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Payer List Table of Contents Professional Claims Payer List 2 Institutional Claims Payer List 36 Eligibility Inquiry Payer List 49 Claim Status Inquiry Payer List 56 Electronic Remittance Advice Payer List 59 Brought to you by
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Payer List
Table of Contents
Professional Claims Payer List 2 Institutional Claims Payer List 36 Eligibility Inquiry Payer List 49
Claim Status Inquiry Payer List 56 Electronic Remittance Advice Payer List 59
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Payer Name State Enrollment Network
13162 1199 NATIONAL BENEFIT FUND NO IN31147 1-888-OHIOCOMP (Ohio BWC) NO OUT31147 3-Hab (Ohio BWC) NO OUT95241 A.G.I.A. Inc. NO IN75240 AAG Benefit Plan Administrators, Inc. NO IN48185 ABC HEALTH PLAN NO OUTE3510 ABMA Medical Corporation CA NO INAHS01 ACCESS ADMINISTRATORS NO INCOACC Access Behavioral Care CO NO IN76049 ACCESS PLUS (UTMB) NO IN64071 ACCLAIM NO IN21356 Acclaim Repricing NO INAHP01 Accountable Health - American Family claims only ALL NO IN81400 Accountable Health Plan NO IN87066 ACMG, Inc.(formally Formax, Inc.) NO OUT72467 ACS CNSULTING SERVICES, INC. NO IN36112 ACS Rewards Administration Center NO IN38254 ACTIVA BENEFIT SERVICES, LLC NO IN95285 ADMAR CORPORATION NO INSMKY0 AdminaStar Federal, Inc. (CMIC) US YES OUT38265 Administration Systems Research Corp. NO IN22384 Administrative Concepts, Inc. NO INSB740 Administrative Services of Kansas - ASK MO YES OUT37278 ADMINONE NO IN
ADOCS ADOC (Affiliated Doctors of Orange County) NO INAMM01 Advanced Medical Management NO OUT35209 Advantage Health Solutions NO IN25152 Advantra Freedom NO IN13373 ADVICA NEW YORK HOSPITAL COMMUNITY NY NO IN13376 ADVICA/NORTHEAST GEORGIA HEALTH GA NO IN31147 AdvoCare Incorporated (Ohio BWC) NO OUT36320 ADVOCATE HEALTH CENTERS NO IN65093 ADVOCATE HEALTH PlLANS NO IN60054 Aetna ALL NO IN57604 Aetna Affordable Health Choices (SM) - SRC NO IN38692 Aetna TX Medicaid & CHIP TX NO IN
ADOCS Affiliated Doctors of Orange County (ADOC) NO IN13334 Affinity Health Plan NO IN34444 AFL-CIO FOOD & BEVERAGE DEALERS NO IN13346 Aftra Health Fund NO IN20048 Agate Resources, Inc. (LIPA) NO IN64158 Agency Services Inc NO INIP080 AKM Medical Group CA NO IN06311 ALABAMA MEDICAL SURGICAL, LLC AL NO IN91136 Alaska Children's Services Inc. AK NO IN92600 Alaska Electrical Health & Welfare Fund NO IN91136 Alaska Laborers Construction AK NO IN91136 Alaska Pipe Traders Local 375 AK NO IN91136 Alaska United Food & Commercial AK NO IN13550 ALICARE NO IN58213 ALIGNIS NO IN39160 ALL SAINTS/COVENANT-MILWAUKEE, WI NO IN81040 Allegiance Benefit Plan Management, Inc. NO INADSL1 ALLIANCE - ALPHA CARE GOLD NO IN52149 Alliance PPO, Inc. NO IN81400 Alliance Select NO IN88461 Alliance, The (A Wisconsin Provider Network) WI NO inALNCE ALLIANCE/ALLIANCE SELECT NO IN58234 ALLIANT HEALTH PLANS (GEORGIA) GA NO OUT94177 ALLIED ADMINISTRATORS (S.F., CA) NO IN37308 ALLIED BENEFITS SYSTEMS NO INSX157 Allied Health - Podiatry (UHIN) YES OUTSX156 Allied Health Systems Chiropractic NO OUT75261 ALPHA DATA SYSTEMS NO IN
PROFESSIONAL CLAIMS PAYER LIST
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31147 ALPS CompCare (Ohio BWC) NO OUT80705 ALTA Health and Life Insurance Company NO INE3510 Alta Senior Care CA NO IN37231 Alternative Technology Resource (ATR) NO IN25149 Altuis NO OUTAMAIA AMA INSURANCE AGENCY NO OUT13550 AMALGAMATED LIFE NO IN
COMPU Amalgamated Transit Union Division 1001 Health & W CO NO IN81400 Amer Healthcare Plan Net NO IN38219 AmeraPlan NO OUT75137 AMERIBEN SOLUTIONS, INC. NO IN26375 Americaid - Dallas Forth Worth NO IN26374 Americaid / Amerigroup NO IN27517 AMERICAID COMMUNITY CARE(MARYLAND) MD NO IN27516 AMERICAID COMMUNITY CARE(NEWJERSEY) NJ NO IN37225 American Benefit Administrative Services, Inc. NO IN34187 AMERICAN BENEFITS MANAGEMENT (NORTH NO IN41161 AMERICAN CHIROPRACTIC NETWORK (PAN) NO IN41160 AMERICAN CHIROPRACTIC NETWORK IPA OF NY NY NO INACN01 American Chiropractic Network, Inc. NY NO IN87726 AMERICAN COMMERCIAL BARGE LINES ALL NO IN60305 AMERICAN COMMUNITY MUTUAL INSURANCE NO INACN01 American Complimentary Care Network, Inc. NY NO INIP080 American Family Health Providers CA NO INTH095 American Family Insurance NO IN98205 AMERICAN FOUNDERS LIFE INSURANCE CO. NO OUT62030 American General Life & Accident NO INAHG99 American Health Group NO OUT01066 American Healthcare Alliance NO IN36369 AMERICAN IMAGING MANAGEMENT NO OUT81949 AMERICAN INSURANCE COMPANY OF TEXAS TX NO OUT16412 American International Group Inc. (AIG) NO IN72099 AMERICAN LIFECARE NO IN81400 American Medical Security NO IN74048 American National Insurance NO INTH097 American Pioneer Brevard Physicians Network NO INTH096 American Pioneer South Florida NO IN44444 American Postal Workers Union NO IN14190 American PPO NO IN42011 American RepublicInsurance NO IN37322 American Worker Health Plan NO IN20029 America's Choice NMA NO IN86049 AmericChoice of Pennsylvania PA NO IN16412 AmeriChoice of Florida NO IN16412 AmeriChoice of Maryland NO IN16412 AmeriChoice of Nebraska NO IN86001 AmeriChoice of New Jersey NJ NO IN86002 AmeriChoice of New York NY NO IN16412 AmeriChoice of Rhode Island NO IN95378 Americhoice of Tennessee NO IN86003 AMERICHOICE PERSONAL CARE PLUS NO IN28809 Amerigroup - Florida FL NO IN28804 Amerigroup - Ft. Worth - Dallas NO IN27514 Amerigroup - Georgia GA NO IN28805 Amerigroup - Houston TX NO IN28808 Amerigroup - Illinois IL NO IN28807 Amerigroup - Maryland MD NO IN28806 Amerigroup - New Jersey NJ NO IN28804 Amerigroup - Tennessee NO IN27519 AMERIGROUP FLORIDA FL NO IN27518 AMERIGROUP ILLINOIS, OHIO NO IN23252 AMERIHEALTH ADMINISTRATORS NO IN54763 AmeriHealth Administrators PA YES IN93688 AmeriHealth DE (PPO) PA YES IN
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PROFESSIONAL CLAIMS PAYER LIST
93688C AmeriHealth DE (PPO) DE NO IN22248 AMERIHEALTH MERCY HEALTH PLAN NO IN60061 AmeriHealth NJ (PPO) PA YES IN
60061C AmeriHealth NJ (PPO) NJ NO IN23037C AmeriHealth NJ/DE (HMO) NO OUt95044 AmeriHealth NJ/DE (HMO) PA YES IN26375 Amerikids- DFW NO INIP080 AMVI CA NO IN38254 AMWAY CORPORATION NO IN53085 Anchor Benefit Counsulting NO IN86062 Ancillary Benefits/Arizona Foundation for Medical NO IN
SYMED Angeles IPA (SynerMed) NO IN34192 Antares Management Solutions NO IN80705 Anthem Health and Life Insurance Company of New Je NO IN16140 APA PARTNERS NO IN
PROSP APAC (Pinnacle Health Resources) (Prospect Medical NO IN34196 Apex Benefit Services NO IN54160 APS Healthcare, Inc. NO IN54100 APS Paper Claim NO IN16120 ARAZ NO IN77045 ARCADIAN MGMT SERVICES NO IN36356 Argus Health Systems NO INAMILR ARIA Network AMIL-Mediview NO IN
HMOBR ARIA Network- HMO Blue- Mediview NO IN03432 Arizona Physicians IPA AZ NO IN75278 Arkansas Best Corporation AR NO IN95440 Arnett Health Plans NO IN38265 ASR Corporation NO IN38265 ASR Health Benefits NO INATPA1 ASSOCIATED THIRD PARTY ADMINISTRATION - ATPA NO IN36326 ASSOCIATES FOR HEALTH CARE, INC NO IN39065 Assurant Employee Benefits (Formerly Fortis Insura NO IN70408 Assurant-Fortis Benefits NO IN74240 ASSURED BENEFITS ADMINISTRATORS NO IN93221 ASURIS NORTHWEST HEALTH NO IN95691 ATHENS AREA HEALTH PLAN NO OUT22304 ATLANTICARE ADMINISTRATORS, INC. NO IN13853 ATLANTIS HEALTH PLAN NO OUTATLAD Atlas Administrators NO IN90956 ATLAS LIFE INSURANCE COMPANY NO OUT31147 AultComp Managed Care Organization (Ohio BWC) NO OUT
CMSEB AUSTIN REGIONAL CLINIC EMPLOYEE NO IN38259 Automated Benefit Services NO IN37280 Automated Group Administration, Inc. IN NO IN91136 Automotive Machinists Local 289 AK NO INIP080 Avalon IPA CA NO IN31147 AvatarComp (Ohio BWC) NO OUT46045 AVERA HEALTH NO IN59274 AvMed Health Plan (providers must include their 6 NO INAZLUT AZ Lutheran PHO/Banner Health Systems NO INM3432 AZ PHYSICIANS IPA AZ NO OUT74227 BANKERS UNITED LIFE (STUDENT DIV) NO INSX145 Banner Health AZ YES INSX145 Banner Health Co, - ROCKY MOUNTAIN HMO GREELEY YES INSX145 Banner Health Co. - ANTERO GREELEY YES INSX145 Banner Health Co. - ANTERO HIGH PLAINS YES INSX145 Banner Health Co. - ANTERO MOUNTAIN SHADOWS YES INSX145 Banner Health Co. - CHOICE PLUS YES INSX145 Banner Health Co. - HMO GREELEY YES INSX145 Banner Health Co. - HMO HIGH PLAINS YES INSX145 Banner Health Co. - HMO MOUNTAIN SHADOWS YES INSX145 Banner Health Co. - PACIFICARE GREELEY YES INSX145 Banner Health Co. - PACIFICARE HIGH PLAINS YES INSX145 Banner Health Co. - PACIFICARE MOUNTAIN SHADOWS YES IN
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SX145 Banner Health Co. - ROCKY MOUNTAIN HMO HIGH PLAINS YES INSX145 Banner Health Co. - SECURE HORIZONS GREELEY YES INSX145 Banner Health Co. - SECURE HORIZONS HIGH PLAINS YES INSX145 Banner Health Co. - SECURE HORIZONS MOUNTAIN SHADO YES IN37248 Bass Administrators, Inc. NO IN16112 BATAVIA CITY SCHOOLS TRI-COUNTY NO IN49153 BCI Administrators, Inc. NO IN95377 BEECH STREET CORPORATION NO IN60054 BELL ATLANTIC ALL NO INPHP01 Bell Atlantic (Prudential) NO INPR002 Bell Atlantic (Prudential) NO INSYMED Bellflower Hospital (Synermed) NO IN33192 Benecorp National Corporation NO IN37125 BENEFIRST NO OUT36149 Benefit Administrative Systems NO IN51037 BENEFIT CONCEPTS NO IN25145 BENEFIT COORDINATORS CORPORATION NO IN
BMATP BENEFIT MANAGEMENT ADMIN (SAN NO INBMG01 BENEFIT MANAGEMENT GROUP, INC. (BMG) NO IN56139 BENEFIT MANAGEMENT SERVICES NO in00999 Benefit Management Services, Inc. (Blue Cross Blue NO IN37212 Benefit Management Systems NO IN62413 BENEFIT PLAN (CNA) NO IN13310 BENEFIT PLAN ADMIN OF ST LOUIS NO IN88027 BENEFIT PLAN ADMINISTRATORS (BPA) NO IN37118 BENEFIT PLAN ADMINISTRATORS (ROANOKE, VA) NO IN39081 BENEFIT PLAN ADMINISTRATORS, CO NO IN37286 BENEFIT PLAN ADMINISTRATORS, INC. NO IN37222 Benefit Plan Management, Inc. NO IN74223 Benefit Planners NO IN82468 Benefit Resources NO IN38257 Benefit Source, Inc NO IN36342 BENEFIT SYSTEMS & SERVICES, INC (BSSI) NO IN61425 BENEFIT TRUST LIFE NO IN87265 Benesight (formerly The TPA) NO IN37248 Benesys NO IN95604 Best Life & Health Insurance Co. NO IN32006 Better Health Plans of South Carolina NO IN62183 BETTER HEALTH PLANS, INC. NO INSX002 BHSG of Tennessee YES OUTCX025 BIG LOTS ASSOCIATES BENEFIT PLANS NO INECIBB BLUE BELL BENEFITS TRUST NO INBS562 Blue Care Family/Anthem Medicaid CT YES OUTBS062 Blue Choice - Missouri MO YES OUTBS900 Blue Choice Network TX NO OUTHM006 Blue Cross - California Care - HMO CA NO INBS029 Blue Cross - Virginia - Trigon VA YES OUTBS731 Blue Cross Blue Shield Mississippi State and Teach NO OUTBS510 Blue Cross Blue Shield of Alabama AL NO OUTBS530 Blue Cross Blue Shield of Arizona AZ YES OUT00520 Blue Cross Blue Shield of Arkansas AR YES INBS550 Blue Cross Blue Shield of Colorado (Anthem) CO YES INBS563 Blue Cross Blue Shield of Connecticut CT YES OUTBS560 Blue Cross Blue Shield of Connecticut (Anthem) CT NO INBS580 Blue Cross Blue Shield of DC - CareFirst DC NO OUTBS570 Blue Cross Blue Shield of Delaware DE YES OUTBS590 Blue Cross Blue Shield of Florida FL YES OUTBS600 Blue Cross Blue Shield of Georgia GA NO IN00621 Blue Cross Blue Shield of Illinois IL NO INBS630 Blue Cross Blue Shield of Indiana (Anthem) IN NO INBS030 Blue Cross Blue Shield of Iowa IA YES OUTBS650 Blue Cross Blue Shield of Kansas KS YES OUTBS651 Blue Cross Blue Shield of Kansas HMO FEP KS YES OUTBS652 Blue Cross Blue Shield of Kansas HMO Regular KS YES OUT
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BS653 Blue Cross Blue Shield of Kansas HMO Senior Plan KS YES OUTBS660 Blue Cross Blue Shield of Kentucky (Anthem) KY NO IN23738 Blue Cross Blue Shield of Louisiana LA YES OUTBS680 Blue Cross Blue Shield of Maine (Anthem) ME NO INBS690 Blue Cross Blue Shield of Maryland - CareFirst MD NO OUTBS700 Blue Cross Blue Shield of Massachusetts MA YES INBS710 Blue Cross Blue Shield of Michigan MI YES OUTBS711 Blue Cross Blue Shield of Michigan - Blue Care Net MI YES OUTBS720 Blue Cross Blue Shield of Minnesota MN YES OUTBS730 Blue Cross Blue Shield of Mississippi MS YES INBS241 Blue Cross Blue Shield of Missouri (Blue Choice) MO NO INBS751 Blue Cross Blue Shield of Montana YES OUTBS760 Blue Cross Blue Shield of Nebraska NE YES OUTBS765 Blue Cross Blue Shield of Nevada (Anthem) NV YES INBS770 Blue Cross Blue Shield of New Hampshire NH YES OUT00790 Blue Cross Blue Shield of New Mexico NM NO INBS063 Blue Cross Blue Shield of New York - Centra (Excellus) NY YES OUTBS033 Blue Cross Blue Shield of New York - Empire NY YES OUTBS086 Blue Cross Blue Shield of New York - Northeastern NY YES OUTBS066 Blue Cross Blue Shield of New York - Utica/Waterto NY YES OUTBS087 Blue Cross Blue Shield of New York - Western (Heal NY YES OUTBS003 Blue Cross Blue Shield of North Carolina NC YES INBS057 Blue Cross Blue Shield of North Dakota ND YES OUTBS338 Blue Cross Blue Shield of Ohio (Anthem) OH NO INBS840 Blue Cross Blue Shield of Oklahoma OK YES OUT00851 Blue Cross Blue Shield of Oregon OR YES IN54771 Blue Cross Blue Shield of Pennsylvania - Highmark YES IN
54771V Blue Cross Blue Shield of Pennsylvania - Highmark YES INBS871 Blue Cross Blue Shield of Rhode Island RI YES OUTBS880 Blue Cross Blue Shield of South Carolina SC YES OUTSX085 Blue Cross Blue Shield of South Carolina - Compani YES OUTSX108 Blue Cross Blue Shield of South Carolina - Consoli YES OUTSX084 Blue Cross Blue Shield of South Carolina - FEP SC YES OUTSX161 Blue Cross Blue Shield of South Carolina - Instil NO OUTSX104 Blue Cross Blue Shield of South Carolina - Planned YES OUTSX103 Blue Cross Blue Shield of South Carolina - State H YES OUTBS889 Blue Cross Blue Shield of South Dakota SD YES OUTBS390 Blue Cross Blue Shield of Tennessee TN YES IN
BS84980 Blue Cross Blue Shield of Texas TX NO INBS088 Blue Cross Blue Shield of Utah (Regence) UT YES OUTBS915 Blue Cross Blue Shield of Vermont VT YES OUTBS923 Blue Cross Blue Shield of Virginia (Anthem) VA NO INBS055 Blue Cross Blue Shield of West Virginia WV YES OUTBS950 Blue Cross Blue Shield of Wisconsin (Anthem) WI NO INBS074 Blue Cross Blue Shield of Wyoming WY YES OUTBC001 Blue Cross of California CA NO IN00610 Blue Cross of Idaho ID YES INBS870 Blue Cross of Rhode Island RI YES OUT00934 Blue Cross of Washington (Premera) WA NO INIP061 Blue Lake Rancheria CA NO INBS064 Blue Shield - Hawaii HI YES INBS006 Blue Shield - King County (Washington King County WA YES OUTHM007 Blue Shield HMO - HMO CA NO OUT94036 Blue Shield of California CA YES IN00611 Blue Shield of Idaho (Regence) ID NO IN00932 Blue Shield of Washington (Regence) WA NO INBS175 BlueChip - Rhode Island RI YES OUT61124 Bluegrass Family Health NO IN74238 Boon-Chapman Benefit Administrators NO IN13337 Boston Medical Center Healthnet NO IN38324 BOTSFORD HEALTH PLAN NO OUT37273 BOYDCARE NO IN48964 BPS, INC. NO IN65005 BREATHCO/CSL PULMONARY NO IN
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PROFESSIONAL CLAIMS PAYER LIST
38365 Bridge Benefits NO IN37285 Bridgestone Claims Services NO IN35182 Brodart NO IN51037 BROKERAGE CONCEPTS NO IN94316 BROWN & TOLAND MEDICAL SERVICES CA NO INBRISD BRYAN INDEPENDENT SCHOOL DISTRICT NO IN32004 Buckeye Community Health NO IN50240 BUENAVENTURA MEDICAL GROUP NO OUT42150 Butler Benefits NO IN23708 C&O EMPLOYEES HOSPITAL ASSOCIATION NO INCLFR2 C.L. Frates NO IN16126 C.N.Y. MANAGED CARE NO IN62413 CAC (Mailhandlers Benefit Plan) NO IN33192 Cadent Administrators NO IN33192 Cadent Underwriters NO INIP059 Calif. Care (Humboldt Del Norte) CA NO IN
CALOP Cal-Optima Direct NO OUT37105 CANNON COCHRAN MANAGEMENT NO INIP080 Cap Management Systems CA NO IN38245 CAPE HEALTH PLAN NO OUT23045 CAPITAL BLUE CROSS/CAIC PA NO INIM0002 Capital Community Health Plan NO INSX065 Capital District Physicians Health Plan NO IN65067 Capital International Management Services NO IN68011 CAPITOL ADMINISTRATORS NO IN57116 Care 1st Health Plan of Arizona NO INHM037 Care Choices HMO NO IN77082 Care Improvement Plus NO IN
AMM01 Care Network NO OUT43172 CARE PARTNERS NO OUT38269 Carechoices Michigan - Mercy Healthplans YES IN14182 CareCore National NO IN14184 CareCore National - Healthnet NO IN14185 CareCore National, LLC - Health Net New Jersey NO IN14179 CareCore National, LLC (Aetna Radiology Claims) NO IN14180 CareCore National, LLC (Oxford Radiology Claims) NO IN52118 CAREFIRST ADMINISTRATORS - MARYLAND MD NO IN25139 Carelink Advantra / Carelink Health Plan NO OUT25142 Carenet NO IN13350 CAREOREGON NO OUT65031 CarePlus Health Plan NO IN31114 CARESOURCE NO IN37311 CareSource of Indiana NO IN10010 Careworks NO IN31147 CareWorks (Ohio BWC) NO OUT62073 CARITEN HEALTHCARE NO IN62072 CARITEN SENIOR HEALTH NO IN57105 CAROLINA CARE PLAN, INC. NO IN56195 CAROLINA SUMMIT HEALTHCARE, INC. NO OUT
COMPU Carpenters' and Millwrights' Health Benefit Trust CO NO IN25125 Carpenter's Health and Welfare Trust Fund of St. L NO IN
COMPU Carpet, Linoleum and Resilient Tile Layers Health CO NO INCAS01 Cascade East Health Plan OR YES IN37060 Caterpillar NO OUTSX183 Catholic Healthcare West NO IN55438 CBCA ADMINISTRATORS NO IN31158 CBIZ BENEFITS & INSURANCE SERVICES NO IN41124 CBSA NO IN
OBAEW CEDAR RAPIDS ELECTRICAL WORKERS NO IN95166 CEDARS-SINAI MEDICAL NETWORK SERVICES CA NO IN95167 CEDARS-SINAI MEDICAL NETWORK SERVICES (ENCOUNTERS) NO INCELTC Celtic Insurance NO IN37250 CEMARA ADMINISTRATORS, INC NO IN91136 Cement Masons & Plasterers Health AK NO IN
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PROFESSIONAL CLAIMS PAYER LIST
68047 Cenpatico Behavioral Health - Kansas NO OUT68048 Cenpatico Behavioral Health of Arizona NO IN68050 Cenpatico Georgia NO IN13357 CenterCare NO INIP080 Centinela IPA CA NO IN31118 CENTRAL BENEFITS LIFE NO INSX169 Central Coast Alliance CA YES OUT34097 CENTRAL RESERVE LIFE NO IN36215 CENTRAL STATES HEALTH & WELFARE FUND NO IN37214 Central States Joint Board Health & Welfare Trust IL NO INE3510 Central Valley Medical Group CA NO IN48120 Century Health Solutions NO IN23171 CHA -- Commonwealth Health Alliance NO IN84146 CHAMP VA - HAC NO IN16600 CHAUTAUQUA COUNTY HEALTHCARE PLAN NO IN75261 CHEC - A SUBSIDIARY OF SPRINT NO IN59223 Chesapeake National Life Insurance (MEGALIFE) NO OUT84146 Children of Women Vietnam Veterans-VA HAC NO IN
AMM01 Childrens Treatment Unit (CTU) NO OUT94302 Chinese Community Health Plan NO INTTPCH CHIP-TEENS TO TOTS / TX UNIVERSITY NO INACN01 ChiroCare NY NO INACN01 Chiropratic Care of Minnesota, Inc. NY NO INACN01 Chiropratic Care of Wisconsin, Inc. NY NO IN33065 CHOC - Childrens Hospital Of Orange County Health NO INPR002 Choice Plus (TRW) NO INCHCNT ChoiceNet NO OUTUHSCH ChoiceOne-UTMB CHIP- Mediview NO IN61271 Christian Brothers Services NO IN
SPOHN CHRISTUS SPOHN NETWORK NO INMCCBV CIGNA Behavioral Health NO IN95266 CIGNA FLEX CARE (NEW MEXICO ONLY) NM NO IN62308 CIGNA HealthCare (HMO & PPO) NO INCIMHP Cimarron Commercial NO INCIMSA Cimarron Salud!- New Mexico NO OUTCMSI1 Citrus Valley Physicians Medical Group NO OUTTH107 City of Amarillo NO INTTCEC CITY OF SAN ANTONIO NO IN39141 CLAIM MANAGEMENT SERVICES, INC NO IN
EPOTX Clarendon Kids Chip Program NO INSHP11 CLARENDON KIDS CHIP PROGRAM (CKCP) NO IN77201 Clearchoice Health Plan / COIHS NO IN71063 CNA NO IN37310 Coast Hotels & Casino, Inc. / DBA Coast Benefits NO IN38335 Cofinity NO IN37123 COLONIAL HEALTHCARE NO IN
COACC Colorado Access HMO CO NO INKSRCS COLORADO KAISER PERMANENTE NO INCOMPU Colorado Laborers Health and Welfare Fund CO NO INCOACC Colorage Access HMO CO NO IN25351 COLUMBIA CORNELL CARE NO OUT91162 COLUMBIA UNITED PROVIDERS NO IN37271 COMBINED BENEFITS, INC. NO INCMSI1 Combined Management Services NO OUT62308 CoMed - CIGNA NO IN34181 COMMERCE BENEFITS GROUP NO IN37237 COMMONWEALTH ADMINISTRATIVE GROUP NO INCATPA Commonwealth Administrators NO IN25179 COMMUNITY CARE BEHAVIORAL HLTH ORG NO IN73143 COMMUNITY CARE MANAGED HEALTH CARE NO IN39126 Community Care Organization NO IN71079 Community Care Plus NO IN38325 COMMUNITY CHOICE OF MICHIGAN NO IN
SYMED Community Family Care (SynerMed) NO IN
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PROFESSIONAL CLAIMS PAYER LIST
