Office Ally may, at its sole option, add or remove Payers to the Services at any time. Office ally will use commercially reasonable efforts to provide Customer with written notice of such removals.
Payer Name
Payer ID
Transaction
Available
Non Par
Enrollment
Secondary
attachment
WC / Auto
NOTES
Humana Behavioral Health (formerly LifeSynch)
Payer ID
61101
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Behavioral Health (formerly LifeSynch) 61101 837P
Humana Behavioral Health (formerly LifeSynch)
Payer ID
61101
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Behavioral Health (formerly LifeSynch) 61101 837I
Humana Behavioral Health (formerly LifeSynch)
Payer ID
61101
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Behavioral Health (formerly LifeSynch) 61101 835
Humana Encounters
Payer ID
61102
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Encounters 61102 837P
Humana Encounters
Payer ID
61102
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Encounters 61102 837I
Humana Gold Choice
Payer ID
61101
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Gold Choice 61101 837P
Humana Gold Choice
Payer ID
61101
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Gold Choice 61101 837I
Humana Gold Choice
Payer ID
61101
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Gold Choice 61101 835
Humana Gold Plus
Payer ID
61101
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Gold Plus 61101 837P
Humana Gold Plus
Payer ID
61101
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Gold Plus 61101 837I
Humana Gold Plus
Payer ID
61101
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Gold Plus 61101 835
Humana Health Plans of Ohio
Payer ID
95348
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Health Plans of Ohio 95348 837P
Humana Healthy Horizons Oklahoma
Payer ID
61101
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Healthy Horizons Oklahoma 61101 837P
Humana Healthy Horizons Oklahoma
Payer ID
61101
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Healthy Horizons Oklahoma 61101 837I
Humana Healthy Horizons Oklahoma
Payer ID
61101
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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ERA enrollment forms will be listed under Humana.
Humana Healthy Horizons Oklahoma 61101 835
Humana LTSS Claims
Payer ID
61115
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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For LTSS claims with DOS on/after January 1, 2017.
Humana LTSS Claims 61115 837P
Humana LTSS Claims
Payer ID
61115
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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For LTSS claims with DOS on/after January 1, 2017.
Humana LTSS Claims 61115 837I
Humana Long Term Care (LTC)
Payer ID
61115
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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For LTC claims with DOS on/after January 1, 2017.
Humana Long Term Care (LTC) 61115 837P
Humana Long Term Care (LTC)
Payer ID
61115
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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For LTC claims with DOS on/after January 1, 2017.
Humana Long Term Care (LTC) 61115 837I
Humana Long Term Care (LTC)
Payer ID
HUMANA-LTC
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Long Term Care (LTC) HUMANA-LTC 270 / 271
Humana Ohio 2
Payer ID
Z0005
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Ohio 2 Z0005 837P
Humana Ohio Medicaid
Payer ID
61103
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Ohio Medicaid 61103 837P
Humana Ohio Medicaid
Payer ID
61103
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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Humana Ohio Medicaid 61103 837I
Humana Ohio Medicaid
Payer ID
61103
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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ERA Enrollment should be completed under Medicaid Ohio. If you are already approved to receive ERA for Medicaid of Ohio, you do not have to re-enroll.
Humana Ohio Medicaid 61103 835
Humana Ohio Medicaid
Payer ID
HUMANA-OHMCD
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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Humana Ohio Medicaid HUMANA-OHMCD 270 / 271
Humana Puerto Rico
Payer ID
65018
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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Humana Puerto Rico 65018 837P
Humana Puerto Rico
Payer ID
65018
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humana Puerto Rico 65018 837I
Humboldt Del Norte Foundation IPA
Payer ID
HDNFC
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humboldt Del Norte Foundation IPA HDNFC 837P
Humboldt Del Norte Foundation IPA
Payer ID
HDNFC
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Humboldt Del Norte Foundation IPA HDNFC 837I
Huntington Park Mission Medical Group
Payer ID
CAPMN
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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Huntington Park Mission Medical Group CAPMN 837P
Huntington Park Mission Medical Group
Payer ID
CAPMN
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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Huntington Park Mission Medical Group CAPMN 837I
Huntington Park Mission Medical Group
Payer ID
CAPMN
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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ERA enrollment under Conifer Health Solutions.
Huntington Park Mission Medical Group CAPMN 835
Hutchinson Technology - CORVEL
Payer ID
J1626
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
View note
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Workers Comp and Auto.
