifton Health Systems N C/P M/H N N N Y
75678 Active Care (UCS) N C/P M/H N N N Y
AHC01 ActivHealthCare N C/P M N N N N Customer Service: (888) 635-0459
38254 Activia Benefit Services N C/P M/H N N Y Y Pre-Enrollment required for Electronic Remittance Advice.
38265 Administration Systems Research Corp N G/NP M/H N N N Y
38265 Administration Systems Research Health Benefits N G/NP M/H N N N Y
22384 Administrative Concepts Inc. N G/NP M/H N N Y Y Pre-Enrollment required for Electronic Remittance Advice.
59141 Administrative Services Inc N C/P M/H N N N Y
37278 AdminOne N C/P M/H N N Y N Pre-Enrollment is required for Electronic Remittance Advice.
NMM01 Advanced Physicians IPA N C/P M/H N N N Y Customer Service: (626) 282-0288
74234 Advanstaff, Inc. N C/P M N N N N
ACIPA Advantage Care IPA N C/P CA M/H N N N Y Customer Service: (626) 388-2300
35209 Advantage Health Solutions N C/P M/H N N N N
35219 Advantage Health Solutions (CMCS) - Medicare Advantage N C/P M/H N N N N
NMM01 Advantage Medical Group N C/P M/H N N N Y Customer Service: (626) 282-0288
77070 Advantage Preferred Plus N C/P M/H N N N N
ADVTK Advantek Benefit Administrators (SANTE) N C/P M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
59374 Advantica Benefits N C/P M N N N Y
95340 Adventist Health System West N G/NP CA M/H N N Y Y Roseville, California. Pre-Enrollment is required for Electronic Remittance Advice.
45423 Advicare N G/NP M/H N N N Y For claims with DOS prior to 9/1/2016.
36320 Advocate Health Centers N C/P M/H N N N Y
65093 Advocate Health Partners N G/NP IL M/H N N N Y
60054 Aetna Advantage N C/P M/H Y Y Y Y Customer Service: (888) 632-3862. Pre-Enrollment is required for Electronic Remittance Advice.
60054 Aetna Affordable Health Choices - SRC/Boone N C/P M/H Y Y Y Y Customer Service: (888) 632-3862. Pre-Enrollment is required for Electronic Remittance Advice.
58730 Aetna ASA PPO/Assurant Health (Signature Admin) N G/NP M N N N N Customer Service: (888) 632-3862
66917 Aetna Better Health - Parkland (TX) N C/P TX M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
128FL Aetna Better Health of Florida N C/P FL M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
26337 Aetna Better Health of Illinois (Medicaid) N C/P IL M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
128KY Aetna Better Health of Kentucky N C/P KY M/H N N Y Y Formerly CoventryCares of Kentucky (25133). Pre-Enrollment is required for Electronic Remittance Advice.
128LA Aetna Better Health of Louisiana N C/P LA M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
128MD Aetna Better Health of Maryland N C/P MD M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
128MI Aetna Better Health of Michigan N C/P MI M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
128MO Aetna Better Health of Missouri (Medicaid) N C/P MO M/H N N Y Y Effective 6/29/2015. Pre-Enrollment is required for Electronic Remittance Advice.
42130 Aetna Better Health of Nebraska N C/P NE M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
128NV Aetna Better Health of Nevada N C/P NV M/H N N Y Y Effective 7/1/17. Pre-Enrollment is required for Electronic Remittance Advice.
46320 Aetna Better Health of New Jersey N C/P NJ M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
34734 Aetna Better Health of New York N C/P NY M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
50023 Aetna Better Health of Ohio N C/P OH M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
23228 Aetna Better Health of Pennsylvania (Medicaid) N C/P PA M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
38692 Aetna Better Health of Texas N C/P TX M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
128VA Aetna Better Health of Virginia N C/P VA M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
128VA Aetna Better Health of Virginia - CCC Plus N C/P VA M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
128WV Aetna Better Health of West Virginia N C/P WV M/H N N Y Y Formerly known as Coventry Healthcare of West Virginia (25133). Pre-Enrollment required for Electronic Remittance Advice.