COMMF Community First Health Plan, Inc. NO IN35193 Community Health Alliance NO IN48145 Community Health Choice NO IN75261 COMMUNITY HEALTH ELEC. CLEARINGHOUSE NO IN62149 COMMUNITY HEALTH NETWORK OF CT NO IN90010 COMMUNITY HEALTH PLAN NO IN39162 COMMUNITY HEALTH PLAN - MILWAUKEE, WI NO IN23742 COMMUNITY HEALTH PLAN NY NO IN
95155R Community Health Plan of the Rockies NO INCHPWA COMMUNITY HEALTH PLAN OF WASHINGTON NO INCMGWV Community Medical Group of the West Valley CA NO IN
32481 COMMUNITY PREMIER PLUS FOR NEIGHBOR NO OUT34177 COMP - OHIO (AUSTINTOWN, OH) NO INBS060 Companion Healhcare SC YES OUTBS880 Companion Technologies SC YES OUT37297 CompBenefits Corporation NO IN31147 CompManagement Health Systems, Inc. (Ohio BWC) NO OUT31147 CompManagement/Integrated Comp (Ohio BWC) NO OUT31147 Comprehensive Medical Care (Ohio BWC) NO OUT
COMPU CompuSys Incorporated of Colorado CO NO INCMPUU Compusys of Utah NO IN80667 CONFED ADMIN SERVICES, INC. NO IN80705 Confederation Admin Services NO IN80705 Confederation Life Insurance NO IN06105 Connecticare, Inc. NO IN37307 Connecticut Carpenters Health Fund NO IN62308 CONNECTICUT GENERAL - MEDICAL CLAIMS NO IN37135 CONSOCIATE GROUP (DECATUR, IL) NO OUT75284 Consolidated Associations of Railroad Employees NO OUT04274 Consolidated Group/HPS NO IN71404 CONTINENTAL GENERAL INSURANCE CO NO OUT13397 CONTINUUM ABC MSO NO IN55544 Conversion Plan-APWU NO INTH104 Cook Childrens Health Group NO INCCHP1 Cook Children's Health Plan NO INCCHP9 Cook Children's Star Plan NO IN52132 Cooperative Benefit Administrators NO IN35199 COOPERATIVE MANAGED CARE SERVICES NO IN58204 Coordinated Medical Specialists NO IN
41045X CoreSource / CoreStar NO IN41045 Coresource of AZ, MN NO IN75136 Coresource of Little Rock NO IN35182 Coresource of MD, PA, IL NO IN35180 Coresource of NC, IN NO IN35183 Coresource of OH NO IN35202 Cornerstone Benefit Administrators NO IN56116 CORPORATE BENEFITS SERVICE, INC (NC) NO IN37246 CORPORATE SYSTEMS ADMINISTRATION NO IN43160 Correctional Medical Service NO IN48146 CORSOLUTIONS NO IN31147 Corvel Corporation (Ohio BWC) NO OUT62553 COUNTRY LIFE INSURANCE COMPANY NO OUT58102 COVENANT ADMINISTRATORS, INC. NO IN
CMSEB COVENANT MGMT SYSTEMS EMPLOYEE NO IN25133 Coventry Health and Life (Oklahoma) NO IN25130 Coventry Health Care of Delaware, Inc. NO OUT25127 Coventry Health Care of Georgia, Inc. NO IN25132 Coventry Health Care of Iowa, Inc. NO IN25134 Coventry Health Care of Kansas, Inc. - Wichita NO IN
25133KC Coventry Health Care of Kansas, Inc.. - Kansas Cit NO IN25135 Coventry Health Care of Louisiana, Inc. NO IN25136 Coventry Health Care of Nebraska, Inc. NO IN25147 COVENTRY HEALTH CARE SOUTH NO IN
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PROFESSIONAL CLAIMS PAYER LIST
31147 CRA Managed Care (Ohio BWC) NO OUT31147 Crawford & Company (Ohio BWC) NO OUT64068 CREATIVE MEDICAL SYSTEMS NO IN37320 Creative Plan Administrators NO IN80705 Crown Life NO IN37266 Croy-Hall Mgmt. Inc. NO IN
AMM01 Custody Medical Services (CMS) NO OUT39170 CUSTOM BENEFIT ADMINISTRATORS NO IN60054 CUSTOMCARE (PRUDENTIAL) ALL NO INPR002 Customcare (Southwestern Bell-Exec.) NO IN57080 CWIBENEFITS, INC. NO INDAK01 DakotaCare SD YES INDARTC DART MANAGEMENT CORP/DART CONTAINER NO IN95748 DC Chartered Health Plan, Inc. (Medicaid & Allianc NO IN39113 Dean Health Plan? YES IN87726 Definity Health ALL NO IN63081 DELAWARE HEALTH PLAN CONSORTIUM NO IN27009 Delaware Physicians Care, Inc. NO IN25137 DELAWARECARE NO INSB691 Delmarva Health Plan - Carefirst MD NO INDHS01 Delta Health Systems CA NO IN81400 Dentemax/DPI (MI) NO IN84134 Denver Health - Indigent NO IN84133 Denver Health and Hospital Authority NO IN84135 DENVER HEALTH MEDICAL PLAN NO INDNS22 Dermatology Network Solutions, LLC BCBS (Payer req NO OUTDNS77 Dermatology Network Solutions, LLC Humana (Payer r NO INDNS44 Dermatology Network Solutions, LLC Vista (Payer re NO OUTSX105 Deseret Mutual YES OUTPPM01 Desert Family Practice Association NO INPPM01 Desert Hosptial NO IN36436 Destiny Health NO IN56240 Detroit Medical Center NO IN25131 Diamond Plan NO IN33192 Direct Assignment Benefit Plan NO IN23706 Directors Guild of America Producers NO IN06102 DIVERSIFIED ADMINISTRATION NO INDMEA DME Region A (DMERC A) - NHIC YES OUTDMEB DME Region B (DMERC B) - AdminaStar YES OUTDMEC DME Region C (DMERC C) - Palmetto GBA YES OUTDMED DME Region D (DMERC D) - Noridian YES OUT37231 Doctor and Patient (medical claims only, no work c NO IN
SYMED Doctors Hospital of Montclair (San Bernadino) (Syn NO INDNLY1 Donley & Company NO INAPP01 Downey Select IPA (Applecare Medical Managment) NO INDCHCH Driscoll Children's Health Plan- CHIP NO IN35186 Dunn and Associates Benefits Administrators, Inc. NO IN61101 EAGLE CREEK MEDICAL PLAZA NO IN36434 EARLY INTERVENTION CENTRAL BILLING NO INCMSI1 Eastland Medical Group NO OUT62308 Eaton Benefits, OH NO INTTCEC EBA - CITY OF SAN ANTONIO NO IN81039 EBMS (EMPLOYEE BENEFIT MANAGEMENT YES INEPF03 EL PASO FIRST - CHIP NO IN52192 Elder Health HMO of Pennsylvania NO IN52192 Elder Health Maryland HMO Inc. NO IN31625 ElderPlan, Inc. NO INECISF ELLIS CONSULTANTS, INC. NO IN37253 ELMCO NO IN
AMM01 Emergency Medical Service Fund (EMSF) NO OUT59299 EMI-KP Ambulance Claims NO INPR002 Emorycare NO IN60054 EMORYCARE (PRUDENTIAL) ALL NO IN61101 EMPHESYS NO IN
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PROFESSIONAL CLAIMS PAYER LIST
EMPHE Emphesys NO INIP079 Empire Physicians Medical Group - EPMG CA NO IN87726 Empire Plan - UHC ALL NO IN95288 Employee Benefit Administration & Management Corpo NO IN38241 EMPLOYEE BENEFIT CONCEPTS, INC. NO OUT37257 Employee Benefit Consultants, Inc. NO IN37215 Employee Benefit Corporation NO INCX025 EMPLOYEE BENEFIT MANAGEMENT CORP. - EBMC NO IN37216 Employee Benefit Services NO OUT41198 EMPLOYEE BENEFIT SERVICES OF LOUISIANA (A DIVISION NO INTH109 Employee Benefit Services of San Antonio NO IN03036 EMPLOYEE BENEFITS PLAN ADMIN (E.B.P.A.) NO IN75184 Employee Claim Adjudication Svc NO IN
EGSEW EMPLOYEE GROUP SERVICES NO IN35112 EMPLOYEE PLANS, LLC NO IN54098 EMPLOYEE SECURITY, INC. NO OUT74212 Employer Plan Services NO INMIDSC EMPLOYERS COALITION ON HEALTH (ECOH) NO IN75232 Employers Direct Health NO IN75236 EMPLOYERS DIRECT HEALTH (EMPLOYEE NO IN75235 EMPLOYERS DIRECT HEALTH (FULLY NO IN75233 EMPLOYERS DIRECT HEALTH (SELF FUNDED NO INMIDSC EMPLOYERS HEALTH COOPERATIVE (EHC) NO INEMPHE Employers Health Insurance NO IN39026 Employers Insurance of Wausau NO IN37249 Employers Life Insurance Corp. - ELIC NO OUT59298 EMPLOYERS MUTUAL,INC.(FL) NO OUT35206 Encircle PPO NO IN37110 Encompass NO INGTPA1 ENCORE ENCORE TX NO IN35206 ENCORE HEALTH NETWORK NO IN36364 ENH MEDICAL GROUP IPA NO IN91136 Enstar Natural Gas - G#P61 AK NO IN62308 Equicor - PPO NO IN75196 EQUIFAX / HEALTHCARE ADMIN (EHAS) NO IN62308 Equitable (Cigna) NO IN73126 EQUITABLE PLAN SERVICES NO IN23250 Erin Group Administrators NO IN74234 ERISA NO OUT34108 ES Beveridge and Associates NO IN34159 E-V Benefits Management, Inc (Columbus, OH) NO IN07501 Evercare Star Plus NO IN58233 EVERGREEN HEALTH PLAN NO INEXC01 Excel MSO NO INIP080 Exceptional Care Medical CA NO IN71412 ExclusiveCare NO IN95432 Facey Medical Foundation NO IN37300 FACS GROUP NO IN22254 Fallon Health Plan NO INIP017 Family / Seniors Medical Group, Inc. (Labs Only) - CA YES INIP080 Family Choice Medical CA NO INIP080 Family Health Alliance CA NO IN81400 Family Health Network NO IN43173 FAMILY HEALTH PARTNERS NO OUT31472 Family Health Partners - Healthwave of Kansas NO IN96865 Family Health Plan NO IN36396 Family Medical Network NO INFPA11 Family Practice Associates NO INAMM01 Family Seniors Medical Group NO OUT37289 FARA BENEFIT SERVICES NO IN14140 Farm Family Life Insurance NO IN33033 FCE Benefit Administrators NO IN84980 FEDERAL EMPLOYEE PROGRAM (TX FEP) TX NO IN37300 Federated Benefits NO IN
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37300 Federated HR Services NO IN41041 FEDERATED MUTUAL NO IN81400 FHC Super Select (FL) NO IN
COFHP FHP of Colorado - HMO claims only. Trading Partne CO NO OUT11315 FIDELIS CARE NEW YORK NO IN77054 Fidelis Secure Care NO IN
FAMR1 First Administrators [Provider id and group id req SD NO IN56196 FIRST CAROLINA CARE NO IN14162 FIRST CHOICE (CT) NO IN91131 FIRST CHOICE HEALTH NETWORK NO IN75138 FIRST CHOICE OF MIDWEST (PPO) NO IN80705 FIRST GREAT WEST LIFE & ANNUITY INS CO NO IN87043 First Health (Alta Health Strategies) NO IN73159 First Health Network (formerly CCN and PPO OK) NO IN22324 FIRST OPTION HEALTH PLAN NO IN23241 FIRST PRIORITY HEALTH NO IN63080 FIRST STATE HEALTH PLAN NO OUT94999 FirstCare NO IN90060 FIRSTGUARD HEALTH PLAN - KANSAS NO IN90061 FIRSTGUARD HEALTH PLAN - MISSOURI NO IN62061 Fiserv Health - Kansas / Tennessee NO IN39026 Fiserv Health Services NO IN11244 FITZHARRIS & COMPANY, INC. NO INFLHLT FL Health Options NO OUTFLENC FL Health Options Encounters NO OUT60054 FLEXCARE ALL NO IN59276 FLORIDA 1ST NO IN81400 Florida Health Choice (FL) NO IN81400 Florida Health Choice/Select (FL) NO IN59321 FLORIDA HOSPITAL HEALTHCARE SYSTEMS NO OUT48116 FLORIDA HOSPITAL WATERMAN NO OUT60054 FLORIDA POWER & LIGHT (PRUDENTIAL) ALL NO IN48117 FMH Coresource NO IN70408 Fortis Benefits NO IN39065 Fortis Insurance Company NO IN
TKFMC Foundation for Medical Care of Tulare & Kings Coun NO INFH001 Foundation Health CA NO INFH002 Foundation Health Amerimed Senior - HMO CA NO INFHFLC Foundation Health of Florida-Claims NO INFHFLE Foundation Health of Florida-Encounters NO IN59257 FOUNDATION HEALTH PLAN (SUNRISE FL) NO IN
FVMCH FOX VALLEY MEDICINE NO IN64067 FOX-EVERETT INGALLS SHIP BUILDING NO IN64069 FOX-EVERETT, INC NO IN62324 FREEDOM LIFE INSURANCE COMPANY OF NO INIP080 Freeman IPA CA NO INTH118 Fresenius Medical Care NO INTKFMC Friant Water Users NO IN59204 Fringe Benefit Coordinators NO IN
59069F Fringe Benefit Management NO IN34171 FrontPath Health Coalition NO IN
PRGON Ft Collins IPA (Paragon) (In Testing) CO NO IN67815 G.E. GROUP LIFE ASSURANCE COMPANY NO IN37283 GALLAGHER BENEFIT ADMINISTRATORS NO IN30005 GALVESTON COUNTY INDIGENT HEALTH NO IN
SYMED Garfield Medical Center (Synermed) NO IN31147 Gates McDonald Health Plus, Inc. (Ohio BWC) NO OUT60550 Gateway Health Plan - Medicare Assured NO IN25169 GATEWAY HEALTH PLAN MEDICAID PA NO IN76028 Gateway Health Plan of Ohio, Inc. NO IN91741 Gateway Health Plan of Ohio, Inc.- Medicare Assure NO IN
PROSP Gateway IPA (Pinnacle Health Resources) (Prospect NO IN6143 GE Group Administrators - South Carolina NO IN75238 GE GROUP ADMINISTRATORS, TEXAS NO IN
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PROFESSIONAL CLAIMS PAYER LIST
16412 GEHA MENTAL HEALTH CLAIMS NO IN75273 GEISINGER HEALTH PLAN NO INMCS01 GEMCare (Golden Empire Managed Care System) NO IN63665 Gencare Health (St. Louis) MO NO IN63665 Genelco (St. Louis Only) MO NO IN63665 General American (Sanus - East) MO NO IN63665 General American Life Ins. Co. (Sanus, St. Louis) MO NO IN16112 GENESEE COUNTY MEDICAL PLAN NO IN
AMM01 Genesis Healthcare NO OUTIP087 Genesis Healthcare (EMG) NO IN31147 GENEX Care of Ohio (Ohio BWC) NO OUT61271 Georgia Power Med. Benefits Pln (Hlth Care Srvcs) NO IN59041 GEVB - PIC (GE Voluntary Benefits Professional Ins NO IN13551 GHI - NEW YORK (GROUP HEALTH,INC. NO IN25531 GHI HMO SELECT NO IN25141 GHP (Group Health Plan) NO IN58204 GI Innovative Management NO IN65099 GIC INDEMNITY PLAN NO IN07205 Gilsbar, Inc. NO IN
COMPU Glassworkers and Glaziers Health and Welfare Fund CO NO IN91136 Glassworkers Health & Welfare AK NO IN07689 Global Care, Inc NO IN
MDAPN Global Healthcare- MD Anderson Phy Network NO INPEFIR Global Healthcare- People First NO IN47083 GMS, Inc NO IN37602 Golden Rule Insurance NO INMBA01 Golden State Medical Group NO IN68041 Golden State Physicians Medical Group NO INGTPA1 Golden Triangle Physician Associates TX NO INAMM01 Good Samaritan Medical Practice Association NO OUTIP086 Good Samaritan Medical Practice Association (GSMPA CA YES IN44054 Government Employees Hospital Association NO IN37234 GRANT PHYSICIANS PRACTICE ASSOCIATION NO OUT95467 GREAT LAKES HEALTH PLAN NO OUT80705 Great West (SF) NO IN80705 Great West (WA) NO IN80705 Great West Care NO IN80705 Great West Denver NO IN80705 Great West Life Assurance Company of America NO INIP080 Greater L.A. Health CA NO INIP080 Greater San Gabriel CA NO IN80705 Great-West Bellevue NO IN66893 Great-West Healthcare (formerly New England Financ NO IN80705 Great-West Healthcare (formerly One Health Plan -- NO IN95379 Great-West Healthcare (formerly One Health Plan of CA NO IN95569 Great-West Healthcare (formerly One Health Plan of GA NO IN80705 Great-West Healthcare/ First Great West Life & Ann NO IN80705 GREAT-WEST LIFE & ANNUITY INS CO NO IN78521 GreenTree Administrators NO IN48143 GROUP & PENSION ADMINISTRATORS NO IN36338 GROUP ADMINISTRATORS NO IN72153 Group Benefit Administrators NO IN39167 Group Health Coop/So. Central WI (Claims) WI NO IN39168 Group Health Coop/So. Central WI (Encounters) WI NO IN91121 Group Health Cooperative - East WA NO IN91051 Group Health Cooperative - West WA NO IN95885 Group Health Insurance-DE NO IN38194 Group Health Managers NO IN37276 GROUP INSURANCE SERVICE CENTER, INC. NO IN68046 Group Practice Affiliates NO IN64246 Guardian Life (The Guardian) NO IN39180 Gundersen Lutheran Health Plan, Inc. NO IN37114 H.E.R.E.I.U. WELFARE PENSION FUNDS NO IN36406 HARMONY HEALTH PLAN OF ILLINOIS NO IN
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PROFESSIONAL CLAIMS PAYER LIST
36405 HARMONY HEALTH PLAN OF INDIANA NO IN59142 HARRINGTON BENEFIT SERVICES - NO IN75196 Harrington Benefit Services - Centra NO IN95266 Harrington Benefit Services, Inc. NM NO IN59142 Harrington Benefit Svcs/Health Plan Svcs-OK NO IN
HARWC Hartford - Work Comp NO IN04271 Harvard Pilgrim Health Care NO IN34185 HAS - HEALTH ADMINISTRATION SERVICES NO IN37329 HCH - Albuquerque NO IN37215 HCH Administration Inc NO IN37111 HCH ADMINISTRATION PEORIA NO IN
HCHNM HCH Administrators- New Mexico NO IN37329 HCHA ALBQ SELF FUNDED NO IN82018 HCS HEALTH CLAIMS SERVICE NO IN
HDMCO HDM BENEFIT SOLUTIONS NO IN90023 HDPC - Premier Healthcare NO IN20257 HDPC/Alliance Physicians NO IN
23173A Health 1,2,3, Inc. NO IN23172 HEALTH ALLIANCE EXCLUSIVE NO OUT77950 HEALTH ALLIANCE MEDICAL PLANS NO IN38224 Health Alliance Plan of Michigan MI NO IN25126 Health Assurance/Health America, Inc./Advantra NO IN60054 HEALTH CARE ALLIANCE (SEARS) ALL NO IN42102 Health Care Network of Wisconsin (HCN) NO IN34193 HEALTH CARE PAYERS COALITION NO IN56142 HEALTH CARE SAVINGS NO IN62179 Health Choice of Arizona AZ NO IN62111 Health Cost Solutions NO IN34158 HEALTH DESIGNS PLUS (HUDSON, OH) NO IN16112 HEALTH ECONOMICS GROUP, INC. NO IN75196 HEALTH ECONOMICS -MICS CORP NO IN16120 Health EZ NO IN95019 Health First Health Plans NO IN75234 HEALTH FIRST TPA TYLER, TX NO INTH049 Health Management Administrators (HMA) NO IN31147 Health Management Solutions (Ohio BWC) NO OUT62295 Health Market Care Assured NO IN95567 Health Net CA NO IN95570 HEALTH NET CALIFORNIA (ENCOUNTERS) NO INHM001 Health Net (Encounters Only) CA YES IN38309 HEALTH NET OF ARIZONA NO IN06108 Health Net of the Northeast, Inc. NO INSX185 Health Net Pear (PFFS) NO IN81400 Health Net Plus (TN) NO IN20199 HEALTH NETWORK AMERICA NO IN04286 HEALTH NEW ENGLAND NO INSX030 Health Options of Florida YES OUT62157 HEALTH PARTNERS - JACKSON, TENN. NO IN80142 Health Partners (PA) NO IN37221 HEALTH PLAN MANAGEMENT NO IN83253 Health Plan of Michigan NO IN68035 Health Plan of San Joaquin NO IN59140 Health Plan Services NO IN59256 HEALTH PLAN SOUTHEAST (TALLAHASSEE, NO IN44273 Health Plans Inc. NO IN95435 HEALTH PLEDGE HMO NO Out11324 Health Plus PHSP (Brooklyn, NY) NO IN41170 HEALTH RISK MANAGEMENT (HRM) NO IN37290 Health Services for Children with Special Needs NO IN34167 HEALTH SERVICES PREFERRED) EMERALD NO IN
OBAVG Health Services Purchasing Coalition NO INSX044 Health Strategies YES OUT61101 HEALTH VALUE MANAGEMENT NO IN95885 Health Value Mgmt-DE (Humana) NO IN
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84980 HEALTHCARE BENEFITS TX NO INHMA01 HEALTHCARE MANAGEMENT ADMIN. (HMA) NO INEPF37 Healthcare Options YES INHCP01 Healthcare Partners NO IN11328 HealthCare Partners, IPA NO IN81400 Healthcare Preferred (IA) NO IN82468 Healthcare Resource Group - HRG NO IN73147 Healthcare Solutions Group NO IN31147 Healthcare Transaction Processing, Inc (HTP) NO OUT25143 Healthcare USA NO IN
HCOMP HealthComp CA NO IN59608H HEALTHEASE NO IN80141 Healthfirst, Inc. NO IN23226 HEALTHGUARD OF LANCASTER NO OUT59087 HEALTHHELP NETWORK, INC (HHNI) NO OUT96475 HEALTHLINK HMO NO IN
90001A HEALTHLINK PPO (Natl Capital Pref Provider Org) NO IN55204 Healthnow Division YES OUTSX009 HealthPartners MN MN YES OUT59140 HEALTHPLAN SERVICES (TAMPA ONLY) NO IN38216 HealthPlus of Michigan MI NO OUT68195 Healthpoint Corp. NO IN31106 HEALTHPOWER HMO NO IN71063 HEALTHSCOPE BENEFITS, INC NO IN48153 HEALTHSCOPE BENEFITS, INC (REPRICING NO IN75250 HealthSmart Preferred Care NO INHSPC1 HEALTHSMART PREFERRED CARE (HSPC) NO IN62308 Healthsource - AR NO IN62308 Healthsource - IN NO IN62308 Healthsource - KY NO IN62308 Healthsource - MA NO IN62308 Healthsource - ME NO IN62308 Healthsource - N. TX NO IN62308 Healthsource - NC NO IN62308 Healthsource - NH NO IN62308 Healthsource - OH NO IN62308 Healthsource - SC NO IN62308 Healthsource - Tennessee NO IN75255 HEALTHSOURCE OF NORTH TEXAS NO IN62308 Healthsource Provident Administrators NO IN62308 Healthsource Provident Ins. Co. NO IN58210 HEALTHSOURCE, GA GA NO IN35167 HEALTHSOURCE, IN IN NO IN61127 HEALTHSOURCE, KY KY NO IN02041 HEALTHSOURCE, MA MA NO IN01041 HEALTHSOURCE, ME ME NO IN56147 HEALTHSOURCE, NC NC NO IN02038 HEALTHSOURCE, NH NH NO IN31141 HEALTHSOURCE, OH OH NO IN06119 HEALTHSOURCE, SC SC NO IN62129 HEALTHSOURCE, TN TN NO IN25193 HEALTHSPRING HMO NO INHT001 HealthSpring: NO PPO claims accepted via this paye TN NO IN36332 HEALTHSTAR, INC NO IN
HGLWF HEAVY & GENERAL LABORERS WELFARE NO IN59230 HERITAGE CONSULTANTS NO IN95378 HERITAGE NATIONAL HEALTH PLANS NO IN11328 HERITAGE NEW YORK MEDICAL GROUP NO INHPN11 Heritage Physicians Network - HPN TX NO IN36335 HFN, Inc. (HEALTHCARES FINEST NETWORK) NO INHERZ0 High Desert Medical Group NO OUT33069 High Desert Primary Care NO IN59347 Hillcrest Benefit Administrators NO IN55247 HIP - HEALTH INSURANCE PLAN OF NEW YORK NY YES IN
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HMA01 HMA - HEALTHCARE MANAGEMENT ADM NO IN86066 HMA Hawaii NO OUT84980 HMO BLUE TX NO IN
COHMO HMO of Colorado, also known as HMOC (Prior apppro CO NO IN95885 HMPK, Inc NO INIP080 Hollywood Presbyterian CA NO IN81400 Homestead CHP/S NO IN34150 HOMETOWN HEALTH NETWORK NO INHMLIC Horace Mann Life Ins NO IN22099 Horizon Blue Cross Blue Shield NJ NO IN22304 Horizon HealthCare Admin (HHA) NO IN37274 Hospital Benefits, Inc. NO IN91136 Hotel Employees & Restaurant AK NO IN95885 Hplan, Inc NO IN94254 HPR- HEALTH PLAN OF REDWOODS NO IN58227 HPS PARADIGM, INC NO IN41170 HRM CLAIM MANAGEMENT NO IN13335 Hudson Health Plan YES IN95885 Human Health Plan NO IN61102 Humana (Encounters Only) NO IN95348 HUMANA HEALTH PLANS OF OHIO NO IN61125 Humana Military - Tricare South US YES IN61101 HUMANA, INC. (CLAIMS) NO IN94154 Humboldt-Del Norte Foundation for Medical Care NO IN59069 HUNT INSURANCE GROUP NO INIP080 Huntington Park Medical Group CA NO INIP080 Huntington Park Mission CA NO IN22175 I.E. SHAFFER (WEST TRENTON, NJ) NO IN38234 IBA HEALTH & LIFE ASSURANCE CO. NO OUT38234 IBA SELF FUNDED GROUP NO OUT41124 IBI NO INPR002 IBM MEDICAL PLANS NO IN37296 ICM NO IN75185 ICON Benefits Administrators NO INSX107 IHC - Intermountain Health Care YES OUT36600 ILLINOIS CENTRAL HOSPITAL ASSOC. NO IN86069 Illinois Health Solutions NO OUT41600 IMCARE NO INIP089 Imperial Valley Medical Group (IMPV) CA YES INTH099 IMS Management Services NO IN86070 IMX Easy NO OUT40585 INDECS Corporation NO IN54704 Independence Blue Cross YES IN54704 Independence Blue Cross YES INSX073 Independent Health YES OUT35204 Indiana Health Network NO OUT35161 INDIANA PRO HEALTH NETWORK NO IN35107 Indiana Teamsters Health Benefits Fund (Indianapol NO IN31053 Individual Health Insurance Companies(State Farm) NO IN