Hutchinson Technology - CORVEL J1626 837P
Hylton Payroll (Benefit Plan Administrators)
Payer ID
19753
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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Hylton Payroll (Benefit Plan Administrators) 19753 837P
Hylton Payroll (Benefit Plan Administrators)
Payer ID
19753
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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Hylton Payroll (Benefit Plan Administrators) 19753 837I
I. E. Shaffer
Payer ID
22175
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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West Trenton, New Jersey.
I. E. Shaffer 22175 837P
I. E. Shaffer
Payer ID
22175
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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West Trenton, New Jersey.
I. E. Shaffer 22175 837I
I. E. Shaffer
Payer ID
22175
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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West Trenton, New Jersey.
I. E. Shaffer 22175 835
IAC Life
Payer ID
30360
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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IAC Life 30360 837P
IAC Life
Payer ID
30360
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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IAC Life 30360 837I
IBC Personal Choice
Payer ID
54704
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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IBC Personal Choice 54704 837P
IBC Personal Choice
Payer ID
54704
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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IBC Personal Choice 54704 837I
IBC Personal Choice
Payer ID
54704
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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IBC Personal Choice 54704 835
IBEW Local 6 - San Francisco Electrical Workers
Payer ID
BS001
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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They will have a prefix code of "XEL" as their member ID on the BSC card.
IBEW Local 6 - San Francisco Electrical Workers BS001 837P
IBEW Local 6 - San Francisco Electrical Workers
Payer ID
BS001
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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They will have a prefix code of "XEL" as their member ID on the BSC card.
IBEW Local 6 - San Francisco Electrical Workers BS001 837I
IBEW Local 6 - San Francisco Electrical Workers
Payer ID
BS001
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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They will have a prefix code of "XEL" as their member ID on the BSC card.
IBEW Local 6 - San Francisco Electrical Workers BS001 835
IBEW Local 640 & AZ Chapter NECA Health & Welfare Trust
Payer ID
74234
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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IBEW Local 640 & AZ Chapter NECA Health & Welfare Trust 74234 837P
IBEW: Local No. 1 Health and Welfare Fund (Mental Health)
Payer ID
44602
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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PO Box 6088 St. Louis MO 63139
IBEW: Local No. 1 Health and Welfare Fund (Mental Health) 44602 837P
IBEW: Local No. 1 Health and Welfare Fund (Mental Health)
Payer ID
44602
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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PO Box 6088 St. Louis MO 63139
IBEW: Local No. 1 Health and Welfare Fund (Mental Health) 44602 837I
IBG Administrators, LLC
Payer ID
81810
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IBG Administrators, LLC 81810 837P
IBG Administrators, LLC
Payer ID
81810
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IBG Administrators, LLC 81810 837I
ICare Health Options
Payer ID
26054
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Pls include Network id (pin) on claims. Call Frank Bove @ Atlantis Health Plan to obtain a network id, 212-747-8393.
ICare Health Options 26054 837P
IDS Property Casualty
Payer ID
C1099
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Auto
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Auto only.
IDS Property Casualty C1099 837P
IDS Property Casualty Insurance Company
Payer ID
12504
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Auto
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Auto Only. At this time, only Professional (HCFA) claims are accepted.
IDS Property Casualty Insurance Company 12504 837P
IEHP Dental (Admin by LIBERTY Dental Plan)
Payer ID
LDP12
Payer ID
Transaction
All
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IEHP Dental (Admin by LIBERTY Dental Plan) LDP12 837D
IHC Health Solutions
Payer ID
86304
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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IHC Health Solutions 86304 837P
IHC Health Solutions
Payer ID
86304
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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IHC Health Solutions 86304 837I
IL Youthcare (Centene)
Payer ID
68069
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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IL Youthcare (Centene) 68069 837P
IL Youthcare (Centene)
Payer ID
68069
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IL Youthcare (Centene) 68069 837I
IL Youthcare (Centene)
Payer ID
68069
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
View note
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ERA forms will be listed under Centene Corporation
IL Youthcare (Centene) 68069 835
ILWU Local 21 (FCHN)
Payer ID
91131
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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ILWU Local 21 (FCHN) 91131 837P
ILWU Local 21 (FCHN)
Payer ID
91131
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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ILWU Local 21 (FCHN) 91131 837I
IMA (Cotiva)
Payer ID
72091
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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1325 Barksdale Blvd Suite 300, Bossier City, LA 71111
IMA (Cotiva) 72091 837P
IMA (Cotiva)
Payer ID
72091
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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1325 Barksdale Blvd Suite 300, Bossier City, LA 71111
IMA (Cotiva) 72091 837I
IMA, Inc
Payer ID
64556
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IMA, Inc 64556 837P
IMA, Inc
Payer ID
64556
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IMA, Inc 64556 837I
IMCare
Payer ID
41600
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IMCare 41600 837P
IMCare
Payer ID
41600
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IMCare 41600 837I
IMCare
Payer ID
41600
Payer ID
Transaction
All
Dental Claims
837D
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IMCare 41600 837D
IMCare
Payer ID
41600
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IMCare 41600 835
IMS - Trial Card (TC-IMS)
Payer ID
56155
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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PO Box 21145 Eagan MN 55121
IMS - Trial Card (TC-IMS) 56155 837P
IMS - Trial Card (TC-IMS)
Payer ID
56155
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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PO Box 21145 Eagan MN 55121
IMS - Trial Card (TC-IMS) 56155 837I
IMS TPA
Payer ID
87765
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IMS TPA 87765 837P
IMS TPA
Payer ID
87765
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IMS TPA 87765 837I
IMS TPA: Parton Lumber (UCS)
Payer ID
17882
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Effective January 1, 2017.