60054 Aetna Choice Plans N C/P M/H Y Y Y Y Customer Service: (888) 632-3862. Pre-Enrollment is required for Electronic Remittance Advice.
60054 Aetna Health, Inc. N C/P M/H Y Y Y Y Customer Service: (888) 632-3862. Pre-Enrollment is required for Electronic Remittance Advice.
60054 Aetna Healthcare N C/P M/H Y Y Y Y Customer Service: (888) 632-3862. Pre-Enrollment is required for Electronic Remittance Advice.
60054 Aetna HealthFund N C/P M/H Y Y Y Y Customer Service: (888) 632-3862. Pre-Enrollment is required for Electronic Remittance Advice.
26337 Aetna Illinois Medicaid N C/P IL M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
60054 Aetna Life & Casualty Company N C/P M/H Y Y Y Y Customer Service: (888) 632-3862. Pre-Enrollment is required for Electronic Remittance Advice.
60054 Aetna Life Insurance Company N C/P M/H Y Y Y Y Customer Service: (888) 632-3862. Pre-Enrollment is required for Electronic Remittance Advice.
60054 Aetna Medicaid Plans N C/P M/H Y Y Y Y Customer Service: (888) 632-3862. Pre-Enrollment is required for Electronic Remittance Advice.
60054 Aetna Medicare N C/P M/H Y Y Y Y Customer Service: (888) 632-3862. Pre-Enrollment is required for Electronic Remittance Advice.
60054 Aetna Senior Plans N C/P M/H Y Y Y Y Customer Service: (888) 632-3862. Pre-Enrollment is required for Electronic Remittance Advice.
60054 Aetna Signature Administrators (ASA) N C/P M/H Y Y Y Y Customer Service: (888) 632-3862. Pre-Enrollment is required for Electronic Remittance Advice.
60054 Aetna Student Health N C/P M/H Y Y Y Y Customer Service: (888) 632-3862. Pre-Enrollment is required for Electronic Remittance Advice.
38692 Aetna TX Medicaid and CHIP N C/P TX M/H N N Y N Pre-Enrollment is required for Electronic Remittance Advice.
60054 Aetna US Healthcare - AUSHC N C/P M/H Y Y Y Y Customer Service: (888) 632-3862. Pre-Enrollment is required for Electronic Remittance Advice.
ADOCS Affiliated Doctor's of Orange County (ADOC) (Regal) N C/P CA M/H N N N N
APG01 Affiliated Physicians Group (APG) N G/NP IL M/H N N N Y
POP06 Affiliated Physicians IPA N C/P CA M N N N N
13333 Affinity Health (Medicare Advantage) N G/NP M/H N N Y Y Pre-Enrollment is required for Electronic Remittance Advice.
13334 Affinity Health Plan Y G/NP M/H Y N Y N Providers must contact Affinity's EDI Department before submitting claims electronically at EDI@Affinityplan.org.
23334 Affinity Health Plan Essential N G/NP M/H N N N Y
46594 Affinity Medical Group N C/P CA M/H N N N Y Customer Service: (800) 615-0261. Claim Status reports available at https://affinity-portals.ikaenterprise.com/Default.aspx.
95426 Affordable Benefit Administrators, Inc. N G/NP M/H N N N Y
62308 AFTRA Health & Retirement Funds N C/P M/H N N N Y For claims with DOS 1/1/15 and after. For DOS prior to 1/1/15, claims should be directed to Payer ID 13346.
LIPA1 Agate Resources, Inc. (LIPA) Y C/P OR M/H N N Y N ERA enrollment forms will be listed under Centene Corporation.
64158 Agency Services Inc. N G/NP M/H N N N Y Now known as Meritain Health
ARA01 AgeRight Advantage N C/P OR M/H N N Y N Effective 1/1/17. Payer returns ERA's automatically once electronic claim submission begins. To request paper EOB’s, email helpdesk@claimsnet.com.
AWNY6 AgeWell New York N C/P NY M/H N N Y N
AGUA1 Agua Caliente N C/P M N N N N
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