COMPU Industrial Machine Specialties CO NO INSKMO0 InfoCrossings MO YES OUT52196 INFORMED, LLC NO INIEHP1 Inland Empire Health Plan NO IN04320 INNOVATIVE HEALTHWARE SOLUTIONS NO IN37279 INSURANCE ADMINISTRATOR OF AMERICA, NO IN63082 INSURANCE CLAIMS SERVICES (BIRMINGHAM, NO IN13315 INSURANCE DESIGN ADMINISTRATORS NO IN88006 INSURANCE MANAGEMENT SERVICES NO INISL11 Insurance Services of Lubbock - ISOL NO INSX011 Insurdata/Insurnational YES OUT86304 Insurer's Administrative Corp. YES INIAC01 INSURERS ADMINISTRATIVE CORPORATION NO IN51020 INTEGRA ADMINISTRATIVE GROUP NO IN31127 INTEGRA GROUP NO IN
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31129 INTEGRA GROUP - CHA NO OUT37124 INTEGRATED BENEFIT SERVICES NO OUT34167 INTEGRATED CARE NETWORK BY EMERALD NO IN68053 Integrated Mental Health Services NO IN58200 INTEGRITY BENEFIT NETWORK NO OUT37227 INTERCARE HEALTH PLANS, INC. NO INSX079 Inter-County Health Plan NO OUT60280 Interface EAP (IEAP) NO IN23287 INTERGROUP SERVICES CORPORATION NO IN36609 International Brotherhood of Boilermakers NO INTH105 International Medical Group NO IN37241 INTERNATIONAL UNION OF OPERATING NO IN37269 INTERNATIONAL UNION OF OPERATING NO IN84137 InterWest Health (Acceptius Gateway payer) NO IN41124 IOWA BENEFITS NO IN86068 Iowa Health Solutions NO OUTOBALB IOWA IRON WORKERS HEALTH PLAN NO INOBALB Iowa Laborer's NO INOBAOE Iowa Operating Engineers NO IN81400 Iowa, Envoy Platinum NO INSX172 IU Medical Group Primary Care NO IN61271 J.F. Molloy & Associates, Inc. NO IN05014 Jackson Memorial Health Plan (FL) NO INPPM01 JFK Hospital NO INJISSP JI Specialty NO IN41099 John Alden Life Ins. NO IN95378 JOHN DEERE HEALTH CARE NO IN80314 JOHN HANCOCK NO INJMH01 John Muir Health Network CA YES IN68036 John Muir Mt. Diablo Health System NO IN37215 JOHN P PEARL & ASSOCIATES NO IN43178 JOPLIN CLAIMS NO IN
AMM01 Joy Medical Group NO OUT34136 JP FARLEY CORPORATION NO IN37272 JSL ADMINISTRATORS NO IN94134 KAISER FOUNDATION HEALTH PLAN NO IN91617 Kaiser Foundation Health Plan of Colorado NO IN21313 Kaiser Foundation Health Plan of Georgia NO INKS003 Kaiser Foundation Health Plan of Northern CA Regio CA YES IN34092 Kaiser Foundation Health Plan of Ohio NO INKS001 Kaiser Foundation Health Plan of Southern CA Regio CA NO IN52095 Kaiser Foundation Health Plan of the Mid-Atlantic NO IN93079 Kaiser Foundation Health Plan of the Northwest NO INHM036 Kaiser Permanente (Encounter data only) CA YES INHM044 Kaiser Permanente (Encounters-Colorado only) CO NO INCOKSR KaiserFoundation Health Plan of Colorado CO NO IN57038 KANAWHA INSURANCE CO. NO IN44030 KANSAS CITY LIFE INSURANCE CO. NO INKAP01 Kapiolani Health Commercial NO INTKFMC Kaweah Delta NO INKELSE Kelsey Seybold NO IN73100 KEMPTON COMPANY,KEMPTON GROUP ADM NO IN63077 KENTUCKY HEALTH SELECT NO OUT95885 Kentucky Kara NO IN37124 KEPPLE AND COMPANY NO OUT77039 Kern Health Systems NO IN37217 Key Benefit Administrators NO INIP082 Key Medical Group CA YES OUT37321 Key Select NO IN23239 KEYSTONE HEALTH PLAN CENTRAL NO INSX051 Keystone Health Plan Central Senior Blue NO OUT95056 Keystone Health Plan East YES INSX056 Keystone Health Plan West PA YES OUT23284 Keystone Mercy Health Plan NO IN
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PROFESSIONAL CLAIMS PAYER LIST
34145 KLAIS & Company NO INKPS01 KPS HEALTH PLANS NO INHM039 LA Care - Encounter data only CA YES INLVPA1 La Vida IPA NO INSX063 LABOR & INDUSTRY (WASHINGTON) WA YES OUT37112 LAKE FOREST MANAGED CARE ASSOCIATES NO IN95415 Lakeside Health Services NO OUT80705 Lakeside Medical Group Inc. NO IN
LNDMK Landmark Healthcare Inc. NO IN75279 LEGGETT AND PLATT NO IN37316 Leon Medical Center Health Plan NO IN37248 LHP Claims Unit NO IN11123 Liberty Mutual Insurance Company NO OUT37281 Liberty Union NO IN37281 Life Assurance Company NO INLIIC2 LIFE INVESTORS INS CO OF AMERICA NO IN
TH120 Life Investors Insurance NO IN41136 LIFE TRAC NO IN
LFGRD LifeGuard CA NO OUT91155 Lifewise Health Plan of Arizona NO IN93093 LIFEWISE OF OREGON, A PREMERA HEALTH YES IN61101 LINCOLN NATIONAL NO IN95885 Lincoln National-Phoenix, AZ (Humana) NO IN75283 Linn County NO INTH106 LIPA/Agate Resources NO IN37267 LOMA LINDA UNIVERSITY ADVENTIST NO IN33036 Loma Linda University Healthcare - ManagedCare Cla NO IN37226 LONDON HEALTH ADMINISTRATORS NO INPR002 Los Alamos Total Care (LATC) NO IN60054 LOS ALAMOS TOTAL CARE (PRU) ALL NO IN90328 Lovelace Sandia Health Plan NM NO IN54195 LUMENOS NO IN52148 M.D. - Individual Practice Assoc. (M.D.-IPA) (HCFA NO IN37292 MACHINIST DISTRICT 9 WELFARE NO IN01260 Magellan Behavioral Health NO IN
MBHCR Magellan Behavioral Health - Case Rate NO IN11303 Magnacare NO IN62413 Mailhanders Benefit Plan (CAC) NO IN16412 MAILHANDLERS MENTAL HEALTH CLAIMS NO IN22195 Maksin Management Corporation NO INMA001 MAMSI Life & Health Ins. Co. (MLH) (HCFA 1500 only NO IN61101 MANAGED CARE INDEMNITY NO IN35162 MANAGED CARE SERVICES NO OUTMCS02 Managed Care Systems (Delano Regional Medical Grou NO INMCS01 Managed Care Systems (Gemcare) NO IN22771 Managed Health Network NO IN39186 Managed Health Services Of Indiana/ Maxicare IN YES IN39187 Managed Health Services of Wisconsin WI NO IN41159 Managed Physical Network NO IN61101 MANAGED PRESCRIPTION SERVICES NO IN41555 MANATEE SERVICE CENTER (BRADENTON, FL) NO IN75258 MAPCO, INC. NO OUTIP097 Marin IPA CA YES IN60054 MARRIOTT ALL NO INPR002 Marriott (Prudential) (Medical) NO IN13310 MARSH ADVANTAGE AMERICA NO IN22347 Maryland Health Insurance Plan NO INSX069 MARYLAND HEALTH PARTNERS NO IN00247 Maryland Physicians Care MD NO IN37121 MASHANTUCKET PEQUOT TRIBAL NATION NO OUT65935 MASSACHUSETTS MUTUAL NO IN
MMPHB MASTERS, MATES AND PILOTS PLAN NO IN02030 MATTHEW THORNTON HEALTH PLAN NO IN41154 MAYO MANAGEMENT SERVICES, INC. NO IN
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PROFESSIONAL CLAIMS PAYER LIST
56205 MBS (MEDCOST BENEFIT SERVICES) NO IN59331 MC CREARY CORPORATION NO IN38264 Mcare NO IN
MCCBV MCC Behavioral Care NO IN36328 McHenry Medical Associates (Rockford IL) NO IN38338 McLaren Health Plan NO IN20475 MD Wise Hoosier Alliance NO IN11338 MDNY HEALTHCARE NO IN58202 MedAdmin Solutions NO IN58204 MedAdmin Solutions NO IN61101 MEDBENEFIXX INC NO IN59231 MedCom NO IN60054 MEDCONNECTION (MARRIOTT) ALL NO IN56162 MEDCOST, INC NO IN95321 MEDFOCUS NO IN94265 Medica MN NO IN
MDCLNK Medicaid - Carelink NO IN94999 Medicaid - Firstcare Star NO IN
MDMSTAR Medicaid - METROWEST STAR YES OUTMDPROPT Medicaid - Providence Medicaid Option YES INMDSHPS Medicaid - SETON HEALTH PLAN - STAR YES OUTMDWI01 Medicaid - Wisconsin HIRSP Only WI YES OUTMDAL00 Medicaid of Alabama - EDS AL NO OUTMDAK00 Medicaid of Alaska - First Health Services Corp. AK NO OUTMDAZ00 Medicaid of Arizona - AZ Health Care Cost Containm AZ YES OUTMDAR00 Medicaid of Arkansas AR YES OUTMDCA00 Medicaid of California - EDS - Medi-Cal CA YES INMDCO00 Medicaid of Colorado CO NO OUTMDCT00 Medicaid of Connecticut - EDS CT YES OUTMDDE00 Medicaid of Deleware - EDS DE YES OUTMDFL00 Medicaid of Florida - ACS Inc. FL YES OUTMDGA00 Medicaid of Georgia - ACS Inc. GA NO OUTMDHI00 Medicaid of Hawaii - ACS Inc. HI YES OUTMDID00 Medicaid of Idaho - EDS ID NO OUTMDIL00 Medicaid of Illinois IL YES OUTMDIN00 Medicaid of Indiana - EDS IN YES OUTMDIA00 Medicaid of Iowa IA YES OUTMDKS00 Medicaid of Kansas - EDS KS YES OUTMDKY00 Medicaid of Kentucky - EDS KY YES INMDLA01 Medicaid of Louisiana - Ambulance claims NO OUTMDLA00 Medicaid of Louisiana - UNISYS Corp. LA YES OUTMDLA02 Medicaid of Louisiana- KidMed Claims NO OUTMDME00 Medicaid of Maine ME YES OUTMDMD00 Medicaid of Maryland - Department of Health and Me MD YES OUTMDMA00 Medicaid of Massachusetts MA NO OUTMDMI00 Medicaid of Michigan MI YES OUTMDMN00 Medicaid of Minnesota - Dept. of Human Services MN YES OUTMDMS00 Medicaid of Mississippi - ACS Inc. MS YES OUTMDMO00 Medicaid of Missouri MO YES INMDMT00 Medicaid of Montana MT YES OUTMDNE00 Medicaid of Nebraska - Health and Human Services o NE YES OUTMDNV00 Medicaid of Nevada - First Health Services Corp. NV YES OUTMDNH00 Medicaid of New Hampshire NH YES OUTMDNJ00 Medicaid of New Jersey - UNISYS Corp. NJ YES OUTMDNM00 Medicaid of New Mexico - CONSULTEC NM NO OUTMDNM01 Medicaid of New Mexico - LOVELACE SALUD NM NO OUTMDNY00 Medicaid of New York NY YES OUTMDNC00 Medicaid of North Carolina - EDS NC YES OUTMDNC01 Medicaid of North Carolina - Mental Health ONLY NC NO OUTMDOH00 Medicaid of Ohio - Dept. of Human Services OH YES OUTMDOK00 Medicaid of Oklahoma OK NO inMDOR00 Medicaid of Oregon OR YES OUTMDPA00 Medicaid of Pennsylvania - EDS PA NO OUTMDRI00 Medicaid of Rhode Island - EDS RI YES OUT
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PROFESSIONAL CLAIMS PAYER LIST
MDSC00 Medicaid of South Carolina - South Carolina Depart SC YES OUTMDSD00 Medicaid of South Dakota - Dept. of Human Services SD YES OUTMDTN00 Medicaid of Tennessee TN YES INMDTX00 Medicaid of Texas TX NO INMDTX02 Medicaid of Texas - CHILDRENS STAR MEDICAID TX NO INMDTX01 Medicaid of Texas - PREMIER PLAN (STAR HMO) TX NO OUTMDUT00 Medicaid of Utah UT YES OUTMDVT00 Medicaid of Vermont VT YES OUTMDVA00 Medicaid of Virginia - First Health Services Corp. VA YES OUTMDWA00 Medicaid of Washington - ACS Inc. WA YES INMDDC00 Medicaid of Washington DC DC YES OUTMDWV00 Medicaid of West Virginia - UNISYS Corp. WV YES OUTMDWI00 Medicaid of Wisconsin WI YES OUTMDWY00 Medicaid of Wyoming WY YES OUT
31147 Medical Administrators, Inc. (Ohio BWC) NO OUT68041 Medical Benefit Administration, Inc. NO IN37298 Medical Benefit Administrators, Inc/dba MBA of MD, NO IN74323 MEDICAL BENEFITS MUTUAL NO IN04258 MEDICAL CLAIMS SERVICE, INC. NO IN75229 Medical Control, Inc. NO IN52181 MEDICAL DEVELOPMENT INTERNATIONAL NO IN29076 Medical Mutual of Ohio NO IN
CSMED MEDICAL NETWORK OF COLORADO SPRINGS NO IN33029 MEDICAL PATHWAYS NO IN61101 MEDICAL PLAN OF KANSAS CITY NO IN95885 Medical Plan of Kansas City-MO NO IN58203 MEDICAL RESOURCE NETWORK NO IN13375 MEDICAL SELECT MANAGEMENT NO IN38224 Medical Value Plan-MVP-OH MI NO IN16412 Medicare - Complete - United HealthCare of the Mid NO IN58228 Medicare - Medicare Smart NO INPHP01 Medicare - Providence Medicare Extra NO IN
MCAL00 Medicare of Alabama - Cahaba GBA AL YES OUTMCAK00 Medicare of Alaska - Noridian AK YES OUTMCAZ01 Medicare of Arizona - CIGNA Healthcare for Seniors NO INMCAZ00 Medicare of Arizona - Noridian AZ YES OUTMCAR00 Medicare of Arkansas - Noridian AR YES OUTMCCA01 Medicare of California - Northern Region - NHIC CA YES INMCCA00 Medicare of California - Southern Region CA YES INMCCO00 Medicare of Colorado - Noridian CO YES OUTMCCT00 Medicare of Connecticut - NGS CT YES INMCDC00 Medicare of DC DC YES INMCDE00 Medicare of Delaware - Trailblazers DE YES OUTMCFL00 Medicare of Florida - First Coast Services FL YES INMCGA00 Medicare of Georgia - Cahaba GBA GA YES OUTMCHI00 Medicare of Hawaii - Noridian HI YES INMCID00 Medicare of Idaho - CIGNA ID YES OUTMCIL00 Medicare of Illinois - Wisconsin Physicians Servic IL YES INMCIN00 Medicare of Indiana - AdminaStar IN YES OUTMCIA00 Medicare of Iowa - Noridian IA YES OUTMCKS00 Medicare of Kansas - Blue Cross Blue Shield of Kan KS YES OUTMCKS02 Medicare of Kansas (HMO Regular) - Blue Cross Blue KS YES OUTMCKS03 Medicare of Kansas (HMO Senior Plan) - Blue Cross KS YES OUTMCKS01 Medicare of Kansas City - Coventry KS YES OUTMCKY00 Medicare of Kentucky - AdminaStar KY YES OUTMCLA00 Medicare of Louisiana LA YES INMCME00 Medicare of Maine - NHIC ME YES OUTMCMD00 Medicare of Maryland MD YES INMCMA00 Medicare of Massachusetts - NHIC MA YES OUTMCMI00 Medicare of Michigan - Wisconsin Physicians Service MI YES INMCMN00 Medicare of Minnesota - Wisconsin Physicians Servi MN YES OUTMCMS00 Medicare of Mississippi - Cahaba GBA MS YES OUTMCMO00 Medicare of Missouri (Eastern) MO YES INMCMO01 Medicare of Missouri (Western) - Blue Cross Blue S MO YES OUT
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10/30/2008
External Payer ID
Payer Name State Enrollment Network
PROFESSIONAL CLAIMS PAYER LIST
MCMT00 Medicare of Montana - Blue Cross Blue Shield of Montana MT YES OUTMCNE00 Medicare of Nebraska - Blue Cross Blue Shield of K NE YES OUTMCNV00 Medicare of Nevada - Noridian NV YES OUTMCNH00 Medicare of New Hampshire - NHIC NH YES OUTMCNJ00 Medicare of New Jersey - HGSA NJ YES INMCNM00 Medicare of New Mexico NM YES INMCNY00 Medicare of New York - Empire NY YES OUTMCNY01 Medicare of New York - Queens County (GHI) NY YES OUTMCNY02 Medicare of New York - Upstate/Albany (Healthnow) NY YES OUTMCNC00 Medicare of North Carolina - CIGNA NC YES INMCND00 Medicare of North Dakota - Noridian ND YES OUTMCOH00 Medicare of Ohio - Palmetto OH YES INMCOK00 Medicare of Oklahoma OK YES INMCOR00 Medicare of Oregon - Noridian OR YES OUTMCPA00 Medicare of Pennsylvania - HGSA PA YES INMCRI00 Medicare of Rhode Island RI YES INMCSC00 Medicare of South Carolina - Palmetto GBA SC YES OUTMCSD00 Medicare of South Dakota - Noridian SD YES OUTMCTN00 Medicare of Tennessee - CIGNA TN YES INMCTX00 Medicare of Texas - Trailblazers TX YES INMCUT00 Medicare of Utah - Medicare/Blue Shield of Utah UT YES OUTMCUT01 Medicare of Utah - Nordian UT YES OUTMCVT00 Medicare of Vermont - NHIC VT YES OUTMCVA00 Medicare of Virginia - Trailblazers VA YES INMCWA00 Medicare of Washington - Noridian WA YES INMCWV00 Medicare of West Virginia - Palmetto GBA WV YES INMCWI00 Medicare of Wisconsin - Wisconsin Physicians Service WI YES INMCWY00 Medicare of Wyoming - Noridian WY YES OUT
IP080 Medicina Familiar Medical Group CA NO IN95655 MEDIGOLD NO OUT37304 MEDIVERSAL NO IN62160 MEDSOLUTIONS, INC. NO OUT00243 MedStar Physician Partners MD NO IN59222 Mega Life - Transamerica Life Insurance NO OUT74227 Mega Life and Health Ins. Co - Student Division NO INMCA11 MEMORIAL CLINICAL ASSOCIATES NO INTH092 Memorial Herman Health Network Providers NO IN36193 MEMPHIS MANAGED CARE NO IN
MRC01 Mercy Care (Arizona) AZ NO IN86052 MERCY CARE PLAN NO IN22326 Mercy Health Plan of NJ NO OUTMER11 MERCY HEALTH PLANS NO INIP079 Mercy Physicians Medical Group - San Diego - MPMG CA NO IN39114 MercyCare NO IN77042 MERIDIAN HEALTH CARE MANAGEMENT NO IN34159 Meritain Health NO IN64158 Meritain Health / Agency Services NO IN85035 MESA MENTAL HEALTH NO OUT16412 MET LIFE NO IN65113 Metcare Health Plans, Inc. NO IN62168 METHODIST ASSOC HEALTH PLAN NO OUT95420 METHODIST CARE NO IN23550 Methodist First Choice NO IN81400 Methodist SW Prv Org NO IN16412 Metrahealth/Metrahealth Railroad (A United HealthC NO IN82135 METRO ALLIANCE NO IN13265 Metro Plus Health Plan NO IN10850 Metropolitan Health Plan NO IN16412 METROPOLITAN LIFE INS CO NO IN
MWP01 METROWEST HEALTH PLAN-PREFERRED NO INTH069 Metrowest Star Medicaid NO IN16412 MICHAEL REESE HMO NO IN95885 Michael Reese HMO Plan-IL, IN NO IN37127 MICHAEL REESE PHYSICIANS GROUP NO IN
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DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
PROFESSIONAL CLAIMS PAYER LIST
25133 MID AMERICA HEALTH (HEALTH NET) NO IN25147 MID AMERICA HEALTH (LEASED PPO) NO IN52149 Mid Atlantic Psychiatric Services, Inc. (MAPSI) NO IN37281 MID-AMERICA ASSOCIATES, INC. NO IN63079 MID-ATLANTIC HEALTH SYSTEM NO OUT
SYMED Mid-County Physicians Medical Group (San Diego) (S NO IN90956 MIDLAND NATIONAL LIFE INSURANCE CO. NO OUT47080 Midlands Choice NO IN47080 Midlands Health Partners NO IN
62168M MidSouth Administrative Group NO IN31140 MID-VALLEY CARENET, INC NO IN76079 Midwest Health Partners NO INMHP77 MIDWEST HEALTH PLAN NO IN59224 Mid-West National Life Insurance (MEGALIFE) NO INMIDSC MIDWEST PREFERRED NO INMIDSC MIDWEST SECURITY ADMINISTRATORS (MSA) NO INMIDSC MIDWEST SECURITY INSURANCE CO. (MSIC) NO INMPMG1 Mills Peninsula Medical Group CA YES IN60054 MINNEAPOLIS PRUDENTIAL ALL NO INPR002 Minneapolis Prudential Business (Medical) NO IN05018 MIPS NO INSTJOE Mission (St. Joseph Heritage Healthcare) NO INPPM01 Mission Medical Group NO IN37233 Mississippi Public Entity Employee Benefit Trust NO OUT64088 MISSISSIPPI SELECT HEALTH CARE NO IN37275 MISSOULA COUNTY MEDICAL BENEFITS PLAN NO OUT43179 Missouri Care/MC NO IN37265 MLINK NO IN31147 MMAC (Managed Medical Assurance Co., Ltd.) (Ohio B NO OUT62178 MMS, LLC. NO IN38333 Molina Healthcare of California NO IN38334 Molina Healthcare of Michigan NO IN20676 Molina Healthcare of Nevada NV NO IN09824 Molina Healthcare of New Mexico NM NO IN20149 Molina Healthcare of Ohio NO IN20554 Molina Healthcare of Texas NO INSX109 Molina Healthcare of Utah NO OUT38336 Molina Healthcare of Washington NO IN91128 Molina Healthcare of Washington ASO WA NO IN00076 Molina of Indiana NO IN72135 MOMENTUM HEALTH SERVICES NO INIP095 Monarch Healthcare IPA (Monarch assigned rendering NO INIPA95 Monarch IPA NO IN13174 MONTEFIORE CONTRACT MANAGEMENT NO INMMLI3 MONUMENTAL LIFE INS CO NO IN67466 Mony Financial Services (Pacific Mutual) NO INIP083 Mosaic IPA Medical Group (Providers please contact CA YES OUTMPI01 MOTION PICTURE INDUSTRY HEALTH PLAN NO IN36111 MOTOROLA, INC. NO INBS941 Mountain State Blue Cross Blue Shield WV YES OUT86040 MOUNTAIN STATES ADMINISTRATIVE NO IN
MTNST Mountain States Administrators CO NO OUT35177 MPlan (Medicaid) NO IN95444 MPLAN, INC/HEALTHCARE GROUP, LLC NO OUT95655 MT. CARMEL HEALTH PLAN NO OUT
SYMED Multicultural Primary Care Medical Group (San Dieg NO IN39634 Multiplan Inc. for American Family (Arizona) AZ NO IN39634 Multiplan Inc. for American Family (Illinois) AZ NO IN39634 Multiplan Inc. for American Family (Indiana) AZ NO IN39634 Multiplan Inc. for American Family (Ohio) AZ NO IN34080 Multiplan Wisconsin Preferred Provider Network NO IN37256 MUTUAL ASSURANCE ADMINISTRATORS NO IN70408 Mutual Benefit Life (Western Life-Fortis) NO IN70491 MUTUAL GROUP (THE) NO OUT
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Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
PROFESSIONAL CLAIMS PAYER LIST
71412 Mutual of Omaha Insurance Company NO IN14165 MVP Health Care NY NO IN91136 N.W. Iron Workers Health & Security AK NO IN91136 N.W. Roofers & Employers Health & Security AK NO IN91136 N.W. Textile Processors AK NO IN65085 NAA - NORTH AMERICAN ADMINISTRATORS NO IN
NHCA1 NAPERVILLE HEALTH CARE ASSOCIATES NO IN81400 National Assoc Preferred Prv TX NO IN
71412NLC National Association of Letter Carriers NO IN56176 NATIONAL BENEFIT ADMIN. N.C. NO IN56175 NATIONAL BENEFIT ADMINISTRATORS NJ NO OUT37126 NATIONAL CLAIM ADMINISTRATION NO IN90956 NATIONAL FINANCIAL INSURANCE COMPANY NO OUT98205 NATIONAL FOUNDATION LIFE INSURANCE NO OUT75275 National Health Insurance Company NO IN37232 National Healthcare Exchange Services NO IN86916 NATIONAL HERITAGE INS CO (NHIC) NO IN52132 NATIONAL RURAL ELECTRIC COOP (NRECA) NO IN53011 NATIONAL RURAL LETTER CARRIER ASSOC NO INNTA11 National Teachers Association NO IN52103 National Telecommunications Cooperative Associatio NO IN52104 National Telecommunications Cooperative Associatio NO INPV150 NATIONAL TELEPHONE COOP ASSOC. (NTCA) - PlanVista NO IN37120 NATIONAL TRAVELERS LIFE COMPANY NO IN31417 Nationwide Health Plans NO IN75191 NCAS - CHARLOTTE, NC NO IN75190 NCAS - FAIRFAX, VA NO IN52118 NCAS - OWINGS MILL, MD. MD NO IN95123 Neighborhood Health Partnership of Florida NO IN04293 NEIGHBORHOOD HEALTH PLAN (Boston, MA) NO IN05047 Neighborhood Health Plan of Rhode Island (NHPRI) RI NO IN11325 NEIGHBORHOOD HEALTH PROVIDERS NO IN37255 NESIKA HEALTH GROUP NO IN66055 NETCARE LIFE AND HEALTH INSURANCE NO IN81400 Network Health PPO NO IN39144 NETWORK HEALTH SOLUTIONS NO IN86067 NevadaCare NO OUT80705 NEW ENGLAND FINANCIAL NO IN66893 New England, The NO IN75281 NEW ERA LIFE NO IN65056 NEW MARKET DIMENSIONS NO IN37312 New Source Benefits, LLC NO IN38332 NEW WORLD CLAIMS SERVICE NO INTH122 New York Life NO IN14179 NEW YORK MEDICAL IMAGING - MVP NO IN11334 New York Network Management NO IN48186 NEW YORK PRESBYTERIAN COMMUNITY NY NO OUT24819 New York Presbyterian System Select Health NO IN38225 NGS AMERICAN, INC. NO IN62124 NHC Health Benefit Plan NO IN81264 Nippon Life Insurance Company of America NO IN22603 NJ Carpernters Health Fund NO INPDT01 Noble AMA Select IPA NO INIP080 Noble Community CA NO IN