IMS TPA: Parton Lumber (UCS) 17882 837P
IMS TPA: Parton Lumber (UCS)
Payer ID
17882
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Effective January 1, 2017.
IMS TPA: Parton Lumber (UCS) 17882 837I
IMS TPA: The Spencer Group
Payer ID
52393
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Effective January 1, 2017.
IMS TPA: The Spencer Group 52393 837P
IMT
Payer ID
J3930
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp
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Workers Comp only.
IMT J3930 837P
IN Physician Associates
Payer ID
INPA1
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IN Physician Associates INPA1 837P
IN Physician Associates
Payer ID
INPA1
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IN Physician Associates INPA1 837I
IN Physician Associates
Payer ID
INPA1
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IN Physician Associates INPA1 835
INDECS Corporation
Payer ID
40585
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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INDECS Corporation 40585 837P
INDECS Corporation
Payer ID
40585
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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INDECS Corporation 40585 837I
INDECS Corporation
Payer ID
40585
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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INDECS Corporation 40585 835
INS Health Services (AKA ICE Health)
Payer ID
VAICE
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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TAR # required in Box 23 (HCFA) or 63 (UB). If submitting ANSI, Loop 2300 REF*G1.
INS Health Services (AKA ICE Health) VAICE 837P
INS Health Services (AKA ICE Health)
Payer ID
VAICE
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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TAR # required in Box 23 (HCFA) or 63 (UB). If submitting ANSI, Loop 2300 REF*G1.
INS Health Services (AKA ICE Health) VAICE 837I
IPMG Claims Management Services
Payer ID
J1887
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp
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Workers Comp Only. At this time, only Professional (HCFA) claims are accepted.
IPMG Claims Management Services J1887 837P
IPS SAGE 1
Payer ID
SAGE1
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IPS SAGE 1 SAGE1 837P
IPS SAGE 1
Payer ID
SAGE1
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IPS SAGE 1 SAGE1 837I
IQVIA
Payer ID
15060
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IQVIA 15060 837P
IQVIA
Payer ID
15060
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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IQVIA 15060 837I
ISO International Student Insurance
Payer ID
ISOSH
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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ISO International Student Insurance ISOSH 837P
ISO International Student Insurance
Payer ID
ISOSH
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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ISO International Student Insurance ISOSH 837I
ISS Facility Services - CORVEL
Payer ID
J2276
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Workers Comp and Auto.
ISS Facility Services - CORVEL J2276 837P
Ichahn Automotive Group (Pep Boys & AutoPlus) - CORVEL
Payer ID
J3747
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Workers Comp and Auto.
Ichahn Automotive Group (Pep Boys & AutoPlus) - CORVEL J3747 837P
Illinicare Health Plan (Centene)
Payer ID
ILLINICARE
Payer ID
Transaction
All
Eligibility
270 / 271
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Illinicare Health Plan (Centene) ILLINICARE 270 / 271
Illinois Casualty
Payer ID
J1575
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
Work Comp & Auto
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Workers Comp and Auto. At this time, only Professional (HCFA) claims are accepted.
Illinois Casualty J1575 837P
Illinois Health Plans (IHP)
Payer ID
DMG01
Payer ID
Transaction
All
Professional Claims
837P
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Illinois Health Plans (IHP) DMG01 837P
Illinois Health Plans (IHP)
Payer ID
DMG01
Payer ID
Transaction
All
Institutional Claims
837I
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Illinois Health Plans (IHP) DMG01 837I
Illinois Health Plans (IHP)
Payer ID
DMG01
Payer ID
Transaction
All
Remits
835
Support
Available
Non Par
Non-participating payer
Enrollment
Enrollment required
Secondary
Secondary
Attachment
Available
WC / Auto
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Enrollment is completed under Dupage Medical Group
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