HMS01 Noble Mid Orange - HealthSmart NO IN34159 NORTH AMERICA BENEFITS NETWORK (Cleveland, OH) NO IN64157 NORTH AMERICAN ADMINISTRATORS (Meritain) NO INE3510 North American Medical Management - Northern Calif CA NO INIP079 North American Medical Management - So. California CA NO IN36398 NORTH AMERICAN MEDICAL MGMT -- IL NO IN37314 North Broward Hospital District NO INSKND0 North Dakota Medicaid (Medical) NO OUT35212 North Texas Healthcare Network NO INNTX11 NORTH TEXAS HEALTHCARE NETWORK NO IN
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Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
PROFESSIONAL CLAIMS PAYER LIST
PROSP North West Orange County Medical Group NO IN38238 Northern California Sheet Metal Workers Health Car NO IN36347 Northern Illinois Health Plan NO IN88027 Northern Nevada Trust Fund NO IN
NGM01 Northridge Medical Group NO IN36346 Northwest Suburban IPA (IL) NO IN41045 NORTHWESTERN NATIONAL LIFE NO INPH018 Northwestern National Life (Reliastar Emp Ben) NO IN16644 NOVA HEALTH ADMIN. (GRAND ISLAND, NY) NO IN71080 NOVASYS NO IN
PROSP Nuestra Familia Medical Group (Prospect Medical Gr NO IN37299 NYHART NO IN14180 NYMI OXFORD NO IN31147 Occupational Health Mgmt, Inc. (HealthManage) (Ohi NO OUT72127 OCHSNER HEALTH PLAN NO IN13350 ODS HEALTH PLAN NO OUT13350 OEA CHOICE TRUST NO OUT13310 OFFICE OF ADMINISTRATOR, WASHINGTON NO IN31147 Ohio BWC NO OUT31147 Ohio Comp Choice, Inc. (HMS) (Ohio BWC) NO OUT31147 Ohio Employee Health Partnership (Ohio BWC) NO OUT81400 Ohio Health Choice Plan (OH) NO IN34189 OHIO HEALTH CHOICE, PPO NO IN95435 Ohio Health Group NO Out91151 OLYMPIC HEALTH MANAGEMENT SYSTEMS NO IN38252 Omnicare Health Plan of Michigan NO OUT
OMN02 Omnicare Medical Group (OMNI) NO IN25150 OMNICARE, A COVENTRY HEALTH PLAN NO IN80705 ONE HEALTH PLAN (ALL 50 STATES) NO IN80705 One Health Plan Inc. NO IN80705 One Health Plan Michigan, Inc. NO IN80705 One Health Plan New York, Inc. NO IN80705 One Health Plan of Alaska NO IN80705 One Health Plan of Arizona, Inc. NO IN95379 One Health Plan of California CA NO IN95412 One Health Plan of Colorado CO NO IN80705 One Health Plan of DC Inc, NO IN80705 One Health Plan of Florida NO IN95569 One Health Plan of Georgia GA NO IN95388 One Health Plan of Illinois IL NO IN80705 One Health Plan of Indiana, Inc. NO IN80705 One Health Plan of Kansas and Missouri NO IN80705 One Health Plan of Maine, Inc. NO IN80705 One Health Plan of Massachusetts, Inc. NO IN80705 One Health Plan of Minnesota, Inc. NO IN80705 One Health Plan of Nevada, Inc. NO IN80705 One Health Plan of New Jersey NO IN80705 One Health Plan of North Carolina NO IN80705 One Health Plan of Ohio NO IN80705 One Health Plan of Pennsylvania NO IN80705 One Health Plan of South Carolina NO IN80705 One Health Plan of Tennessee NO IN95415 One Health Plan of Texas NO OUT80705 One Health Plan of Virginia, Inc. NO IN80705 One Health Plan of Washington NO IN80705 One Health Plan of Wisconsin, Inc. NO IN80705 One Health Plan of Wyoming NO IN52149 Onenet PPO NO IN91136 Operating Engineers Local 302 & 612 AK NO IN56190 OPTICARE EYE HEALTH NETWORK NO IN54154 Optima Health Plan NO IN54154 Optima Insurance Company NO IN52148 OPTIMUM CHOICE INC - OCI NO IN52152 Optimum Choice of the Carolinas NO IN
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Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
PROFESSIONAL CLAIMS PAYER LIST
37125 OPTION SERVICES GROUP NO OUTSKOR0 Oregon Medical Assistance Program NO OUT87043 ORNDA Health D296Corp (First Health) NO IN13382 Orthonet - Uniformed Services Family Health Plan OR NO IN13383 Orthonet- Aetna NO IN13381 Orthonet Corporation - CIGNA NO INORT88 Orthopedix Network of South Florida, LLC (Payer re FL NO OUTORT33 Orthopedix Network, Inc. Humana (Payer requires 11 NO OUTOSFMC OSF Care Advantage (Enrollment required. Contact IL NO INOSFIL OSF Health Plans (Enrollment required. Contact O IL NO IN37116 OSG - ST. THERESE PHYSICIAN ASSOC. NO IN36365 Our Lady of the Resurrection Physician Association NO IN06111 Oxford Health Plans, Inc. NO IN87068 P5 Health Plan Solutions of Utah NO IN
SYMED Pacific Alliance Medical Group and Hospital (Syner NO IN60054 PACIFIC GAS AND ELECTRIC (PG &E) ALL NO IN67466 PACIFIC LIFE & ANNUITY COMPANY NO INIP101 Pacific Lumber Company - PALCO (Humboldt Del Norte CA NO IN67466 Pacific Mutual Life Ins. Co. NO INPCFCI Pacifica IPA NO IN33053 Pacificare Behavioral Health NO INHM012 Pacificare Encounters (CA, OR, TX, WA) NO IN95964 PacifiCare of Arizona AZ YES IN95959 PacifiCare of California CA NO IN
COFHP PacifiCare of Colorado CO NO OUT95959OK PacifiCare of Oklahoma - Claims (For payable Pacif NO IN95959OR PacifiCare of Oregon - Claims (For payable PacifiC NO IN95959TX PacifiCare of Texas - Claims (For payable PacifiCa NO IN95959WA PacifiCare of Washington - Claims (For payable Pac NO IN
95999 PacifiCare PPO - All States (For payable PPO claim NO IN93029 PACIFICSOURCE HEALTH PLANS NO IN57106 Palmetto GBA NO IN58174 Paragon Benefits, Inc. NO INSX158 Paramount Health NO OUT31147 Paramount Preferred Network (Ohio BWC) NO OUT58204 Parity Healthcare LLC NO IN66917 PARKLAND HEALTH FIRST NO IN81400 Partners in Practice (TX) NO IN56152 PARTNERS NATIONAL HEALTH PLANS OF NC NO INSX140 Partnership Health of California-CAPHP YES OUTPHP02 Partnership Health Plan CA YES INIP080 Pasadena Primary Care Physicians CA NO INSX154 Passport Advantage YES OUT61129 PASSPORT HEALTH PLAN NO IN10525 Patient Advocates, LLC NO INPPN11 Patient Physician Network - PPN NO IN37210 PAYNET, INC NO IN65018 PCA HEALTH PLAN OF FLORIDA NO OUT61101 PCA STAR MEDICAID NO IN65000 PCMC/ICSL ALLERGY NO IN65007 PCMC/ICSL CHIROPRACTIC NO IN65001 PCMC/ICSL DERMATOLOGY NO IN65003 PCMC/ICSL GASTROENTEROLOGY NO IN65002 PCMC/ICSL PODIATRY NO IN68049 Peach State Health Plan NO IN20472 Pediatric Associates Health Plan NO INSX106 PEHP - Utah Public Employee Health Plan NO OUTPBLIC PEOPLES BENEFIT LIFE INSURANCE NO IN72126 Peoples Health Network NO IN13522 Perfect Health NO IN41124 Performax, Inc. NO IN34173 PERSONAL PHYSICIAN CARE NO IN25146 PersonalCare NO IN95183 PHA INSURANCE SERVICES NO IN
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Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
PROFESSIONAL CLAIMS PAYER LIST
PHIF4 PHIFER WIRE PRODUCTS, INC. NO IN06143 PHOENIX GROUP SERVICES NO IN75238 PHOENIX GROUP SERVICES (TEXAS) NO IN03440 Phoenix Health Plan NO IN62153 PHOENIX HEALTHCARE NO IN67814 Phoenix Home Life Mutual Insurance Co. NO INIM0001 PHP of Mid-Michigan NO INIM0001 PHP of South Michigan NO INIM0001 PHP of Southwest Michigan NO INIM0001 PHP of West Michigan NO IN62155 PHP TENNCARE NO IN
PHYCR Phycor (Ft Collins office only) CO NO OUTIP094 Physician Associates of Greater San Gabriel Valley CA YES IN58204 Physician Associates of Louisiana NO IN38265 Physicians Care Health Plans NO IN38265 Physicians Care Network NO IN57098 PHYSICIANS CARE NETWORK (PCN) NO OUT36345 Physicians Care Network (Rockford, IL only) NO IN95885 Physicians Corporation of America NO INPDT01 Physicians Data Trust NO IN75297 Physicians Direct NO IN37136 Physicians Health Association of Illinois NO INTH114 Physicians Health Choice - Encounters NO INTH113 Physicians Health Claims - Claims NO IN20398 Physicians Health Collaborative NO IN16412 Physicians Health Plan (PHP) - Missouri(Greater St NO IN16412 Physicians Health Plan (PHP) - North Carolina NO IN16412 Physicians Health Plan (PHP) - South Carolina NO IN12399 Physicians Health Plan of Northern Indiana NO IN65031 PHYSICIANS HEALTHCARE PLANS NO IN
PMGSJ Physicians Medical Group of San Jose NO IN47027 PHYSICIANS MUTUAL INSURANCE COMPANY NO IN39156 PHYSICIANS PLUS INS. CORP NO IN87056 PIASC (SOUTHERN CALIFORNIA) NO IN56151 PIEDMONT ADMINISTRATORS NO IN09861 PIMA Health NO OUT24735 Pinnacle Claims Management, Inc. NO IN
PROSP Pinnacle Health Resources (Prospect Medical Group) NO INCCIA1 Pinnacol Assurance CO NO OUTPIONR Pioneer Medical Group NO INCOMPU Pipe Industry Health & Welfare Fund of Colorado CO NO IN59700 PIPEFITTERS LOCAL 597 NO IN73074 PIPELINE INDUSTRY BENEFIT FUND (TULSA, OK) NO IN37224 PITTMAN & ASSOCIATES NO IN64160 Pivotal Plan NO IN81400 Plaines (IA) NO IN81400 Plaines Advisor (FL) (WI) NO IN81400 Plaines Networks - Envoy NO IN37287 Planned Administrators, Inc. (PAI) NO IN58204 Podi Care Managed Care NO INPOD12 Podiatry Network Solutions of South Florida, LLC ( FL NO OUT32680 Poly-American Medical & Dental Benefits Plan NO IN16111 POMCO NO INPPN11 PPN - Patient Physician Network NO IN59333 PPO PLUS NO IN72148 PPO Plus, LLC NO IN
PPOM1 PPOM MI NO IN04334 PRACTICARE, INC. NO INLVPA1 Prairie Medical Group (La Vida) NO IN36373 Prairie States Enterprises, Inc. NO IN53476 Preferred Benefit Administrators NO INSX089 Preferred Care YES OUT59291 Preferred Care FL NO IN56178 Preferred Care NC NO IN
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Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
PROFESSIONAL CLAIMS PAYER LIST
65088 Preferred Care Partners (Miami, Florida) NO IN73145 PREFERRED COMMUNITY CHOICE NO IN81400 Preferred Community Choice (OK) NO IN35173 PREFERRED HEALTH NETWORK (PHN) {providers in MD an NO IN61106 PREFERRED HEALTH PLAN (Louisville, KY) NO IN31478 Preferred Health Professionals NO IN60110 Preferred Health Systems NO INPFIPA Preferred IPA NO IN36401 PREFERRED NETWORK ACCESS, INC. NO IN41147 PREFERRED ONE (MN) NO IN60110 PREFERRED PLUS OF KANSAS (PPK) NO IN43166 Premier Benefits, Inc. WA NO IN31147 Premier Comp of Hometown Health Network (Ohio BWC) NO OUT
PREYE Premier Eye Care NO OUT37119 PREMIER HEALTH NETWORK NO INMER11 PREMIER HEALTH PLANS NO IN90440 Premier Health Systems, Inc NO IN31147 Premier Managed Care, Inc. (Ohio BWC) NO OUT
PREHP Presbyterian Health Plan -New Mexico NO INPRESA Presbyterian Salud!- New Mexico NO IN39185 PREVEA HEALTH INSURANCE PLAN NO INIP096 PrimaHealth IPA (Prima assigned rendering provider NC YES IN60054 Primary Choice (Aetna HP-NY/NJ) ALL NO IN
FPRIME Primary Health Plan NO INPRIME PRIMARY HEALTH PLAN NO INPMC11 Primary Medical Care NO IN56144 PRIMARY PHYSICIAN CARE, INC NO IN61101 PRIME BENEFITS SYSTEM NO INUH015 Prime Care Health Plan WI YES IN95885 Prime Health Kansas City Inc.-MO NO IN95885 Prime Health Mgmt Services-MO NO IN56190 PRIME VISION HEALTH PLAN NO IN61604 Prime West Health Plan NO INIP079 PrimeCare Medical Network - Chino CA NO INIP079 PrimeCare Medical Network - Corona CA NO INIP079 PrimeCare Medical Network - Hemet CA NO INIP079 PrimeCare Medical Network - Inland Valley CA NO INIP079 PrimeCare Medical Network - Moreno CA NO INIP079 PrimeCare Medical Network - Redlands CA NO INIP079 PrimeCare Medical Network - Riverside CA NO INIP079 PrimeCare Medical Network - Sun City CA NO INIP079 PrimeCare Medical Network - Temecula CA NO IN04320 PRIMESOURCE HEALTH NETWORKS NO IN61271 Principal Mutual Life Insurance Company (Principal NO IN38217 PRIORITY HEALTH NO IN37303 PRISM - FIRST HEALTH NO IN37268 PRISM NETWORK, INC. NO IN37315 Prism-Univera NO IN38329 Pro Care Health Plan, Inc. (Detroit, MI) NO IN31132 PRO HEALTH COMPCARE NO IN
PROSP ProCare (Prospect) NO IN59296 Professional Benefit Admin-FL NO IN36331 PROFESSIONAL BENEFIT ADMINISTRATORS, NO IN34176 PROFESSIONAL BENEFITS ADMINISTRATORS NO IN41163 PROFESSIONAL CLAIM ADMINISTRATORS NO IN37242 Professional Claims Management (Canton, OH) NO OUT34134 Professional Risk Management NO IN58226 Promina ASO NO IN
PROSP Prospect Health Network NO INPROSP Prospect Medical Group NO INPROSP Prospect Sherman Oaks Medical Group (Prospect Medi NO IN31147 Protegrity Services (Ohio BWC) NO OUTPHP01 Providence Health Plan HMO NO INSX131 Providence of Oregon Choice Option NO OUT
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Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
PROFESSIONAL CLAIMS PAYER LIST
SX132 Providence of Oregon Good Health Plan YES OUTSX133 Providence of Oregon Health Plan YES OUTSX135 Providence of Oregon Medicaid YES OUTSX136 Providence of Oregon Medicaid Option YES OUTSX137 Providence of Oregon Medicare Extra YES OUTSX138 Providence of Oregon Option YES OUTSX139 Providence of Oregon Traditional Option YES OUTPHP01 Providence Option NO IN91131 PROVIDENCE PREFERRED OF WASHINGTON NO IN62308 Provident Healthsource (Cigna) NO IN62308 Provident Life & Accident NO IN62308 Provident Life & Casualty NO IN68195 PROVIDENT LIFE AND ACCIDENT INS NO IN62308 Provident Preferred Network NO IN51032 Provider Networks of America- PRONET NO INPR002 Prucare - ASO NO INHM015 PruCare HMO (Encounters Only) NO OUTPR002 PruChoice NO IN60054 PRUDENTIAL (ALL PLANS) ALL NO INPR002 Prudential (Medical) NO INHM015 Prudential Encounters NO OUTPR002 Prudential Health Care Systems: Amarillo, Corpus NO INPR002 Prudential Health Insurance NO INPR002 Prudential Indemnity NO INPR002 Prudential In-Network NO INPR002 Prudential Managed Health Care NO INPR002 Prudential Out-of-Network NO INPR002 Prudential Pharmacy Mgt NO INPR002 Prudential Plus NO INPR002 Prudential Point of Service NO INPR002 Prudential Psychiatric Mgt NO INPR002 Prudential Resources Mgt NO INPR002 Prudential Select NO INPR002 Prudential Traditional NO INPR002 Prunet NO INPR002 Prunet Work (Medical) NO INPR002 PruNetwork NO INPR002 PruNetwork PPO NO INPR002 PruPPO (PIASC) (PINC) NO INPR002 PruPsych NO IN09822 PSN - Florida Medicaid (JMH NO IN91136 Puget Sound Benefits Trust AK NO IN39197 Quad Med LLC (Pewaukee, WI) NO IN35174 QUAL CHOICE OF ARKANSAS NO IN35172 QUAL CHOICE OF NORTH CAROLINA NO IN35171 QUAL CHOICE OF VIRGINIA NO IN23342 QUALCARE, INC NO IN
QUANM QUAL-MED NEW MEXIICO NO INQMDCE QUAL-MED, COLORADO EPO NO INQMDPO QUAL-MED, PORTLAND (PO) NO IN37129 QUINCY HEALTH CARE MANAGEMENT, INC. NO OUT57117 QVI Risk Solutions, Inc. NO IN
TKFMC R&N Market NO IN00882 RAILROAD MEDICARE YES IN61101 RANDMARK, INC NO IN91176 RBMS, LLC NO IN
SYMED Redlands IPA (Synermed) NO INREGAL Regal Medical Group NO INBS850 Regence Blue Cross Blue Shield of Oregon YES OUTBS611 Regence Blue Shield of Idaho YES OUT38221 Regency Employee Benefits NO IN47076 Regional Care, Inc. NO INREH55 Rehab Network, LLC Humana (Payer requires 11 digit NO INRPN01 Rehab Provider Network (RPN) SPECIALIZED FORMAT RE CO NO OUT
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Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
PROFESSIONAL CLAIMS PAYER LIST
41045 RELIA STAR NO INRENGQ Renassaince Gulf Quest NO IN37277 RESURRECTION HEALTH CARE HEALTH NO IN37270 REYNOLDS AND REYNOLDS NO IN84980 RIO GRANDE HMO TX NO IN37129 RIVER QUEST NETWORK, INC. NO OUT16117 RMSCO, INC. NO INBS790 Rocky Mountain Health Care Corp. NO OUTSX141 Rocky Mountain Health Plan - Grand Junction NM YES OUT
RMHMO Rocky Mountain HMO * CO NO IN37602 Rooney Life Inc. NO INPR002 RUSH PRUDENTIAL NO IN36389 RUSH PRUDENTIAL HMO NO IN31441 S & S HEALTHCARE STRATEGIES NO IN35164 SAGAMORE HEALTH NETWORK NO IN37259 SAMBA NO IN37236 San Francisco Electrical Workers Health & Welfare NO IN60054 SANDIA TRIPLE OPTIONAL PLUS ALL NO IN37288 SANTA BARBARA COTTAGE HOSPITAL NO IN77038 Sante Health Systems NO OUT63665 SANUS- HMO/PPO ST LOUIS MO NO IN63665 Sanus PPO (General American) - Sanus East MO NO IN99999 SC Champus NO INSCAN1 SCAN Health Plan NO IN16146 SCHC Total Care Inc. (Acceptius Gateway payer) NO IN88030 Scott & White Health Plan NO IN
SCHPC Scripps Clinic Health Plan Services - Capitated en CA YES INSCHPS Scripps Clinic Health Plan Services - Fee for serv CA YES IN13310 SEABURY & SMITH NO INSVIPA Seaview IPA NO IN28530 SECURE HEALTH PLANS OF GEORGIA, LLC NO IN95964 Secure Horizons Arizona - Claims AZ YES IN95962 Secure Horizons Colorado - Claims NO IN95959 Secure Horizons of California - Pacificare CA NO IN
95959OK Secure Horizons of Oklahoma - Claims NO IN95959OR Secure Horizons of Oregon - Claims NO IN95959TX Secure Horizons of Texas - Claims NO IN
87726 Secure Horizons Private Fee for Service (PFFS) ALL NO IN95959WA Secure Horizons Washington - Claims NO IN
42142 SecureCare of Iowa NO IN39045 SECURITY HEALTH PLAN NO IN64088 SELECT ADMINISTRATIVE SERVICES (SAS) NO IN42137 SELECT BENEFIT ADMINISTRATORS (DES NO IN37282 SELECT BENEFIT ADMINISTRATORS OF AMERICA NO INPR002 Select Care (Coca Cola) NO IN60054 Select Choice ALL NO IN23285 Select Health of South Carolina NO IN00014 SELECTCARE NO INGTPA1 Selectcare of Texas (Beaumont) TX NO INHPN11 Selectcare of Texas (Houston) TX NO INTH119 Selectcare of Texas (Integranet) TX NO INKLSY1 Selectcare of Texas (Kelsey-Seybold) TX NO IN59111 SELF INSURED BENEFIT ADMINISTRATORS NO IN36404 SELF INSURED PLANS NO IN34131 SELF-FUNDED PLANS (IL PA OH) NO IN60054 Senior Choice (Aetna HP-NY/NJ) ALL NO IN54154 SENTARA HEALTH MANAGEMENT NO IN23249 SENTINEL MANAGEMENT SERVICES NO OUT39033 Sentry Life Insurance Company NO INIP080 Seoul Medical Group CA NO IN
TKFMC Sequoia Beverage NO IN38610 SET SEG NO IN
SHEBP SETON EMPLOYEE PLAN NO INEPNSH SETON HEALTH PLAN - EXCLUSIVE PROVIDER NO IN
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SHMAP SETON HEALTH PLAN - MAP PROGRAM NO INSET22 SETON HEALTH PLAN - STAR MEDICAID NO OUTSHPCH SETON HEALTH PLAN (CHIP) NO INTH098 Seton Health Plan Care Program NO INUH005 SHARE HEALTH PLAN ILL/HMO NO IN16412 Share Health Plan - ILL/PPO NO INUH006 SHARE HEALTH PLAN ILL/PPO NO IN75280 SHASTA ADMINISTRATIVE SERVICES NO IN87815 Shaw Industries (Acordia) NO IN31147 Sheakley UNICOMP (Ohio BWC) NO OUT38238 Sheet Metal Workers Local 104 Health Care Plan (Sa NO IN
OBASM SHEET METAL WORKERS LOCAL 263 HEALTH NO INSMW91 SHEET METAL WORKERS LOCAL 91 NO IN41143 Sheffield, Olson, & McQueen, Inc NO INHM024 Shield 65+ (formerly Care America) CA YES INPROSP Sierra Family Network (Prospect Medical Group) NO IN76342 SIERRA HEALTH SERVICES (CLAIMS) NO IN76343 Sierra Health Services Encounters CA,NV NO IN68041 Sierra Nevada Medical Associates, Inc. NO IN62159 SIGNATURE HEALTH ALLIANCE NO IN84076 SINCLAIR HEALTH PLAN NO IN
SLOAN Sloans Lake CO NO IN72112 SMA HEALTH PLANS NO IN02057 Smith Administrators NO INSMITH SMITH ADMINISTRATORS NO IN31147 Solidarity Managed Care Organization (Ohio BWC) NO OUTE3510 Sonoma County Primary Care CA NO IN81400 SoNoran Desert Health NO IN81400 Sooner Health Network NO IN91131 SOUND HEALTH (PROVIDENCE) NO INSKSC0 South Carolina Department of Health & Human Servic NO OUTSX142 South Indiana Health Options - HMO NO OUTSX143 South Indiana Health Options - Prime Care Choice YES OUTSX144 South Indiana Health Options - TPA YES OUT25147 SOUTHCARE/HEALTHCARE PREFERRED NO INTH116 Southeast Texas Govt Employees Benefit Pool NO IN37318 Southern Benefit Services NO IN
SYMED Southern CA Childrens Network (SynerMed) NO IN81400 SOUTHERN DESERT HEALTH (WISCONSIN) NO IN56131 Southern Group Administrators NO IN25128 Southern Healh Services, Inc. NO IN37220 SOUTHERN NATIONAL LIFE NO IN
SWADM Southwest Administrators NO IN37266 Southwest Service Life NO IN60054 SOUTHWESTERN BELL (MEDICAL) ALL NO INPR002 Southwestern Bell (Prudential) (Medical) NO INPR002 Southwestern Bell Exec - Custom Care (Medical) NO INPR002 Southwestern Bell Exec - Southwestern Bell (Medica NO IN52190 SPECIAL RISK INTERNATIONAL NO IN23253 Spectrum Administrators Inc. - TPA Allentown, PA ( NO IN84146 Spina Bifida - VA HAC NO IN35199 St Anthony Memorial Healthcare Centers MDWISE NO IN22240 ST. BARNABAS SYSTEM HEALTH PLAN NO IN35199 St. Catherine Hospital PHO - MDWISE NO IN35199 St. Francis Health Network NO INPDT01 St. Francis IPA NO IN37264 St. John's Claim Administration NO INIP062 St. Joseph Health CA NO IN68033 ST. JOSEPH HEALTH FOUNDATION OF NO. CA NO INSTJOE St. Joseph Heritage Healthcare NO INSTJOE St. Jude (St. Joseph Heritage Healthcare) NO IN35199 St. Margaret Mercy Healthcare Centers - MDWISE NO INSTM01 ST. THOMAS MEDICAL NETWORK NO INPDT01 St. Vincent IPA NO IN
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PROFESSIONAL CLAIMS PAYER LIST
59225 Star HRG NO IN72087 STATE EMPLOYESS GROUP BENEFITS NO IN31053 State Farm Insurance Companies NO IN75087 State General Life Insurance ME NO INBS600 State Merit GA NO INSKME0 State of Maine Bureau of Medical Services GA YES OUT14163 Staywell Health Plan (Wellcare HMO) NO IN91151 Sterling Option 1 NO IN06089 Stirling & Stirling NO IN31121 STONER AND ASSOCIATES (CINCINNATI, OH) NO IN58128 STOWE ASSOCIATES (ATLANTA, GA) NO OUT35199 Suburban Health Organization NO IN88331 SUFFOLK HEALTH PLAN OF NEW YORK NO IN95202 SUMMACARE HEALTH PLAN NO IN86071 Summerlin Life & Health Insurance NO OUT37301 SUMMIT AMERICA INSURANCE SERVICES NO IN31147 SummitCorp (Ohio BWC) NO OUT60054 SUN TRUST BANK ALL NO INPR002 Sun Trust Bank, Inc. (Prudential) (Medical) NO IN90956 SUNAMERICA LIFE INSURANCE COMPANY NO OUT23218 SUPERIOR BENEFITS NO INSHP11 Superior Health Plan Texas NO INIP084 SUTTER - ALTA BATES MG - ABMG (ENCOUNTERS) YES IN
HM057 SUTTER - MG OF THE REDWOODS ENCNTERS YES INIP084 Sutter Connect - ABMG YES IN
HM063 Sutter Connect - Delta CA YES INIP100 Sutter Connect - Delta NO IN
HM060 Sutter Connect - Family Doctor Medical Group CA YES INIP098 Sutter Connect - Family Doctor Medical Group CA YES OUT
HM057 Sutter Connect - Santa Rosa Network YES INIP090 Sutter Connect - Santa Rosa Network - MG of the Re CA YES IN
HM059 Sutter Connect - SIP, SMG, SWMG CA YES INIP092 Sutter Connect - SIP, SMG, SWMG NO IN
HM062 Sutter Connect - Solano Regional Medical Group CA YES INIP099 Sutter Connect - Solano Regional Medical Group NO IN
HM058 Sutter Connect - Sutter Gould Medical Foundation CA YES INIP091 Sutter Connect - Sutter Gould Medical Foundation NO IN
SYMED Synermed NO INTALMG Talbert Medical Group NO IN88067 Tall Trees Administrators NO IN37228 Tarrant Health Services TX NO IN
TKFMC TASEBA NO INCOMPU Tattered Cover, Inc. CO NO IN39157 TBG Administrative Services NO IN88019 Teachers Health Trust NO INADSL1 TEAM CHOICE - ALPHA CARE GOLD NO IN75139 TEAM CHOICE GOLD NO IN75133 TEAM CHOICE PNS NO IN75134 TEAM CHOICE UMC NO IN36215 TEAMCARE NO IN36612 TEAMSTERS LOCAL UNION #301 NO OUTTTASB TEXAS ASSOCIATION OF SCHOOL BOARDS TX NO IN76048 Texas Childrens Health Plan NO INBS900 Texas Health Insurance Risk Pool TX NO OUT86916 TEXAS HEALTH STEPS NO IN74214 TEXAS MUNICIPAL LEAGUE GROUP NO INTXP11 Texas Plan Administrators NO INTPG11 TEXAS PODIATRY GROUP NO INTH089 Texas Premier Plan TX NO INTTCEC TEXAS TRUE CHOICE NO INBOONG The Boon Group NO IN75600 The City of Odessa NO IN28777 THE EPOCH GROUP NO INEYEPA The EyePA NO IN
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37305 THE FORD METER BOX COMPANY, INC. NO IN20356 The Health Exchange (Cerner Corporation) NO IN31147 The Health Plan (Ohio BWC) NO OUT35206 The Healthcare Group NO IN58200 THE INTEGRITY BENEFIT NETWORK, INC. NO OUT23223 The Loomis Company - TPA Wyomissing, PA (IHS Gatew NO IN59221 THE MEGA LIFE & HEALTH INS. CO. NO IN59225 The MEGA Life & Health Insurance Company - (Star H NO IN59227 The MEGA Life & Health Insurance Company-OKC NO IN63092 THE OATH HEALTH PARTNERS OF ALABAMA NO IN72112 THE OATH FOR LOUISIANA NO IN04320 THE PREFERRED HEALTHCARE SYSTEM-PPO NO IN87265 THE TPA (BENESIGHT) NO IN38200 THE WELLNESS PLAN NO IN
THERA Theraphysics (All but Colorado) ALL BUT CO NO INCOTHE THERAPHYSICS- COLORADO ONLY NO IN16131 Third Party Claim Management NO IN95266 THIRD PARTY CLAIMS MANAGEMENT NM NO INSX160 Thomas H. Cooper NO IN39065 Time Insurance NO IN48055 Today's Option (American Progressive and Pyramid L NO INAFL01 TOLEDO PUBLIC SCHOOLS NO IN92620 Tongass Timber Trust NO IN61425 Tooling and Manufacturing Assocation NO INTHIPA Torrance Hospital IPA NO IN16126 TOTAL CARE CHOICE NO IN31182 Total Community Care NO OUT31147 Total Health Management - PBM (Ohio BWC) NO OUT38201 Total Healthcare, Inc. NO IN97910 Touchpoint Health Plan HMO NO IN23856 Touchstone Health PSO NO IN13402 Touchstone Health/Health Net SmartChoice NO IN69493 Tower Life NO IN
TKFMC Town & Country NO IN37230 TR PAUL, INC. NO IN
SMDC0 TrailBlazer Health Enterprises (THE) NO OUTTOLI2 TRANSAMERICA OCCIDENTAL LIFE INS CO NO IN37284 TRANSCHOICE - KEY BENEFIT ADMINISTRATORS NO INTRAN1 TRANSWESTERN INSURANCE ADMIN, INC. NO IN16412 Travelers Health Network - HMO (Metrahealth) NO IN16412 Travelers/CGT-PPO NO IN39181 TRIAD HEALTHCARE, INC (PLAINSVILLE, CT) NO IN38520 Tricare (CHAMPUS) - North Region YES IN38520 Tricare (CHAMPUS) - South Region YES IN
CHTRW TRICARE (CHAMPUS) - West Region NO INPDT01 TriCities IPA NO INBS924 Trigon Blue Cross Blue Shield (Virginia) NO OUTIP060 Trinidad Rancheria CA NO IN38269 Trinity Health Plans YES IN81400 Tristate NO IN
TCUSA TRUE CHOICE USA NO INTCUCH TRUE CHOICE USA-CHRISTUS HEALTH PLAN NO IN91078 TRUSTEED PLANS SERVICE CORPORATION NO IN61425 Trustmark NO IN76054 TTPA COMM NO IN04298 Tufts Health Plan YES IN
UPGUT TX UNIVERSITY HEALTH PLAN UPG NO IN75206 TXEN ALTPROS NO OUTOBAPL UA 125 HEALTH AND WELFARE PLAN NO INUBHRI UBH Employer Division NO IN16412 UBH- United Behavioral Health (former MetraHealth NO IN60054 UC CARE (UNIV. OF CA) ALL NO IN33056 UCMN - United Care Medical Network NO IN65006 UCSF/CSL PULMONARY NO IN
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TH065 UFCW NO IN22329 UHP of New Jersey UT NO IN75240 UICI-ADMINISTRATORS NO IN75245 UICI-ADMINISTRATORS - ST OF NEVADA NO IN37292 UMMH NO IN52180 UMWA HEALTH & RETIREMENT FUNDS NO IN80314 UNICARE NO IN65099 UNICARE (Old John Hancock) NO IN47195 UNICARE of Texas NO IN65099 UNICARE- Special Accounts NO IN35198 Unified Group Services NO IN62170 UNIFIED HEALTH SERVICES NO IN75243 Uniform Medical Plan/ Harrington Benefit Services NO IN13142 UNION LABOR LIFE INSURANCE COMPANY NO IN87042 UNION PACIFIC RAILROAD EMPLOYEES NO IN70408 Union Security Insurance Company NO IN25175 Unison Health Plan / Three Rivers Health Plans NO IN62183 Unison Health Plan/Better Health Plans NO INSKLA0 UNISYS Corp. NO OUTUBHRI United Behavioral Health - UBH RIOS NO INUBHRI United Behavioral Health (UBH) NO IN59069 UNITED BENEFITS/POE & BROWN NO IN
UFCW1 UNITED FOOD AND COMMERCIAL WORKERS - UFCW NO INUFWIF UNITED FURNITURE WORKERS INSURANCE NO IN87726 United Healthcare ALL NO IN87726 United Healthcare - Evercare ALL NO IN87726 United HealthCare (formerly MetraHealth Care Plans ALL NO IN87726 United HealthCare (formerly The Travelers, Travele ALL NO IN87726 United HealthCare of Alabama ALL NO IN87726 United HealthCare of Arizona, Inc. ALL NO IN87726 United HealthCare of Arkansas ALL NO IN87726 United HealthCare of California - Northern California ALL NO IN87726 United HealthCare of California - Southern California ALL NO IN87726 United HealthCare of Colorado, Inc. ALL NO IN87726 United HealthCare of Florida ALL NO IN87726 United HealthCare of Georgia ALL NO IN87726 United HealthCare of Illinois ALL NO IN87726 United HealthCare of Kentucky, Ltd. ALL NO IN87726 United HealthCare of Mississippi ALL NO IN87726 United HealthCare of New England ALL NO IN87726 United HealthCare of New York (includes New York a ALL NO IN87726 United HealthCare of North Carolina, Inc. ALL NO IN87726 United HealthCare of Ohio ALL NO IN87726 United HealthCare of Texas -Dallas ALL NO IN87726 United HealthCare of Texas- Houston ALL NO IN87726 United HealthCare of the Mid-Atlantic ALL NO IN87726 United HealthCare of the Midlands - HMO (Choice Se ALL NO IN87726 United HealthCare of the Midlands - PPO (Choice Pl ALL NO IN87726 United HealthCare of the Midwest - Choice, Choice ALL NO IN87726 United HealthCare of Upstate New York ALL NO IN87726 United HealthCare of Utah ALL NO IN87726 United HealthCare of Virginia ALL NO IN87726 United Healthcare Plans of Puerto Rico ALL NO IN84132 United Medical Alliance NO IN31107 UNITED MEDICAL RESOURCES NO IN71412 United of Omaha NO IN84132 United Physicians NO CO NO IN
PRGON United Physicians of Northern Colorado CO NO IN41194 UNITED RESOURCES NETWORK NO IN13545 UNITED STATES LIFE INSURANCE COMPANY NO IN66705 Unity Health Insurance NO IN81400 Unity/Precision Health Plans NO INSX087 Univera - Health Care Plan/ChoiceCare Buffalo NO OUTSX086 Univera - Pre Paid Health Plan of NY YES OUT
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SX088 Univera - Univera Health Southern Tier YES OUTSX090 Univera SSA ENY YES OUTSX091 Univera SSA WNY YES OUT33002 UNIVERSAL CARE - TENNESSEE NO IN33001 UNIVERSAL CARE- CALIFORNIA NO INUNIV1 UNIVERSAL HEALTH CARE, INC. (ST. NO IN58246 UNIVERSAL HEALTH PLAN NO IN31147 University Comp Care (Ohio BWC) NO OUT09830 University Family Care NO IN07503 University Family Care - Healthcare Group NO OUT09908 University Family Care - Maricopa Health Plan NO IN58248 UNIVERSITY HEALTH PLAN NO INSX155 University of Utah Health Plans NO OUT91136 University of Washington Students AK NO INIP056 Upland Medical Group NO IN23281 UPMC HEALTH PLAN NO IN38337 UPPER PENINSULA HEALTH PLAN NO OUT93092 US Benefits NO INlabor US Department of Labor YES in
USFHP US FAMILY HEALTH PLAN (USFHP) NO IN23222 US/HEALTHCARE (HMO) NO OUT
USAHW USA Health and Wellness NO IN74095 USAA (UNITED STATES AUTOMOBILE ASSOC) NO INUSC11 USC Health Services NO IN13407 USFHP ST. VINCENT CATHOLIC MEDICAL NO OUT23217 USI ADMINISTRATORS NO OUT36369 UTILMED NO OUT76049 UTMB HEALTHCARE SYSTEMS NO IN12115 VA Fee Basis Programs NO IN
VALHLTH Vale-U-Health NO IN94999 VALLEY BAPTIST HEALTH PLAN NO IN75261 VALLEY HEALTH PLAN NO INIP044 Valley of the Moon CA YES IN77004 VALLEY PHYSICIANS, INC. NO OUT23253 Valley Preferred - PPO Allentown, PA (IHS Gateway NO IN00814 Value Options Arizona Medicaid AZ YES OUT00813 Value Options Commerical Claims YES OUT00816 Value Options Massachusetts Behavioral Health MA YES OUT00819 Value Options New Mexico Medicaid NM YES OUT00817 Value Options Pennsylvania Medicaid PA YES OUT00818 Value Options Texas Northstar TX YES OUT23173 Vanderbilt Health Plan/VHP COMMUNITY CARE NO OUT
SYMED Vanguard Health Systems (SynerMed) NO IN72128 VANTAGE HEALTH PLAN, INC. NO OUTPPM01 Vantage Medical Group NO IN60054 VARIAN HEALTH CARE PLAN ALL NO INGASA1 Verity National Group, Inc. (formerly Group Admin NO IN54182 VICARE ADMINISTRATIVE SERVICES NO INVVIPA Victor Valley IPA NO IN24818 Vida Care NO INCVAK1 Virginia Medicaid NO OUT54176 Virginia Premier Health Plan VA YES IN37297 VISION CARE INCORPORATED NO IN55248 VISTA HEALTH PLAN NO IN59266 Volusia Health Network NO IN22264 VYTRA HEALTHCARE NO IN62111 W.C. BEELER & COMPANY NO IN75257 WAL-MART NO IN84980 WAL-MART (BLUE CARD CARRIERS) TX NO IN37294 WASHINGTON EMPLOYERS TRUST NO IN38356 Washtenaw Community Health Organization NO INOBALB WATERLOO MUNICIPAL EMPLOYEES HEALTH NO IN73155 Waterstone Benefit Administrators NO IN58082 WATKINS ASSOCIATED INDUSTRIES, INC. NO IN
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PROFESSIONAL CLAIMS PAYER LIST
39151 WEA INSURANCE GROUP NO IN75261 WEB TPA NO IN14164 Wellcare of Connecticut NO IN59608 Wellcare of Florida NO IN14163 Wellcare of Georgia NO IN14163 Wellcare of Louisiana NO IN14164 Wellcare of New York NO IN14163 Wellcare of Ohio NO IN77072 Wellcare PFFS NO INBS803 WellChoice of NJ NO OUT
WELMD WELLMED (ENCOUNTERS) NO INWELM2 WELLMED/SECURE HORIZONS (CLAIMS) NO IN25129 WellPath NO IN87815 Wells Fargo TPA (formerly Acordia National) NO IN22925 WELS Benefit Plan Office NO IN91136 West Coast Stationary Engineers AK NO INCMSI1 West Covina Medical Group NO OUT24735 Western Growers Assurance Trust NO IN24735 Western Growers Insurance Company NO IN37306 Western Health Inc NO IN37247 WESTERN MUTUAL INSURANCE NO IN31048 WESTERN SOUTHERN FINANCIAL GROUP NO INTH101 Westlake Financial Group NO IN38232 WEYCO NO IN98010 WILLIAM J. SUTTON & COMPANY NO IN62061 WILLIS ADMINISTRATIVE SERVICES CORP. NO IN62061 WILLIS COROON NO IN62153 Windsor Medicare Extra NO IN
WNHLT WINHEALTH PARTNERS NO IN73159W WINTERBROOK HEALTHCARE NO IN39200 Wisconsin Auto and Truck Dealers NO IN61101 WISCONSIN EMPLOYERS GROUP NO IN81949 WOODMAN ACCIDENT AND LIFE COMPANY TX NO OUTSX067 Workers Comp of West Virginia YES OUT
TWCCP WORKERS' COMPENSATION NO IN20333 Worksite Benefit Services, LLC NO IN75276 WORLD INSURANCE COMPANY NO IN
WPS01 WPS Commercial NO OUTSX022 WPS/Tricare YES IN23710 Writers Guild - Industry Health Plan NO IN62153 XANTUS HEALTHPLAN OF TENNESSEE NO IN06121 YALE NEW HAVEN HEALTH - MSO INC NO IN95376 YALE PREFERRED HEALTH NO OUT09829 Yavapai County NO INSTJOE Yorba Park (St. Joseph Heritage HealthCare) NO IN75285 Young Life NO OUT
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13162 1199 National Benefit Fund NO IN75240 AAG- American Administrative Group NO IN64071 Acclaim NO IN87066 ACMG Inc.(formally Formax Inc.) NO IN61271 Admin Medical Services NO IN38265 Administration Systems Research Corp. NO IN25152 Advantra Freedom NO IN13373 Advica New York Hospital Community NO IN13376 Advica/Northeast Georgia Health System Inc. NO IN36320 Advocate Health Centers NO IN60054 Aetna NO IN57604 Aetna Affordable Health Choices (SM) - SRC NO IN13346 Aftra Health Fund NO IN91136 Alaska Children's Services Inc. AK NO IN91136 Alaska Laborers Construction AK NO IN91136 Alaska Pipe Traders Local 375 AK NO IN91136 Alaska United Food & Commercial AK NO IN37117 Alexian Brothers NO IN13550 Alicare NO IN37602 All Savers Insurance Co. NO IN88461 Alliance (a wisconsin provider network) NO IN52149 Alliance PPO Inc. NO IN58234 Alliant Health Plans of (Georgia) NO IN37308 Allied Benefits Systems NO IN13550 Amalgamated Life NO IN37225 American Benefit Administrative Services, Inc. NO IN60305 American Community Mutual Insurance NO IN01066 American Healthcare Alliance NO IN36369 American Imaging Management NO IN72099 American Lifecare NO IN44444 American Postal Workers Union NO IN42011 American RepublicInsurance NO IN97055 American Service Life Insurance Company NO IN86001 AmeriChoice of New Jersey NJ NO IN86002 AmeriChoice of New York NY NO IN86003 AMERICHOICE PERSONAL CARE PLUS PA NO IN26375 Amerigroup (Dallas/Ft. Worth) NO IN28805 Amerigroup (Houston) NO IN28807 Amerigroup (Maryland) NO IN27516 Amerigroup (New Jersey) NO IN54763 AmeriHealth Administrators NO IN22248 AMERIHEALTH MERCY HEALTH PLAN NO IN60061 Amerihealth NJ (PPO) NO IN
23037C Amerihealth NJ/DE - HMO NO IN95044 Amerihealth NJ/DE- HMO NO IN38254 Amway Corporation NO IN54160 APS Healthcare Inc. NO IN03432 Arizona Physicians IPA AZ NO IN75278 Arkansas Best Corporation AR NO IN95440 Arnett Health Plans NO IN36326 Associates for Health Care Inc NO IN39065 Assurant Employee Benefits (Formerly Fortis Insura NO IN70408 Assurant-Fortis Benefits NO IN95691 Athens Area Health Plan NO IN22304 ATLANTICARE ADMINISTRATORS Inc. YES OUT91136 Automotive Machinists Local 289 AK NO IN46045 Avera Health NO IN74275 Baptist Healthcare Network NO IN90607 Beacon Health Strategies NO IN95377 Beechstreet Corporation NO IN37125 BeneFirst NO IN37212 Benefit Management Systems NO IN88027 BENEFIT PLAN ADMINISTRATORS (BPA) NO IN37118 Benefit Plan Administrators (Roanoke) VA NO IN
INSTITUTIONAL CLAIMS PAYER LIST
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INSTITUTIONAL CLAIMS PAYER LIST
37222 Benefit Plan Management Inc. NO IN74223 Benefit Planners NO IN38257 Benefit Source Inc NO IN36342 Benefits Systems and Services Inc. (BSSI) NO IN87265 Benesight (formerly TPA) NO INBS510 Blue Cross Blue Shield of Alabama AL YES OUTBS530 Blue Cross Blue Shield of Arizona AZ YES OUT00520 Blue Cross Blue Shield of Arkansas AR YES OUTBS550 Blue Cross Blue Shield of Colorado (anthem) CO YES OUTBS563 Blue Cross Blue Shield of Connecticut CT YES OUTBS570 Blue Cross Blue Shield of Delaware DE YES OUTBS590 Blue Cross Blue Shield of Florida FL YES OUTBS600 Blue Cross Blue Shield of Georgia GA YES OUT00621 Blue Cross Blue Shield of Illinois IL YES OUTBS630 Blue Cross Blue Shield of Indiana (Anthem) IN YES OUTBS030 Blue Cross Blue Shield of Iowa IA YES OUTBS660 Blue Cross Blue Shield of Kentucky (Anthem) KY YES OUT23738 Blue Cross Blue Shield of Louisiana LA YES OUTBS680 Blue Cross Blue Shield of Maine (Anthem) ME YES OUTBS690 Blue Cross Blue Shield of Maryland - Carefirst MD YES OUTBS700 Blue Cross Blue Shield of Massachussetts MA YES OUTBS710 Blue Cross Blue Shield of Michigan MI YES OUTBS711 Blue Cross Blue Shield of Michigan - Blue Care Net MI YES INBS720 Blue Cross Blue Shield of Minnesota MN YES OUTBS730 Blue Cross Blue Shield of Mississippi MS YES OUTBS241 Blue Cross Blue Shield of Missouri MO YES OUTBS242 Blue Cross Blue Shield of Missouri - Kansas City MO YES OUTBS760 Blue Cross Blue Shield of Nebraska NE YES OUTBS765 Blue Cross Blue Shield of Nevada (Anthem) NV YES OUTBS770 Blue Cross Blue Shield of New Hampshire NH YES OUTBS003 Blue Cross Blue Shield of North Carolina NC YES INBS338 Blue Cross Blue Shield of Ohio (Anthem) OH YES OUT54771 Blue Cross Blue Shield of Pennsylvania - Highmark PA YES INBS390 Blue Cross Blue Shield of Tennessee TN YES OUT
BS84980 Blue Cross Blue Shield of Texas TX YES OUTBS088 Blue Cross Blue Shield of Utah UT YES INBS923 Blue Cross Blue Shield of Virginia VA YES OUTBS950 Blue Cross Blue Shield of Wisconsin (Anthem) WI YES OUT5522I Blue Cross of Alaska AK YES OUT47198 Blue Cross Of California CA YES OUTBS870 Blue Cross of Rhode Island RI YES OUTBS064 Blue Shield - Hawaii HI YES IN94036 Blue Shield Of California CA YES OUT00611 Blue Shield of Idaho (Regence) ID YES OUT74238 Boon-Chapman Benefit Administrators NO IN13337 Boston Medical Center Healthnet YES OUT48964 BPS Inc. NO IN37285 Bridgestone Claims Services NO IN51037 Brokerage Concepts NO IN94316 Brown & Toland Medical Services NO IN32004 Buckeye Community Health NO IN59334 Cambridge ISG NO IN
CAMAA Cameron and Associates NO IN71063 CAN NO IN38245 Cape Health Plan NO IN68011 Capitol Administrators NO IN77082 Care Improvement Plus NO IN11331 Care Management Group of Greater NY Inc. NO IN14184 CareCore National - Healthnet NO IN25139 Carelink Advantra/Carelink Health Plan NO IN39280 CareOne Health Plan (MED3000) NO IN37311 CareSource of Indiana NO IN62073 Cariten Healthcare NO IN62072 Cariten Senior Health NO IN
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57105 CAROLINA CARE PLAN Inc. NO IN25125 Carpenter's Health and Welfare Trust Fund of St. L NO IN37060 Caterpillar NO IN55438 CBCA Administrators NO IN41124 CBSA NO INCELTC Celtic Insurance NO IN91136 Cement Masons & Plasterers Health AK NO IN13357 CenterCare NO IN31118 Central Benefits Life NO IN31118 Central Benefits Mutual NO IN31118 Central Benefits National NO IN34097 Central Reserve Life NO IN36215 Central States Health & Welfare Funds NO IN48120 Century Health Solutions NO IN23171 CHA- Commonwealth Health Alliance NO IN84146 CHAMP VA - HAC YES OUT68241 Choice Plus (TRW) NO IN39112 CHP/RPU (FABOH) NO IN61271 Christian Brothers Services NO IN95266 CIGNA Flex Care (New Mexico only) NO IN62308 CIGNA HealthCare (HMO & PPO) NO IN86033 CIGNA Senior NO IN39141 CLAIM MANAGEMENT SERVICES Inc NO IN37123 Colonial Healthcare NO IN25351 Columbia Cornell Care NO IN91162 COLUMBIA UNITED PROVIDERS NO IN37237 COMMONWEALTH ADMINISTRATIVE GROUP NO IN25179 Community Care Behavioral Health Organization NO IN73143 Community Care Managed Health Care NO IN39126 Community Care Organization NO IN38325 Community Choice Of Michigan NO IN35193 Community Health Alliance NO IN48145 Community Health Choice NO IN75261 Community Health Elec. Clearinghouse NO IN
CHPWA Community Health Plan Of Washington NO IN13374 COMMUNITY PREMIER PLUS FOR NEIGHBOR NO IN32481 COMMUNITY PREMIER PLUS FOR NEIGHBOR NO IN06105 Connecticare Inc. NO IN62308 Connecticut General - Medical Claims NO IN35196 Conseco Services LLC NO IN71404 Continental General Insurance Co NO IN35196 Continental Life & Accident Co NO IN52132 Cooperative Benefit Administrators NO IN75136 Coresource of Little Rock NO IN35180 Coresource of NC NO IN35182 CoreSource of PA/MD/IL NO IN
41045X CoreSource/CoreStar NO IN62553 Country Life Insurance Company NO IN58102 Covenant Administrators NO IN25133 Coventry Health & Life (Oklahoma) KS NO IN25130 Coventry Health Care of Deleware Inc. DE NO IN25127 Coventry Health Care of Georgia Inc. GA NO IN25132 Coventry Health Care of Iowa Inc. IA NO IN25134 Coventry Health Care of Kansas Inc. KS NO IN25135 Coventry Health Care Of Louisiana Inc. LA NO IN25136 Coventry Health Care of Nebraska Inc. NE NO IN25147 COVENTRY HEALTH CARE SOUTH NO IN64068 Creative Medical Systems NO IN87726 Definity Health ALL NO IN63081 Deleware Health Plan Consortium NO IN25137 DelewareCare DE NO IN35186 Dunn and Associates Benefits Administrators Inc. NO IN81039 EBMS (Employee Benefit Management Services Inc NO IN73288 EHI (Employers Health Insurance) NO IN
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INSTITUTIONAL CLAIMS PAYER LIST
52192 Elder Health Hmo Of Pennsylvania YES OUT34555 Emerald HMO (HMO Claims only) NO IN61101 EMPHESYS NO IN38241 Employee Benefit Concepts Inc. NO IN37215 Employee Benefit Corporation NO IN37216 Employee Benefit Services NO IN41198 EMPLOYEE BENEFIT SERVICES OF LOUISIANA (A DIVISION NO IN03036 EMPLOYEE BENEFITS PLAN ADMIN (E.B.P.A.) NO IN35112 Employee Plans LLC NO IN54098 Employee Security Inc. NO INMIDSC EMPLOYERS COALITION ON HEALTH (ECOH) NO IN75232 Employers Direct Health NO IN
EMPHE Employers Health Insurance NO IN39026 Employers Insurance of Wausau NO IN59298 Employers Mutual Inc (FL) NO IN37110 Encompass NO IN35206 Encore Health Network NO IN91136 Enstar Natural Gas - G#P61 AK NO IN62308 Equicor-PPO NO IN62308 Equitable (CIGNA) NO IN61271 Equitable Health Plan NO IN73126 Equitable Plan Services NO IN23250 Erin Group Administrators NO IN87726 Evercare ALL NO IN58233 Evergreen Heatlh Plan NO IN61271 EXCEL NO IN71412 ExclusiveCare NO IN31472 Famile Health Partners- Healthwave of Kansas NO IN43173 FAMILY HEALTH PARTNERS NO IN
FQHC1 Federally Qualified Healthcare Clinic YES OUT41041 Federated Mutual NO IN11315 FIDELIS CARE NEW YORK NO IN69140 First Allmerica NO IN69140 First Allmerica Financial Life Ins. Co. NO IN56196 First Caroline Care NO IN14162 First Choice (CT) NO IN91131 First Choice Health Network NO IN75138 First Choice of Midwest (PPO) NO IN87043 First Health (Alta Health Strategies) NO IN73159 First Health Network (formerly CCN and PPO OK) NO IN63080 First State Health Plan NO IN39026 Fiserv Health Services NO IN59276 Florida 1ST NO IN3561l Florida Healthy Options HMO NO IN48116 Florida Hospital Waterman NO IN48117 FMH coursource NO IN39065 Fortis Insurance Company NO IN64069 Fox-Everett Inc. NO IN64067 Fox-Everett Ingalls Ship Building NO IN34171 FrontPath Health Coalition NO IN67815 G.E. Group Life Assurance Company NO IN37283 Gallagher Benefit Administrators NO IN31147 Gates McDonald Health Plus Inc. NO OUT25169 Gateway Health Plan Medicaid PA NO IN06143 GE Group Administrators NO IN67815 GE Group Life Assurance Company NO IN75273 GEISINGER HEALTH PLAN NO IN63665 General American Life Insurance Company (Sanus/St. Louis) NO IN52098 George Washington Health Plan NO IN61271 Georgia Power Medical Benefits Plan (Health Care Services) NO IN25531 GHI HMO select NO IN13551 GHI- New York (Group Health Inc.) NO IN25141 GHP (Group Health Plan) NO IN07205 Gilsbar Inc. NO IN
© 2008 DataLink Solutions and it's affiliates 4 of 13
DataLink SolutionsInnovative Revenue Cycle Solutions
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10/30/2008
External Payer ID
Payer Name State Enrollment Network
INSTITUTIONAL CLAIMS PAYER LIST
91136 Glassworkers Health & Welfare AK NO IN37602 Golden Rule Insurance NO IN34025 Goodyear Tire & Rubber Company NO IN44054 Government Employees Hospital Association NO IN95467 Great Lake Health Plan NO IN80705 Great West Life & Annuity Ins. Co NO IN36338 Group Administrators NO IN39167 Group Health Coop/So. Central NO IN39168 Group Health Coop/So. Central NO IN91121 Group Health Cooperative - East NO IN91051 Group Health Cooperative - West NO IN64246 Guardian Life (The Guardian) NO IN37114 H.E.R.E.I.U Welfare Pension Funds NO IN75196 Harrington Benefit Services - Centra NO IN06131 Harrington Benefit Services Inc. NO IN95266 Harrington Benefit Services Inc. NO IN59142 Harrington Benefit Srvs/Health Plan Srvs- OK NO IN75201 Harris Methodist Health Plan NO IN75202 Harris Methodist Health Plan NO IN04271 Harvard Pilgrim Health Care NO IN34185 HAS- Health Administration Services NO IN37215 HCH Administration NO IN37111 HCH Administration Peoria NO IN23172 Health Alliance Exclusive NO IN77950 Health Alliance Medical Plans NO IN38224 Health Alliance Plan of Michigan NO IN25126 Health Assurance/Health America Inc./Advantra NO IN42102 Health Care Network of Wisconsin (HCN) NO IN56142 Health Care Savings NO IN34158 Health Design Plus (Hudson) OH NO IN75234 Health First TPA (Tyler) TX NO IN95567 Health Net CA NO IN20199 Health Net America NO IN95570 Health Net California (Encounters) CA NO IN38309 HEALTH NET OF ARIZONA AZ NO IN06108 Health Net of the Northeast Inc. NO IN58216 Health One Alliance NO IN62157 Health Partners - Jackson TN NO IN80142 Health Partners (PA) PA NO IN37221 Health Plan Management NO IN44273 Health Plans Inc. NO IN11324 Health Plus PHSP (Brooklyn - NY) NO IN41170 Health Risk Management (HRM) NO IN37290 Health Services for Children with Special Needs NO IN34167 Health Services Preferred by Emerald NO IN62168 HealthChoice of Memphis NO IN80141 Healthfirst Inc. NY NO IN23226 HealthGuard of Lancaster NO IN59087 HealthHelp Network Inc. (HHNI) NO IN96475 HEALTHLINK HMO NO IN
90001A Healthlink PPO (Natl Capital Pref Provider Org) NO IN43132 Healthnet- Kansas City MO NO IN48153 Healthscope Benefits Inc. (Repricing) NO IN71063 Healthscope Benefits Inc. (Repricing) NO IN75250 HealthSmart Preferred Care NO IN01041 Healthsource ME NO IN02041 Healthsource MA NO IN16126 Healthsource NY NO IN31141 Healthsource OH NO IN35167 Healthsource IN NO IN58210 Healthsource GA NO IN61127 Healthsource KY NO IN62129 Healthsource TN NO IN62308 Healthsource - AR AR NO IN
© 2008 DataLink Solutions and it's affiliates 5 of 13
DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
INSTITUTIONAL CLAIMS PAYER LIST
62308 Healthsource - IN IN NO IN63208 Healthsource - OH OH NO IN06119 Healthsource (claims) SC NO IN06119 Healthsource (encounters) SC NO IN02041 Healthsource CMHC MA NO IN62308 Healthsource- GA GA NO IN62308 Healthsource- KY KY NO IN62308 Healthsource- ME ME NO IN62308 Healthsource- NH NH NO IN56147 Healthsource North Carolina NC NO IN75255 Healthsource of North Texas TX NO IN62308 Healthsource Provident Insurance Co. NO IN62308 HEALTHSOURCE SOUTH NO IN25193 HealthSpring HMO NO IN36332 Healthstar Inc. NO IN69140 Healthy Choice/Healthy Choice Plus NO IN11328 Heritage New York Medical Group NO IN36335 HFN Inc. NO IN37115 Hinsdale Physicians Healthcare NO IN55247 HIP - Health Insurance Plan of New York NY NO IN86066 HMA Hawaii NO IN22099 Horizon Blue Cross Blue Shield NJ YES OUT22304 Horizon HealthCare Admin (HHA) YES OUT22326 Horizon NJ Health NO IN91136 Hotel Employees & Restaurant AK NO IN58227 HPS Paradigm NO IN41170 HRM Claim Management NO IN13335 Hudson Health Plan NO IN61101 Humana Care Plan NO IN61101 Humana Group Health Plan NO IN61101 Humana Health Chicago NO IN61101 Humana Health Chicago Insurance Company NO IN61101 Humana Health Plan NO IN61101 Humana Insurance Agency NO IN61101 Humana Insurance Company NO IN61101 Humana Medical Plan - CA NO IN61101 Humana Medical Plan - KY NO IN61125 Humana Military - Tricare south NO IN61101 Humana Wisconsin Health Organization NO IN61271 HYVEE NO IN38234 IBA Health & Life Assurance Co. NO IN41124 IBI NO IN41600 IMCARE NO IN54704 Independence Blue Cross PA YES IN35204 Indiana Health Network IN NO IN35107 Indiana Teamsters Health Benefits Fund IN NO IN31053 Individual Health Insurance Companies NO IN52148 Individual Practice Assoc. (M.D. -IPA) (HCFA NO IN04320 INNOVATIVE HEALTHWARE SOLUTIONS NO IN68241 Institutes of Quality NO IN13315 Insurance Design Administrators NO IN88006 Insurance Management Services NO IN31127 Integra Group NO IN34167 Integrated Care Network by Emerald NO IN58200 Integrity Benefit Network NO INSX079 Inter-County Health Plan NO IN36609 International Brotherhood of Boilermakers NO IN41124 Iowa Benefits NO IN61271 J.F. Molloy and Associates Inc. NO IN41099 John Alden Life Insurance Co. NO IN95378 John Deere Health Care NO IN43178 Joplin Claims NO IN34136 JP Farley Corporation NO IN37272 JSL ADMINISTRATORS NO IN
© 2008 DataLink Solutions and it's affiliates 6 of 13
DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
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INSTITUTIONAL CLAIMS PAYER LIST
21313 Kaiser Foundation Health Plan of Georgia NO INKS003 Kaiser Foundation Health Plan of N. California region CA NO INKS001 Kaiser Foundation Health Plan of S. California region CA NO IN52095 Kaiser Foundation Health Plan of the Mid-Atlantic NO IN
COKSR KaiserFoundation Health Plan of Colorado NO IN57038 Kanawha Insurance Co. NO IN44030 Kansas City Life Insurance Co. NO IN73100 Kempton Company/Kempton Group Adm NO IN77039 Kern Health Systems NO IN37217 Key Benefit Administrators NO IN23284 Keystone Mercy Health Plan NO IN34145 KLAIS & Company NO IN37112 Lake Forest Managed Care Associates NO IN75279 Leggett And Platt NO IN11123 Liberty Mutual Insurance Company NO IN61101 Lincoln National NO IN62310 Lovelace Health Plan NO IN90328 Lovelace Sandia Health Plan NO IN62310 Lovelace Senior Options (LSO) NO IN62310 Lovelace Senior Plan (LSP) NO IN54195 LUMENOS NO IN22445 MAG Mutual Healthcare Solutions NO IN01260 Magellan Behavioral Health NO IN11303 Magnacare NO IN62413 Mail Handlers Benefit Plan (CAC) NO INMA001 MAMSI Life & Health Ins. Co. (MLH) (HCFA 1500 only) NO IN35162 Managed Care Services NO IN22771 Managed Health Network NO IN39187 Managed Health Services of Wisconsin WI NO IN35196 Manhattan National Life Insurance Co NO IN00247 Maryland Physicians Care MD NO IN41154 Mayo Management Services NO IN38264 Mcare NO IN38338 Mclaren Health Plan NO IN20475 MD Wise Hoosier Alliance NO IN11338 MDNY Healthcare NO IN58202 Medadmin Solutions NO IN56162 MEDCOST Inc NO IN94265 Medica NO IN
MDCLNK Medicaid - Carelink NO INMDAL00 Medicaid of Alabama - EDS AL YES OUTMDAZ00 Medicaid of Arizona - AZ Health Care Cost Containment AZ YES OUTMDAR00 Medicaid of Arkansas AR YES OUTMDCA00 Medicaid of California - EDS - Medi-Cal CA YES OUTMDCO00 Medicaid of Colorado CO YES OUTMDCT00 Medicaid Of Connecticut - Eds CT YES OUTMDDE00 Medicaid of DE- EDS DE YES OUTMDFL00 Medicaid of Florida - ACS Inc. FL YES OUTMDGA00 Medicaid Of Georgia - Acs Inc. GA YES OUTMDHI00 Medicaid Of Hawaii - Acs Inc. HI YES OUTMDID00 Medicaid Of Idaho - Eds ID YES OUTMDIL00 Medicaid of Illinois IL NO INMDIN00 Medicaid of Indiana - EDS KS YES OUTMDIA00 Medicaid of Iowa KY YES OUTMDKS00 Medicaid of Kansas - EDS LA YES OUTMDKY00 Medicaid of Kentucky - EDS ME YES OUTMDLA01 Medicaid Of Louisiana - Ambulance Claims LA YES OUTMDME00 Medicaid of Maine ME YES OUTMDMD00 Medicaid Of Maryland - Department Of Health And Me MD YES OUTMDMA00 Medicaid of Massachusetts MA YES OUTMDMI00 Medicaid of Michigan MI YES OUTMDMN00 Medicaid Of Minnesota - Dept. Of Human Services MN YES OUTMDMS00 Medicaid Of Mississippi - Acs Inc. MS YES OUTMDMO00 Medicaid of Missouri MO YES OUT
© 2008 DataLink Solutions and it's affiliates 7 of 13
DataLink SolutionsInnovative Revenue Cycle Solutions
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External Payer ID
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INSTITUTIONAL CLAIMS PAYER LIST
MDNE00 Medicaid Of Nebraska - Health And Human Services O NE YES OUTMDNJ00 Medicaid of New Jersey - UNISYS Corp. NJ YES OUTMDNY00 Medicaid of New York - AmeriChoice of NY NY YES OUTMDOH00 Medicaid of Ohio - Dept. of Human Services OH YES OUTMDPA00 Medicaid of Pennsylvania - EDS PA YES OUTMDRI00 Medicaid of Rhode Island - EDS RI YES OUTMDTX00 Medicaid of Texas TX NO INMDVA00 Medicaid of Virginia - First Health Services Corp. VA YES OUTMDWV00 Medicaid of West Virginia - UNISYS Corp. WV YES OUTMDWI00 Medicaid of Wisconsin WI YES OUT
74323 Medical Benefits Mutual NO IN04258 MEDICAL CLAIMS SERVICE Inc. NO IN75229 Medical Control Inc. NO IN52181 Medical Development International NO IN29076 Medical Mutual of Ohio OH NO IN62177 Medical Reimbursement Associates NO IN38224 Medical Value Plan - MVP- OH NO IN
MCAL00 Medicare Of Alabama - Cahaba Gba AL YES OUTMCAK00 Medicare Of Alaska - Noridian AK YES OUTMCAZ00 Medicare Of Arizona - Noridian AZ YES OUTMCAR00 Medicare Of Arkansas - Noridian AR YES OUTMCCA01 Medicare Of California - Northern Region - Nhic CA YES OUTMCCO00 Medicare Of Colorado - Noridian CO YES OUTMCCT00 Medicare Of Connecticut - First Coast Services CT YES OUTMCFL00 Medicare of Florida - First Coast Services FL YES OUTMCGA00 Medicare Of Georgia - Cahaba Gba GA YES OUTMCHI00 Medicare Of Hawaii - Noridian HI YES OUTMCID00 Medicare Of Idaho - Cigna ID YES OUTMCIL00 Medicare Of Illinois - Wisconsin Physicians Servic IL YES OUTMCIN00 Medicare Of Indiana - Adminastar IN YES OUTMCIA00 Medicare Of Iowa - Noridian IA YES OUTMCKS00 Medicare Of Kansas - Blue Cross Blue Shield Of Kan KS YES OUTMCKY00 Medicare Of Kentucky - Adminastar KY YES OUTMCLA00 Medicare of Louisiana LA YES OUTMCME00 Medicare Of Maine - Nhic ME YES OUTMCMD00 Medicare Of Maryland MD YES OUTMCMA00 Medicare Of Massachusetts - Nhic MA YES OUTMCMI00 Medicare Of Michigan - Wisconsin Physicians Service MI YES OUTMCMS00 Medicare Of Mississippi - Cahaba Gba MS YES OUTMCNE01 Medicare of Mutual of Omaha * NE YES OUTMCNE00 Medicare Of Nebraska - Blue Cross Blue Shield Of K NE YES OUTMCNJ00 Medicare Of New Jersey - Hgsa NJ YES OUTMCNY00 Medicare of New York - Empire NY YES OUTMCOH00 Medicare Of Ohio - Palmetto OH YES OUTMCRI00 Medicare of Rhode Island RI YES OUTMCTN00 Medicare Of Tennessee - Cigna TN YES OUTMCTX01 Medicare Of Texas - Healthfirst TX YES INMCTX00 Medicare of Texas - Trailblazers TX YES INMCUT00 Medicare Of Utah - Medicare/Blue Shield Of Utah UT YES OUTMCVA00 Medicare Of Virginia - Trailblazers VA YES IN
16412 Medicare-Complete - United Healthcare of the Midwest NO IN58216 MedPlan PPO NO IN62160 MedSolutions Inc. NO IN59222 Mega Life- Transamerica Life Insurance NO IN62181 Memorial Clinical Associates NO IN36193 Memphish Managed Care NO IN71079 Mercy CarePlus (formerly Community Care Plus NO INMER11 Mercy Health Plans NO IN77042 Meridian Health Care Management NO IN95420 Methodist Care NO IN37127 Michael Reese Physicians Group NO IN52149 Mid Atlantic Psychiatric Services Inc. (MAPSI) NO IN63079 Mid-Atlantic Health System NO IN47080 Midlands Health Partners NO IN
© 2008 DataLink Solutions and it's affiliates 8 of 13
DataLink SolutionsInnovative Revenue Cycle Solutions
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INSTITUTIONAL CLAIMS PAYER LIST
31140 Mid-Valley CareNet NO INMHP77 Midwest Health Plan NO IN59224 Mid-West National Life Insurance (Megalife) NO IN68241 Minneapolis Prudential Business (Medical) NO IN64088 Mississippi Select Healthcare NO IN38334 Molina Healthcare Of Michigan MI NO IN20149 Molina Healthcare of Ohio OH NO IN00076 Molina of Indiana IN NO INMMLI3 Monumnetal Life Insurance Co. YES OUT36111 Motorola Inc NO IN86040 Mountain States Administrative NO IN95444 MPLAN Inc/HEALTHCARE GROUP LLC NO IN69140 Mutual Alliance Plan (MAP) NO IN37256 Mutual Assurance Administrators NO IN70491 Mutual Group (The) NO IN71412 Mutual of Omaha Insurance Company NO IN91136 N.W. Iron Workers Health & Security AK NO IN91136 N.W. Roofers & Employers Health & Security AK NO IN91136 N.W. Textile Processors AK NO IN56176 National Benefit Administrators - N.C. NC NO IN35196 National Group Life Insurance Company NO IN75275 National Health Insurance Company NO IN53011 National Rural Letter Carrier Association NO IN31417 Nationwide Health Plans NO IN75190 NCAS - Fairfax VA NO IN8588M Neighborhood Health Plan NO IN04293 NEIGHBORHOOD HEALTH PLAN (Boston) NO IN11325 NEIGHBORHOOD HEALTH PROVIDERS NO IN81400 Network Health PPO MA NO IN39111 Network Healthplan of Wisconsin NO IN96218 New Alliance Health Plan NO IN75281 New Era Life NO IN84141 New West Health Plan NO IN48186 NEW YORK PRESBYTERIAN COMMUNITY NY NO IN38225 NGS American Inc. NO IN81264 Nippon Life Insurance Company of America NO IN34159 North America Benefits Network (Cleveland) OH NO IN16644 NOVA HEALTH ADMIN. (GRAND ISLAND - NY) NO IN71080 NOVASYS NO IN35197 NPPN/Conseco NO IN37299 NYHART NO IN66916 NYLCare Health Plan NO IN72127 Ochsner Health NO IN13350 ODS Health Plan NO IN34189 OHIO HEALTH CHOICE PPO NO IN25150 Omnicare - A Coventry Health Plan NO IN80705 ONE Health Plan Inc NO IN95379 One Health Plan of California CA NO IN95412 One Health Plan of Colorado CO NO IN95569 One Health Plan of Georgia GA NO IN95388 One Health Plan of Illinois IL NO IN95415 One Health Plan of Texas TX NO IN91136 Operating Engineers Local 302 & 612 AK NO IN52148 Optimum Choice Inc. - OCI NO IN52152 Optimum Choice of the Carolinas NO IN37125 Option Services Group NO INOSFIL OSF Health Plans NO IN37116 OSG - St. Therese Physicians Association NO IN06111 Oxford Health Plans Inc. NO IN67466 Pacific Life & Annuity Company NO IN67466 Pacific Mutual Life Ins. Company NO IN95959 PacifiCare of California NO IN
COFHP Pacificare Of Colorado NO IN95999 PacifiCare PPO - All States NO IN
© 2008 DataLink Solutions and it's affiliates 9 of 13
DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
INSTITUTIONAL CLAIMS PAYER LIST
93029 PacificSource Health Plans NO IN66917 Parkland Health First NO IN56152 PARTNERS NATIONAL HEALTH PLANS OF NC NO IN61129 PASSPORT HEALTH PLAN NO IN25146 PersonalCare NO IN63088 PHA Admin Serv. NO IN06143 PHOENIX GROUP SERVICES NO IN75238 Phoenix Group Services (Texas) NO IN62155 PHP Tenncare NO IN62155 PHP TennCare (Covenant Health) NO IN
PHPMC Physician Health Partners NO IN57098 Physicians Care Network NO IN36345 Physicians Care Network (Rockford, IL only) IL NO IN12399 Physicians Health Plan of Northern Indiana NO IN47027 Physicians Mutual Insurance Company NO IN39156 Physicians Plus Insurance Corp. NO IN56151 Piedmont Administrators NO IN24735 Pinnacle Claims Management Inc NO IN35196 Pioneer Life Insurance Co NO IN73074 Pipeline Industry Benefit Fund (Tulsa) OK NO IN37224 PITTMAN & ASSOCIATES NO IN16111 Pomco NO IN72148 PPO Plus LLC NO IN38335 PPOM NO IN73145 Preferred Community Choice NO IN35173 Preferred Health Network (PHN) NO IN61106 Preferred Health Plan (Louisville) KY NO IN31478 Preferred Health Professionals NO IN36401 Preferred Network Access NO IN41147 Preferred One NO IN43166 Premier Benefits Inc. NO IN37199 Premier Health Network NO INMER11 Premier Health Plans NO IN39185 Prevea Health Insurance Plan NO IN82048 Primary Health Network NO IN56144 Primary Physician Care Inc NO IN63088 Prime Health NO IN61271 Principal Healthcare NO IN61271 Principal Healthcare Life Insurance Co. (Principal Financial) NO IN61271 Principal Life Insurance Co. NO IN36331 Professional Benefit Administrator NO IN37242 Professional Claims Management (Canton OH) NO IN58226 Promina ASO NO IN62308 Provident Healthsource (Cigna) NO IN68195 Provident Life and Accident Ins. NO IN51032 Provider Networks of America (ProNet) NO IN68241 PRU Plus NO IN68241 PruCare (of California/HMO/Plus/Wrap/PruCare 1/PruCare 2000) NO IN68241 PruChoice NO IN68241 Prudential NO IN68241 Prudential (Health Insurance/Managed Healthcare/Indemnity/Traditional) NO IN68241 Prudential (Plus/Point of Service/In-Network/Out-of-Network/Select/Plus Select) NO IN68241 Prudential (Psychiatric Mgmt./Resources Mgmt.) NO IN68241 Prudential for Health NO IN68241 Prudential HealthCare & Life Ins. Co of America NO IN68241 Prudential Healthcare (HMO/Regional Nwk/HMO Regional Nwk/HMO Metro Nwk/Associate N NO IN68241 Prudential Healthcare (Metro Nwk/Affiliates Nwk/HMO Affiliates Nwk/POS/PPO/SeniorCare/C NO IN68241 Prudential HealthCare Health Maintenance Organization NO IN68241 Prudential HealthCare HMO for Small Business NO IN68241 Prudential Healthcare of America Inc. NO IN68241 Prudential HealthCare POS for Small Business NO IN68241 Prudential HealthCare PPO for Small Business NO IN68241 Prudential HealthCare Systems (PHCS) NO IN68241 PruNet NO IN
© 2008 DataLink Solutions and it's affiliates 10 of 13
DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
INSTITUTIONAL CLAIMS PAYER LIST
68241 PruNetwork NO IN68241 PruPsych NO IN51052 PsychCare LLC NO IN91136 Puget Sound Benefits Trust AK NO IN911336 Puget Sound Electrical Trust NO IN35174 Qual Choice of Arkansas NO IN23342 QualCare Inc. NO IN37129 QUINCY HEALTH CARE MANAGEMENT Inc. NO IN00882 Railroad Medicare YES IN91176 RBMS LLC NO IN12005 Riverbend GBA NO IN37602 Rooney Life Inc. NO IN36215 Rosemont of Des Plaines NO IN68241 Rush Prudential NO IN36389 Rush Prudential HMO NO IN31441 S & S Healthcare Strategies NO IN35164 Sagamore Health Network NO IN37259 Samba NO IN13310 Seabury & Smith NO IN39045 Security Health Plan NO IN42137 Select Benefit Administrators NO IN23285 Select Health of South Carolina NO IN00014 SELECTCARE NO IN36404 Self Insured Plans NO IN34131 Self-Funded Plans Inc (IL/PA/OH) NO IN83035 Senior Whoe Health NO IN68241 SeniorCare NO IN39033 Sentry Life Insurance Company NO IN75280 Shasta Administrative Services NO IN62159 SIGNATURE HEALTH ALLIANCE NO IN94249 SMIPA/SFIPA NO IN02057 Smith Administrators NO IN25128 Southern Health Services Inc. NO IN37266 Southewest Service Life NO IN52190 Special Risk International NO IN22240 St. Barnabas System Health Plan NO IN37264 St. Johns Claims Adminstration NO IN59225 Star HRG NO IN72087 State Employees Group Benefits NO IN31053 State Farm Insurance Companies NO IN91151 Sterling Option 1 NO IN74227 Student Insurance - Boston Mutual Life Insurance Company NO IN74227 Student Insurance - Life Insurance Company of Boston and New York NO IN74227 Student Insurance - MEGA Life & Health Insurance Company NO IN74227 Student Insurance - Mid-West National Life Insurance Company of Tennessee NO IN74227 Student Insurance - Reliance Insurance Company NO IN74227 Student Insurance - Reliance National Insurance Company NO IN95202 Summacare Health Plan NO IN86071 Summerlin Life & Health Insurance NO IN23218 Superior Benefits NO INSHP11 Superior Health Plan Texas NO IN75133 Team Choice PNS NO IN75134 Team Choice UMC NO IN36215 Teamcare NO IN36612 Teamsters Local Union #301 NO IN76048 Texas Children's Health Plan NO IN74214 Texas Municipal League Group NO IN75600 The City of Odessa NO IN28777 The Epoch Group NO IN23223 The Loomis Company NO IN59221 The Mega Life & Health Insurance Co. NO IN59221 The MEGA Life & Health Insurance company NO IN59227 The MEGA Life & Health Insurance Company-OKC NO IN72112 The Oath for Louisiana NO IN
© 2008 DataLink Solutions and it's affiliates 11 of 13
DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
INSTITUTIONAL CLAIMS PAYER LIST
68241 The Prudential NO IN48055 Today's Option (American Progressive and Pyramid L NO IN61425 Tooling & Manufacturing Association NO IN38201 Total Healthcare Inc. NO IN23856 Touchstone Health PSO NO IN13402 Touchstone Health/Health Net Smart Choice NO IN69493 Tower Life NO IN38520 Tricare (CHAMPUS) - North Region YES OUT38520 Tricare (CHAMPUS) - South Region YES OUT
CHTRW Tricare (CHAMPUS) - West Region YES OUT61425 Trustmark NO IN61425 Trustmark - Starmark Only NO IN04298 Tufts Health Plan NO IN75240 UICI- Administrators NO IN75245 UICI- Administrators- St. of NV NO IN80314 UNICARE NO IN65099 UNICARE - Special Accounts NO IN62170 Unified Health Services NO IN75243 Uniform Medical Plan/Harrington Benefit Services NO IN87042 Union Pacific Railroad Employees NO IN87726 United Behavioral Health ALL NO IN59069 United Benefits/Poe & Brown NO IN87726 United Healthcare ALL NO IN87726 United HealthCare (formerly American International Group) ALL NO IN87726 United HealthCare (formerly MetraHealth) ALL NO IN87726 United Healthcare (formerly The Travelers) ALL NO IN87726 United HealthCare of Alabama ALL NO IN87726 United HealthCare of Arizona, Inc. ALL NO IN87726 United Healthcare of Arkansas ALL NO IN87726 United Healthcare of California - Northern California ALL NO IN87726 United Healthcare of California - Southern California ALL NO IN87726 United Healthcare of Colorado Inc. ALL NO IN87726 United Healthcare of Florida ALL NO IN87726 United Healthcare of Georgia ALL NO IN87726 United Healthcare of Illinois ALL NO IN87726 United Healthcare of Kentucky Ltd. ALL NO IN87726 United Healthcare of Mississippi ALL NO IN87726 United Healthcare of New England ALL NO IN87726 United Healthcare of New York (includes New York and New Jersey) ALL NO IN87726 United Healthcare of North Carolina Inc. ALL NO IN87726 United Healthcare of Ohio ALL NO IN87726 United Healthcare of Tennessee ALL NO IN87726 United Healthcare of Texas - Dallas ALL NO IN87726 United Healthcare of Texas - Houston ALL NO IN87726 United Healthcare of the Mid Atlantic ALL NO IN87726 United Healthcare of the Midlands - HMO (Choice or Select) ALL NO IN87726 United Healthcare of the Midlands - PPO (Choice Plus/Select/Select Plus) ALL NO IN87726 United Healthcare of the Midwest ALL NO IN87726 United Healthcare of Upstate New York ALL NO IN87726 United Healthcare of Utah ALL NO IN87726 United Healthcare of Virginia ALL NO IN87726 United Healthcare Plans of Puerto Rico ALL NO IN71412 United of Omaha NO IN87726 UnitedHealthcare of Louisiana ALL NO INSX088 Univera - Univera Health Southern Tier NO IN16107 Univera Healthcare NO IN16105 Univera Healthcare - CNY NO INUNIV1 Universal Health Care Inc. NO IN58248 University Health Plan NO IN58247 University Health Plan (Medicaid) NO IN58246 University Health Plans of Georgia GA NO IN91136 University of Washington Students AK NO IN23281 UPMC HEALTH PLAN NO IN38337 Upper Peninsula Health Plan NO IN
© 2008 DataLink Solutions and it's affiliates 12 of 13
DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
INSTITUTIONAL CLAIMS PAYER LIST
USFHP US FAMILY HEALTH PLAN (USFHP) NO IN74095 USAA (United States Automobile Association) NO IN13407 USFHP ST. VINCENT CATHOLIC MEDICAL NO IN23217 USI Administrators NO IN76049 UTMBP Healthcare Systems NO IN12115 VA Fee Basis Programs NO IN00813 Value Options Commercial Claims NO IN55248 Vista Health Plan NO IN22264 Vytra Healthcare NO IN75257 Wal-Mart NO IN35196 Washington National Insurance Co NO IN73155 Waterstone Benefit Administrators NO IN58082 Watkins Associated Industries Inc. NO IN39151 WEA Insurance Group NO IN75261 WebTPA/Community Health Electronic/CHEC NO IN14163 Wellcare NO IN14164 Wellcare of Connecticut NO IN14164 Wellcare of New York NO IN87815 Wells Fargo TPA formerly Acordia National NO IN91136 West Coast Stationary Engineers AK NO IN24735 Western Grower's Assurance Trust NO IN24735 Western Grower's Insurance Company NO IN38232 Weyco NO IN62061 Willis Administrative Services NO IN62153 Windsor Medicare Extra NO IN75276 World Insurance Company NO IN95376 Yale Preferred Health NO IN
© 2008 DataLink Solutions and it's affiliates 13 of 13
DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
10003 Acordia National - CHIPS/PEIA ONLY NO OUT10321 Acordia National - Mohawk/ Hickory Springs ONLY NO OUT60054 Aetna ALL NO IN60054L Aetna Long Term Care NO IN13346 Aftra Health Fund NO IN92600 Alaska Electrical Health & Welfare Fund NO IN26374 Americaid / Amerigroup NO IN60305 AMERICAN COMMUNITY MUTUAL INSURANCE NO IN62030 American General Life & Accident NO IN81400 American Medical Security NO IN44444 American Postal Workers Union NO IN42011 American RepublicInsurance NO IN86001 AmeriChoice of New Jersey NO IN00425 Ameritas Life Insurance Co. NO IN3432 Arizona Physicians IPA NO IN70408 Assurant-Fortis Benefits NO IN93221 Asuris Northwest Health NO IN59274 AvMed Health Plan (providers must include their 6 NO OUT10256 Best Choice Health Plan NO OUT95604 Best Life & Health Insurance Co. NO INBS731 Blue Cross Blue Shield Mississippi State and Teach NO OUTBS510 Blue Cross Blue Shield of Alabama AL YES OUTBS054 Blue Cross Blue Shield of Alabama - Medicare Part AL NO OUTBS530 Blue Cross Blue Shield of Arizona AZ YES OUT00520 Blue Cross Blue Shield of Arkansas AR YES OUTBS550 Blue Cross Blue Shield of Colorado (Anthem) CO NO OUTBS560 Blue Cross Blue Shield of Connecticut (Anthem) CT NO OUTBS590 Blue Cross Blue Shield of Florida FL YES INBS600 Blue Cross Blue Shield of Georgia GA NO OUT00621 Blue Cross Blue Shield of Illinois IL NO OUTBS630 Blue Cross Blue Shield of Indiana (Anthem) IN NO INBS030 Blue Cross Blue Shield of Iowa IA NO OUTBS650 Blue Cross Blue Shield of Kansas KS YES OUTBS660 Blue Cross Blue Shield of Kentucky (Anthem) KY NO OUT23738 Blue Cross Blue Shield of Louisiana LA NO OUTBS680 Blue Cross Blue Shield of Maine (Anthem) ME NO OUTBS690 Blue Cross Blue Shield of Maryland MD NO OUTBS700 Blue Cross Blue Shield of Massachusetts MA NO OUTBS710 Blue Cross Blue Shield of Michigan MI YES OUTBS720 Blue Cross Blue Shield of Minnesota MN YES OUTBS730 Blue Cross Blue Shield of Mississippi MS NO OUTBS241 Blue Cross Blue Shield of Missouri (Anthem) MO NO OUTBS765 Blue Cross Blue Shield of Nevada (Anthem) NV NO OUTBS067 Blue Cross Blue Shield of New Hampshire (Anthem) NH NO OUT00790 Blue Cross Blue Shield of New Mexico NM NO OUTBS063 Blue Cross Blue Shield of New York - Centra (Excellus) NY NO OUTBS061 Blue Cross Blue Shield of New York - Rochester (Excellus) NY NO OUTBS066 Blue Cross Blue Shield of New York - Utica/Waterto NY NO OUTBS003 Blue Cross Blue Shield of North Carolina NC YES OUTBS338 Blue Cross Blue Shield of Ohio (Anthem) OH NO OUT00851 Blue Cross Blue Shield of Oregon OR NO IN54771 Blue Cross Blue Shield of Pennsylvania - Highmark PA YES IN
54771V Blue Cross Blue Shield of Pennsylvania - Highmark PA YES INSX084 Blue Cross Blue Shield of South Carolina SC NO OUTSX084 Blue Cross Blue Shield of South Carolina - FEP SC NO OUTBS889 Blue Cross Blue Shield of South Dakota SD NO OUTBS390 Blue Cross Blue Shield of Tennessee TN YES IN
BS84980 Blue Cross Blue Shield of Texas TX NO INBS923 Blue Cross Blue Shield of Virginia (Anthem) VA NO OUTBS950 Blue Cross Blue Shield of Wisconsin (Anthem) WI NO IN10264 Blue Cross Northeastern Pennsylvania PA NO OUT10257 Blue Cross of Alaska (Premera) AK NO OUTBC001 Blue Cross of California CA NO OUT00610 Blue Cross of Idaho ID NO IN
ELIGIBILITY INQUIRY PAYER LIST
© 2008 DataLink Solutions and it's affiliates 1 of 7
DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
ELIGIBILITY INQUIRY PAYER LIST
00934 Blue Cross of Washington (Premera) WA NO OUT10284 Blue Exchange NO OUT10319 Blue Exchange 2 (Fed Tax Required) NO OUTBS064 Blue Shield - Hawaii HI NO IN94036 Blue Shield of California CA NO OUT00611 Blue Shield of Idaho (REGENCE) ID NO IN00932 Blue Shield of Washington (Regence) WA NO OUT62413 CAC (Mailhandlers Benefit Plan) NO IN23045 Capital Blue Cross / CAIC PA NO OUTIM0002 Capital Community Health Plan NO IN10327 Carefirst- Federal Employee Program NO OUT25139 Carelink Advantra / Carelink Health Plan NO IN25142 Carenet NO IN65031 CarePlus Health Plans, Inc. NO IN31114 CARESOURCE NO OUT62073 CARITEN HEALTHCARE NO OUT62072 CARITEN SENIOR HEALTH NO OUT23171 CHA -- Commonwealth Health Alliance NO OUT10060 CHA Health of KY NO OUT84146 CHAMP VA - HAC NO IN10216 CHC - Altius Health Plans NO OUT59223 Chesapeake National Life Insurance (MEGALIFE) NO IN
84146C Children of Women Vietnam Veterans-VA HAC NO IN61271 Christian Brothers Services NO IN62308 CIGNA HealthCare (HMO & PPO) NO INCIMHP Cimarron Commercial YES IN31114 Cincinatti health - CareSource Ohio NO OUT
CMSELIG CMS National Eligibility Database ALL YES INCOACC Colorado Access HMO NO OUT91162 COLUMBIA UNITED PROVIDERS NO OUT31114 Columbis Health - CareSource Ohio NO OUT39126 Community Care Organization NO OUT
CHPWA COMMUNITY HEALTH PLAN OF WASHINGTON NO OUTBS060 Companion Healhcare NO OUT06105 Connecticare, Inc. NO IN62308 Connecticut General NO IN75284 Consolidated Associations of Railroad Employees NO IN52132 Cooperative Benefit Administrators NO IN
41045X CoreSource / CoreStar NO IN41045 Coresource of AZ, MN NO IN75136 Coresource of Little Rock NO IN35182 Coresource of MD, PA, IL NO IN35180 Coresource of NC, IN NO IN35183 Coresource of OH NO IN10075 Covenant Health- TennCare NO OUT25133 Coventry Health and Life (Oklahoma) OK NO IN25130 Coventry Health Care of Delaware, Inc. DE NO IN25127 Coventry Health Care of Georgia, Inc. GA NO IN25132 Coventry Health Care of Iowa, Inc. IA NO IN25134 Coventry Health Care of Kansas, Inc. - Wichita KS NO IN
25133KC Coventry Health Care of Kansas, Inc.. - Kansas Cit MO NO IN25135 Coventry Health Care of Louisiana, Inc. LA NO IN25136 Coventry Health Care of Nebraska, Inc. NE NO IN84135 DENVER HEALTH MEDICAL PLAN NO OUT25131 Diamond Plan NO IN23706 Directors Guild of America Producers NO INBS033 Empire Blue Cross Blue Shield NO IN62308 EQUICOR - PPO NO IN23250 Erin Group Administrators NO IN22254 Fallon Health Plan NO IN10332 Family Care NO OUT84980 Federal Employee Program (TX FEP) TX NO OUT37300 Federated Benefits NO IN00426 First Ameritas of New York NO IN
© 2008 DataLink Solutions and it's affiliates 2 of 7
DataLink SolutionsInnovative Revenue Cycle Solutions
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External Payer ID
Payer Name State Enrollment Network
ELIGIBILITY INQUIRY PAYER LIST
10233 First Reliance Standard Life Ins Co. NO IN59321 FLORIDA HOSPITAL HEALTHCARE SYSTEMS NO OUT48117 FMH Coresource NO IN39065 Fortis Life Insurance Company NO IN97003 Glassman- Directors Guild NO IN97007 Glassman- Writers Guild NO OUT80705 Great West Life NO IN48143 GROUP & PENSION ADMINISTRATORS NO IN72153 Group Benefit Administrators NO IN58231 Group Health Plan - Core Management Resources NO IN04271 Harvard Pilgrim NO OUT
23173A Health 123/Tripoint NO IN77950 HEALTH ALLIANCE MEDICAL PLANS NO OUT25126 Health America Inc./Health Assurance/Advantra NO IN62179 Health Choice of Arizona NO IN30946 Health Future, LLC. NO IN95567 Health Net CA NO IN10094 Health Net Medi-Cal NO IN38309 HEALTH NET OF ARIZONA NO OUT10095 Health Net of Oregon NO IN06108 Health Net of the Northeast, Inc. NO IN80142 Health Partners (PA) NO IN84980 Healthcare Benefits TX NO OUT10221 Healthcare Inc. (Promina) NO OUT25143 Healthcare USA NO IN22345 Healthchoice of Memphis NO IN80141 Healthfirst, Inc. NO IN23226 HEALTHGUARD OF LANCASTER NO OUT38216 HealthPlus of Michigan NO OUT55247 HIP - Health Insurance Plan of New York NY NO IN84980 HMO Blue Texas TX NO OUT34150 HOMETOWN HEALTH NETWORK NO OUT22099 Horizon Blue Cross Blue Shield NJ NO IN10041 Horizon Healthcare of NY NO IN10337 Horizon NJ Health - Keystone Mercy Health Plan NO OUT61101 HUMANA NO IN95348 Humana Health Plan NO IN10338 Humana of Florida NO OUT54704 Independence Blue Cross PA NO OUTIEHP1 Inland Empire Health Plan NO OUT1052 InterValley Health Plan NO OUT
SX172 IU Medical Group Primary Care NO OUT61271 J. F. Molloy and Associates, Inc. NO IN05014 Jackson Memorial Health Plan (FL) NO OUT10109 Jefferson Pilot Financial NO IN41099 John Alden Life Insurance Co. NO IN52189 John Hopkins Healthcare NO OUT34136 JP FARLEY CORPORATION NO IN
COKSR Kaiser Foundation Health Plan of Colorado NO IN21313 Kaiser Foundation Health Plan of Georgia NO INKS003 Kaiser Foundation Health Plan of Northern CA Regio NO IN34092 Kaiser Foundation Health Plan of Ohio NO INKS001 Kaiser Foundation Health Plan of Southern CA Regio NO IN52095 Kaiser Foundation Health Plan of the Mid-Atlantic NO IN93079 Kaiser Foundation Health Plan of the Northwest NO IN00278 Kaiser Foundation Health Plan, Inc. - Hawaii Regio NO IN23284 Keystone Mercy Health Plan NO OUT10341 Kitsap Physician Services NO OUT75283 Linn County NO IN90328 Lovelace Sandia Health Plan NO OUT54195 LUMENOS NO OUTMA001 MAMSI Life & Health Ins. Co. (MLH) (HCFA 1500 only NO IN41154 MAYO MANAGEMENT SERVICES, INC. NO OUT56205 MBS (MEDCOST BENEFIT SERVICES) NO OUT
© 2008 DataLink Solutions and it's affiliates 3 of 7
DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
ELIGIBILITY INQUIRY PAYER LIST
94265 Medica Health Plans NO INMDCLNK Medicaid - Carelink NO IN
MDPROPT Medicaid - Providence Medicaid Option NO OUTMDAL00 Medicaid of Alabama - EDS AL NO OUTMDAZ00 Medicaid of Arizona AZ NO OUTMDAR00 Medicaid of Arkansas AR NO OUTMDCA00 Medicaid of California - EDS - Medi-Cal CA NO OUTMDCO00 Medicaid of Colorado CO NO OUTMDCT00 Medicaid of Connecticut - EDS CT NO OUTMDDE00 Medicaid of Deleware - EDS DE YES OUTMDFL00 Medicaid of Florida - ACS Inc. FL NO OUTMDGA00 Medicaid of Georgia - ACS Inc. GA NO OUTMDHI00 Medicaid of Hawaii - ACS Inc. HI NO OUTMDID00 Medicaid of Idaho - EDS ID NO OUTMDIL00 Medicaid of Illinois IL NO OUTMDIN00 Medicaid of Indiana - EDS IN NO OUTMDIA00 Medicaid of Iowa IA NO OUTMDKS00 Medicaid of Kansas - EDS KS NO OUTMDKY00 Medicaid of Kentucky - EDS KY NO OUTMDLA00 Medicaid of Louisiana LA NO OUTMDME00 Medicaid of Maine ME NO OUTMDMA00 Medicaid of Massachusetts MA NO OUTMDMI00 Medicaid of Michigan MI NO OUTMDMN00 Medicaid of Minnesota - Dept. of Human Services MN NO OUTMDMS00 Medicaid of Mississippi - ACS Inc. MS NO OUTMDMO00 Medicaid of Missouri - InfoCrossings MO NO OUTMDMT00 Medicaid of Montana MT NO OUTMDNV00 Medicaid of Nevada NV NO OUTMDNH00 Medicaid of New Hampshire NH NO OUTMDNJ00 Medicaid of New Jersey - UNISYS Corp. NJ NO OUTMDNM00 Medicaid of New Mexico NM NO OUTMDNM01 Medicaid of New Mexico - LOVELACE SALUD NM NO OUTMDNY00 Medicaid of New York NY YES OUTMDNC00 Medicaid of North Carolina NC NO OUTMDOH00 Medicaid of Ohio - Dept. of Human Services OH NO OUTMDOK00 Medicaid of Oklahoma OK NO OUTMDOR00 Medicaid of Oregon OR NO OUTMDPA00 Medicaid of Pennsylvania - EDS PA NO OUTMDSD00 Medicaid of South Dakota SD NO OUTMDTN00 Medicaid of Tennessee TN YES INMDTX00 Medicaid of Texas TX NO OUTMDVT00 Medicaid of Vermont VT NO OUTMDVA00 Medicaid of Virginia - First Health Services Corp. VA NO OUTMDWA00 Medicaid of Washington - ACS Inc. WA NO OUTMDDC00 Medicaid of Washington DC DC NO OUTMDWV00 Medicaid of West Virginia - UNISYS Corp. WV NO OUTMDWI00 Medicaid of Wisconsin WI NO OUTMDWY00 Medicaid of Wyoming WY NO OUTMDSD00 Medicaidof South Dakota SD NO OUT
29076 Medical Mutual of Ohio OH NO INMCAL00 Medicare of Alabama - Cahaba GBA AL YES INMCAK00 Medicare of Alaska - Noridian AK YES INMCAZ00 Medicare of Arizona - Noridian AZ YES INMCAR00 Medicare of Arkansas - Noridian AR YES INMCCA01 Medicare of California - Northern Region - NHIC CA YES INMCCA00 Medicare of California - Southern Region CA YES INMCCO00 Medicare of Colorado - Noridian CO YES INMCCT00 Medicare of Connecticut - First Coast Services CT YES INMCDC00 Medicare of DC DC YES INMCDE00 Medicare of Delaware - Trailblazers DE YES INMCFL00 Medicare of Florida - First Coast Services FL YES INMCGA00 Medicare of Georgia - Cahaba GBA GA YES INMCHI00 Medicare of Hawaii - Noridian HI YES INMCID00 Medicare of Idaho - CIGNA ID YES IN
© 2008 DataLink Solutions and it's affiliates 4 of 7
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ELIGIBILITY INQUIRY PAYER LIST
MCIL00 Medicare of Illinois - Wisconsin Physicians Servic IL YES INMCIN00 Medicare of Indiana - AdminaStar IN YES INMCIA00 Medicare of Iowa - Noridian IA YES INMCKS00 Medicare of Kansas - Blue Cross Blue Shield of Kan KS YES INMCKS02 Medicare of Kansas (HMO Regular) - Blue Cross Blue KS YES INMCKS03 Medicare of Kansas (HMO Senior Plan) - Blue Cross KS YES INMCKS01 Medicare of Kansas City - Coventry KS YES INMCKY00 Medicare of Kentucky - AdminaStar KY YES INMCLA00 Medicare of Louisiana - Blue Cross Blue Shield of A LA YES INMCME00 Medicare of Maine - NHIC ME YES INMCMD00 Medicare of Maryland MD YES INMCMA00 Medicare of Massachusetts - NHIC MA YES INMCMI00 Medicare of Michigan - Wisconsin Physicians Service MI YES INMCMN00 Medicare of Minnesota - Wisconsin Physicians Servi MN YES INMCMS00 Medicare of Mississippi - Cahaba GBA MS YES INMCMO00 Medicare of Missouri (Eastern) MO YES INMCMO01 Medicare of Missouri (Western) - Blue Cross Blue S MO YES INMCMT00 Medicare of Montana - Blue Cross Blue Shield of Montana MT YES INMCNE00 Medicare of Nebraska - Blue Cross Blue Shield of K NE YES INMCNV00 Medicare of Nevada - Noridian NV YES INMCNH00 Medicare of New Hampshire - NHIC NH YES INMCNJ00 Medicare of New Jersey - HGSA NJ YES INMCNM00 Medicare of New Mexico - Blue Cross Blue Shieldof NM YES INMCNY00 Medicare of New York - Empire NY YES INMCNY01 Medicare of New York - Queens County (GHI) NY YES INMCNY02 Medicare of New York - Upstate/Albany (Healthnow) NY YES INMCNC00 Medicare of North Carolina - CIGNA NC YES INMCND00 Medicare of North Dakota - Noridian ND YES INMCOH00 Medicare of Ohio - Palmetto OH YES INMCOK00 Medicare of Oklahoma - Blue Cross Blue Shield of A OK YES INMCOR00 Medicare of Oregon - Noridian OR YES INMCPA00 Medicare of Pennsylvania - HGSA PA YES INMCRI00 Medicare of Rhode Island - Blue Cross Blue Shield RI YES INMCSC00 Medicare of South Carolina - Palmetto GBA SC YES INMCSD00 Medicare of South Dakota - Noridian SD YES INMCTN00 Medicare of Tennessee - CIGNA TN YES INMCTX01 Medicare of Texas - HealthFirst TX YES INMCTX00 Medicare of Texas - Trailblazers TX YES INMCUT00 Medicare of Utah - Medicare/Blue Shield of Utah UT YES INMCUT01 Medicare of Utah - Nordian UT YES INMCVT00 Medicare of Vermont - NHIC VT YES INMCVA00 Medicare of Virginia - Trailblazers VA YES INMCWA00 Medicare of Washington - Noridian WA YES INMCWV00 Medicare of West Virginia - Palmetto GBA WV YES INMCWI00 Medicare of Wisconsin - Wisconsin Physicians Service WI YES INMCWY00 Medicare of Wyoming - Noridian WY YES IN
10001 Medicare Part A & B- National CMS YES IN59222 Mega Life - Transamerica Life Insurance NO IN74227 Mega Life and Health Ins. Co - Student Division NO IN59227 Mega Life and Health Insurance - OKC Division NO IN59221 MEGA Life Health Insurance Co NO IN10283 MemorialCare - BCI NO OUT10132 MemorialCare - TPA NO OUT
MRC01 Mercy Care (Arizona) NO OUT10850 Metropolitan Health Plan NO IN00403 Michigan MIChild NO OUT59224 Mid-West National Life Insurance (MEGALIFE) NO IN10241 Mississippi Admin Services NO OUT00089 Mississippi Childrens Health Insurance Program NO OUT38333 Molina Healthcare of California CA NO IN38334 Molina Healthcare of Michigan MI NO INCIMSA Molina Healthcare of New Mexico NM NO OUT20149 Molina Healthcare of Ohio OH NO INSX109 Molina Healthcare of Utah UT NO IN
© 2008 DataLink Solutions and it's affiliates 5 of 7
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ELIGIBILITY INQUIRY PAYER LIST
38336 Molina Healthcare of Washington NO IN00076 Molina of Indiana NO IN35177 MPlan (Medicaid) NO OUT71412 Mutual of Omaha Insurance Company NE NO IN14165 MVP Health Care NO IN
71412NLC National Association of Letter Carriers NO IN31417 Nationwide Health Plans NO IN95123 Neighborhood Health Partnership of Florida NO IN10356 Nevada Checkup - CHIP NO OUT10376 New England Health EDI Network LLC-Harvard Pilgrim NO OUT10377 New England Health EDI Network LLC-Neighborhood He NO OUT81264 Nippon Life Insurance Company of America NO INSKND0 North Dakota Medicaid (Medical) NO OUT72127 OCHSNER HEALTH PLAN NO OUT38252 Omnicare Health Plan of Michigan NO IN06111 Oxford Health Plans, Inc. NO IN10375 Pacific Source Health Plan NO OUT95964 PacifiCare of Arizona NO OUT95959 PacifiCare of California CA NO IN
COFHP PacifiCare of Colorado NO OUT10274 PacifiCare of Nevada NO OUT
95959OK PacifiCare of Oklahoma OK NO IN95959OR PacifiCare of Oregon OR NO IN95959TX PacifiCare of Texas TX NO IN95959WA PacifiCare of Washington WA NO IN
95999 PacifiCare PPO - All States (For payable PPO claim NO OUT56152 PARTNERS NATIONAL HEALTH PLANS OF NC NO OUTSX140 Partnership Health of California-CAPHP NO OUTSX154 Passport Advantage NO OUT68049 Peach State Health Plan NO OUT25146 PersonalCare NO IN03440 Phoenix Health Plan NO INIM0001 PHP of Michigan NO INIM0001 PHP of Mid-Michigan NO INIM0001 PHP of South Michigan NO INIM0001 PHP of Southwest Michigan NO INIM0001 PHP of West Michigan NO IN62155 PHP TENNCARE NO IN10365 Physician Hospital Community Organization NO OUT47027 PHYSICIANS MUTUAL INSURANCE COMPANY NO IN32680 Poly-America Medical & Dental Benefits Plan NO IN60110 Preferred Health Systems NO IN41147 Preferred One (MN) NO IN61271 Principal Financial Group NO IN61271 Principal Life Insurance Company NO IN34176 PROFESSIONAL BENEFITS ADMINISTRATORS NO IN58226 Promina ASO NO INPHP01 Providence Health Plan HMO NO IN10364 Providence Health System NO OUT10363 QualChoice of Ohio NO OUT00882 Railroad Medicare YES IN10234 Reliance Standard Life Ins Co. NO IN84980 RIO Grande HMO TX NO OUTSX141 Rocky Mountain Health Plan - Grand Junction NO OUT10176 San Francisco Health Plan NO OUT1046 San Joaquin Health Plan NO OUT10362 San Mateo - Healthplan of San Mateo or HPSM NO OUT10361 Santa Clara Valley Health and Hospital System NO OUT97002 SCAN HMO NO OUT88030 Scott & White Health Plan NO OUT95959 Secure Horizons California CA NO IN
95959OK Secure Horizons of Oklahoma OK NO IN95959OR Secure Horizons of Oregon OR NO IN95959TX Secure Horizons of Texas TX NO IN
© 2008 DataLink Solutions and it's affiliates 6 of 7
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External Payer ID
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ELIGIBILITY INQUIRY PAYER LIST
95959WA Secure Horizons Washington WA NO IN76342 SIERRA HEALTH SERVICES (CLAIMS) NO OUT25128 Southern Health Services, Inc. NO IN
84146S Spina Bifida - VA HAC NO IN10243 SRT Administrators, Inc. NO IN10236 Standard Ins. Co. NO IN10237 Standard Life Ins. Co. of New York NO IN1045 Stanislaus County MIA NO OUT59225 Star HRG NO IN
74227S STUDENT INSURANCE DIVISION NO OUT95202 SUMMACARE HEALTH PLAN NO OUT10244 Superior Administrators, Inc. NO IN76048 Texas Childrens Health Plan NO OUT59227 The MEGA Life & Health Insurance Company-OKC NO INPH017 Time Insurance Company NO IN10188 TLC Family Health Care Plan NO IN23856 Touchstone Health PSO NO IN13402 Touchstone Health/Health Net SmartChoice NO IN38520 Tricare (CHAMPUS) - North Region NO OUT38520 Tricare (CHAMPUS) - South Region NO OUT
CHTRW Tricare (CHAMPUS)- West Region NO OUT38269 Trinity Health Plans NO OUT61425 Trustmark NO IN04298 Tufts Health Plan NO IN10352 Ucare of Minnesota NO OUT10351 UCI Medical Group NO OUT10246 Underwriters Safety and Claims NO OUT80314 UNICARE NO OUT70408 Union Security Insurance Company NO IN62183 Unison Health Plan / Better Health Plans NO IN25175 Unison Health Plan / Three Rivers Health Plans NO IN87726 United Healthcare NO IN87726 United Healthcare - Evercare NO IN66705 Unity Health Insurance NO OUT33001 UNIVERSAL CARE- CALIFORNIA NO OUT09830 University Family Care NO IN09908 University Family Care - Maricopa Health Plan NO OUT23281 UPMC Health Plan NO OUT12115 VA Fee Basis Programs NO IN23173 VanderbiltHealth Plan NO IN10346 Virginia Premier NO OUT84980 Wal-Mart (Blue Card Carriers) TX NO OUTBS803 Wellchoice of NJ NO IN25129 Wellpath NO IN10003 Wells Fargo TPA - CHIPS/PEIA ONLY NO OUT10321 Wells Fargo TPA - Mohawk/ Hickory Springs ONLY NO OUT1043 Western Health Advantage NO OUT23710 Writers Guild - Industry Health Plan NO IN
© 2008 DataLink Solutions and it's affiliates 7 of 7
DataLink SolutionsInnovative Revenue Cycle Solutions
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External Payer ID
Payer Name State Enrollment Network
36273 AARP NO IN60054 Aetna ALL NO IN60054L Aetna Long Term Care NO IN13346 Aftra Health Fund NO IN62030 American General Life & Accident NO IN42011 American RepublicInsurance NO IN54763 AmeriHealth Administrators PA YES IN93688 AmeriHealth DE (PPO) PA YES IN60061 AmeriHealth NJ (PPO) PA YES IN95044 AmeriHealth NJ/DE (HMO) PA YES IN00425 Ameritas Life Insurance Co. NO IN70408 Assurant-Fortis Benefits NO IN93221 Asuris Northwest Health NO IN95604 Best Life & Health Insurance Co. NO IN00520 Blue Cross Blue Shield of Arkansas AR NO OUTBS550 Blue Cross Blue Shield of Colorado (Anthem) CO YES OUTBS560 Blue Cross Blue Shield of Connecticut (Anthem) CT YES OUTBS590 Blue Cross Blue Shield of Florida FL NO OUTBS630 Blue Cross Blue Shield of Indiana (Anthem) IN NO INBS660 Blue Cross Blue Shield of Kentucky (Anthem) KY NO INBS680 Blue Cross Blue Shield of Maine (Anthem) ME YES OUTBS700 Blue Cross Blue Shield of Massachusetts MA NO OUTBS730 Blue Cross Blue Shield of Mississippi MS NO OUTBS760 Blue Cross Blue Shield of Nebraska NE NO OUTBS765 Blue Cross Blue Shield of Nevada (Anthem) NV YES OUTBS770 Blue Cross Blue Shield of New Hampshire (Anthem) NH YES OUT00790 Blue Cross Blue Shield of New Mexico NM NO INBS338 Blue Cross Blue Shield of Ohio (Anthem) OH NO OUT00851 Blue Cross Blue Shield of Oregon (Regence) OR NO IN54771 Blue Cross Blue Shield of Pennsylvania - Highmark YES IN
54771V Blue Cross Blue Shield of Pennsylvania - Highmark YES INBS880 Blue Cross Blue Shield of South Carolina SC NO OUTBS390 Blue Cross Blue Shield of Tennessee TN YES INBS950 Blue Cross Blue Shield of Wisconsin WI NO OUTBC001 Blue Cross of California CA YES OUT00610 Blue Cross of Idaho ID NO IN00611 Blue Shield of Idaho (Regence) ID NO IN00932 Blue Shield of Washington (Regence) WA NO INIM0002 Capital Community Health Plan NO IN25139 Carelink Advantra/ Carelink Health Plan NO IN25142 Carenet NO IN84146 CHAMP VA - HAC NO IN59223 Chesapeake National Life Insurance (MEGALIFE) NO IN84146 Children of Women Vietnam Veterans-VA HAC NO IN61271 Christian Brothers Services NO IN62308 CIGNA HealthCare (HMO & PPO) NO IN06105 Connecticare, Inc. NO IN62308 Connecticut General NO IN75284 Consolidated Associations of Railroad Employees NO IN52132 Cooperative Benefit Administrators NO IN
41045X CoreSource / CoreStar NO IN41045 CoreSource of AZ, MN NO IN75136 Coresource of Little Rock NO IN35182 Coresource of MD, PA, IL NO IN35180 Coresource of NC, IN NO IN35183 Coresource of OH NO IN25133 Coventry Health and Life (Oklahoma) NO IN25130 Coventry Health Care of Delaware, Inc. DE NO IN25127 Coventry Health Care of Georgia, Inc. GA NO IN25132 Coventry Health Care of Iowa, Inc. IA NO IN
25133KC Coventry Health Care of Kansas, Inc. - Kansas City MO NO IN25134 Coventry Health Care of Kansas, Inc. - Wichita KS NO IN25135 Coventry Health Care of Louisiana, Inc. LA NO IN25136 Coventry Health Care of Nebraska, Inc. NE NO IN
CLAIM STATUS INQUIRY PAYER LIST
© 2008 DataLink Solutions and it's affiliates 1 of 3
DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
CLAIM STATUS INQUIRY PAYER LIST
25131 Diamond Plan NO IN23706 Directors Guild of America - Producers NO IN62308 EQUICOR - PPO NO IN23250 Erin Group Administrators NO IN22254 Fallon Health Plan NO IN84980 Federal Employee Program (TX FEP) TX NO IN37300 Federated Insurance Company NO IN87043 First Health NO IN48117 FMH Coresource NO IN39065 Fortis Life Insurance Company NO IN80705 Great West Life NO IN58231 Group Health Plan - Core Management Resources NO IN25126 Health America Inc./Health Assurance/Advantra NO IN30946 Health Future, LLC. NO IN84980 Healthcare Benefits TX NO IN25143 Healthcare USA NO IN80141 Healthfirst, Inc. NO IN00288 HealthPartners (PA) NO IN84980 HMO Blue TX NO IN84980 HMO Blue Texas TX NO IN22099 Horizon Blue Cross Blue Shield NJ NO IN61101 Humana NO IN54704 Independence Blue Cross YES IN61271 J. F. Molloy and Associates, Inc. NO IN41099 John Alden Life Insurance Co. NO IN95056 Keystone Health Plan East YES IN75283 Linn County NO IN62413 Mailhandlers Benefit Plan (CAC) NO INMA001 MAMSI Life & Health Ins. Co. (MLH) (HCFA 1500 only NO OUT94265 Medica Choice (ALLINA) NO IN
MDCLNK Medicaid - Carelink NO INMDAL00 Medicaid of Alabama - EDS AL NO OUTMDFL00 Medicaid of Florida - ACS Inc. FL YES OUTMDKY00 Medicaid of Kentucky - EDS KY NO OUTMDMO00 Medicaid of Missouri MO YES INMDNC00 Medicaid of North Carolina - EDS NC NO OUTMDTN00 Medicaid of Tennessee TN YES INMDTX00 Medicaid of Texas TX YES INMDVT00 Medicaid of Vermont VT NO OUTMDOK00 Medicaid Oklahoma OK NO INMDWA00 Medicaidof Washington WA NO OUT
29076 Medical Mutual of Ohio OH NO INMCLA00 Medicare of Louisiana LA YES INMCMO00 Medicare of Missouri (Eastern) MO YES INMCNJ00 Medicare of New Jersey - HGSA NJ YES INMCNM00 Medicare of New Mexico NM YES INMCOK00 Medicare of Oklahaoma OK YES INMCPA00 Medicare of Pennsylvania - HGSA PA YES INMCRI00 Medicare of Rhode Island RI YES IN
MCWA00 Medicare of Washington - Noridian WA YES IN74227 Mega Life and Health Insurance NO IN59227 Mega Life and Health Insurance- OKC Division NO IN85035 Mesa Mental Health NO IN16412 MetLife NO OUT59224 Mid West National Life Insurance (MEGALIFE) NO IN38333 Molina Healthcare of California CA NO IN38334 Molina Healthcare of Michigan MI NO IN20149 Molina Healthcare of Ohio OH NO IN20554 Molina Healthcare of Texas TX NO INSX109 Molina Healthcare of Utah UT NO IN38336 Molina Healthcare of Washington WA NO IN00076 Molina of Indiana IN NO IN71412 Mutal of Omaha Insurance Company NE NO IN71412 Mutual of Omaha Insurance Company NE NO IN
© 2008 DataLink Solutions and it's affiliates 2 of 3
DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
CLAIM STATUS INQUIRY PAYER LIST
71412NLC National Association of Letter Carriers NO IN31417 Nationwide Health Plans NO IN81264 Nippon Life Insurance Company of America NO IN38252 Omnicare Health Plan of Michigan NO IN06111 Oxford Health Plans, Inc. NO IN95964 PacifiCare of Arizona AZ NO IN95959 PacifiCare of California CA NO IN
COFHP Pacificare of Colorado CO NO INCOFHP Pacificare of Colorado (HMO) CO NO IN
95959OK PacifiCare of Oklahoma OK NO IN95959OR PacifiCare of Oregon OR NO IN95959TX PacifiCare of Texas TX NO IN95959WA PacifiCare of Washington WA NO IN
68049 Peach State Health Plan GA NO OUT25146 PersonalCare NO INIM0001 PHP of Michigan NO INIM0001 PHP of Mid-Michigan NO INIM0001 PHP of South Michigan NO INIM0001 PHP of Southwest Michigan NO INIM0001 PHP of West Michigan NO IN32680 Poly-America Medical & Dental Benefits Plan NO IN60110 Preferred Health Systems NO IN61271 Principal Financial Group NO IN61271 Principal Life Insurance Company NO IN58226 Promina ASO NO IN84980 RIO Grande HMO TX NO IN95959 Secure Horizons California CA NO IN
95959OK Secure Horizons of Oklahoma OK NO IN95959OR Secure Horizons of Oregon OR NO IN95959TX Secure Horizons of Texas TX NO IN95959WA Secure Horizons Washington WA NO IN
25128 Southern Health Services, Inc. NO IN84146 Spina Bifida - VA HAC NO IN59225 Star HRG NO IN59227 The MEGA Life & Health Insurance Company-OKC NO INPH017 Time Insurance Company NO IN23856 Touchstone Health PSO NO IN13402 Touchstone Health/Health Net SmartChoice NO INTFLIC TransAmerica Life Insurance (MEGALIFE) NO IN61425 Trustmark NO IN70408 Union Security Insurance Company NO IN62183 Unison Health Plan / Better Health Plans NO IN25175 Unison Health Plan / Three Rivers Health Plans NO IN87726 United Healthcare NO IN87726 United Healthcare - Evercare NO IN12115 VA Fee Basis Programs NO IN84146 VA Health Admin Ctr (CHAMPVA/Spina Bifida/Children NO IN84980 Wal-Mart (Blue Card Carriers) TX NO IN25129 Wellpath NO IN23710 Writers Guild - Industry Health Plan NO IN87726 United Healthcare NO IN87726 United Healthcare - Evercare NO IN12115 VA Fee Basis Programs NO IN84146 VA Health Admin Ctr (CHAMPVA/Spina Bifida/Children NO IN84980 Wal-Mart (Blue Card Carriers) NO IN25129 Wellpath NO IN23710 Writers Guild - Industry Health Plan NO IN
© 2008 DataLink Solutions and it's affiliates 3 of 3
DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
BS740 Administrative Services of Kansas - ASK MO YES OUT25152 Advantra Freedom YES IN60054 Aetna YES IN25149 Altuis YES IN60305 American Community Mutual Insurance YES IN62030 American General YES IN16412 American International Group, Inc. (AIG) YES IN42011 American Republic Insurance YES IN86047 Americhoice of New Jersey, Inc (Medicaid) NJ YES IN54763 AmeriHealth Administrators YES IN93688 AmeriHealth DE (PPO) YES IN22248 AmeriHealth Mercy Health Plan YES IN60061 AmeriHealth NJ (PPO) YES IN95440 Arnett Health Plans YES OUT70408 Assurant-Fortis Benefits YES INBS562 Blue Care Family/Anthem Medicaid CT YES OUTBS510 Blue Cross Blue Shield of Alabama AL YES OUTBS530 Blue Cross Blue Shield of Arizona AZ YES OUT00520 Blue Cross Blue Shield of Arkansas AR YES OUTBS550 Blue Cross Blue Shield of Colorado (Anthem) CO YES INBS560 Blue Cross Blue Shield of Connecticut (Anthem) CT YES INBS580 Blue Cross Blue Shield of DC - CareFirst DC YES INBS570 Blue Cross Blue Shield of Delaware DE YES OUTBS590 Blue Cross Blue Shield of Florida FL YES OUTBS600 Blue Cross Blue Shield of Georgia GA YES IN00621 Blue Cross Blue Shield of Illinois IL YES OUTBS621 Blue Cross Blue Shield of Illinois IL YES OUTBS630 Blue Cross Blue Shield of Indiana (Anthem) IN YES INBS650 Blue Cross Blue Shield of Kansas KS YES OUTBS660 Blue Cross Blue Shield of Kentucky (Anthem) KY YES IN23738 Blue Cross Blue Shield of Louisiana LA YES OUTBS680 Blue Cross Blue Shield of Maine ME YES INBS680 Blue Cross Blue Shield of Maine (Anthem) ME YES INBS690 Blue Cross Blue Shield of Maryland - CareFirst MD YES INBS700 Blue Cross Blue Shield of Massachusetts MA YES INBS710 Blue Cross Blue Shield of Michigan MI YES OUTBS720 Blue Cross Blue Shield of Minnesota MN YES OUTBS730 Blue Cross Blue Shield of Mississippi MS YES OUTBS241 Blue Cross Blue Shield of Missouri MO YES INBS742 Blue Cross Blue Shield of Missouri (Blue Choice) MO YES INBS760 Blue Cross Blue Shield of Nebraska NE YES OUTBS765 Blue Cross Blue Shield of Nevada (Anthem) NV YES INBS770 Blue Cross Blue Shield of New Hampshire NH YES OUT00790 Blue Cross Blue Shield of New Mexico NM YES OUTBS061 Blue Cross Blue Shield of New York - Rochester (Excellus) NY YES OUTBS087 Blue Cross Blue Shield of New York - Western (Heal NY YES OUTBS003 Blue Cross Blue Shield of North Carolina NC YES INBS338 Blue Cross Blue Shield of Ohio (Anthem) OH YES INBS840 Blue Cross Blue Shield of Oklahoma OK YES OUT00851 Blue Cross Blue Shield of Oregon (Regence) OR YES OUT54771 Blue Cross Blue Shield of Pennsylvania - Highmark YES IN
54771V Blue Cross Blue Shield of Pennsylvania - Highmark YES INBS880 Blue Cross Blue Shield of South Carolina SC YES OUTBS889 Blue Cross Blue Shield of South Dakota SD YES OUTBS390 Blue Cross Blue Shield of Tennessee TN YES IN
BS84980 Blue Cross Blue Shield of Texas TX YES OUTBS923 Blue Cross Blue Shield of Virginia (Anthem) VA YES INBS941 Blue Cross Blue Shield of West Virginia WV YES OUTBS950 Blue Cross Blue Shield of Wisconsin (Anthem) WI YES INBS074 Blue Cross Blue Shield of Wyoming WY YES INBC001 Blue Cross of California CA YES IN12B59 Blue Cross of Oklahoma OK YES INBS870 Blue Cross of Rhode Island RI YES OUT00934 Blue Cross of Washington (Premera) WA YES OUT
ELECTRONIC REMITTANCE ADVICE (ERA) PAYER LIST
© 2008 DataLink Solutions and it's affiliates 1 of 5
DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
ELECTRONIC REMITTANCE ADVICE (ERA) PAYER LIST
94036 Blue Shield of California CA YES IN00932 Blue Shield of Washington (Regence) WA YES OUT94316 Brown & Toland Medical Group YES IN62413 CAC (Mailhandlers Benefit Plan) YES IN23045 Capital Blue Cross/CAIC PA YES OUTIM0002 Capital Community Health Plan YES INSX065 Capital District Physicians Health Plan YES OUT25139 Carelink Advantra / Carelink Health Plan YES IN25142 Carenet YES IN62073 Cariten Healthcare YES IN62072 Cariten Senior Health YES IN23171 CHA - Commonwealth Health Alliance YES IN84146 CHAMP VA - HAC YES IN59223 Chesapeake Life Insurance Company - Insurance Cent YES IN
84146C Children of Women Vietnam Veterans-VA HAC YES IN62308 CIGNA HealthCare (HMO & PPO) YES INBS880 Companion Technologies SC YES OUT06105 Connecticare, Inc. YES OUT52132 Cooperative Benefit Administrators (CBA) YES IN
41045X CoreSource / CoreStar YES IN41045 CoreSource of AZ, MN YES IN75136 CoreSource of Little Rock YES IN35182 CoreSource of MD, PA, IL YES IN35180 CoreSource of NC, IN YES IN35183 CoreSource of OH YES IN25133 Coventry Health & Life (Oklahoma) YES IN25130 Coventry Health Care of Delaware, Inc. YES IN25127 Coventry Health Care of Georgia, Inc. YES IN25132 Coventry Health Care of Iowa, Inc. YES IN25133 Coventry Health Care of Kansas, Inc. - Kansas City YES IN25135 Coventry Health Care of Louisiana, Inc. YES IN25136 Coventry Health Care of Nebraska, Inc. YES INSX105 Deseret Mutual YES OUT25131 Diamond Plan YES INDMEA DME Region A (DMERC A) - NHIC US YES OUTDMEB DME Region B (DMERC B) - AdminaStar US YES OUTDMEC DME Region C (DMERC C) - Palmetto GBA US YES OUTDMED DME Region D (DMERC D) - Noridian US YES OUT87726 Empire Plan - UHC YES IN41041 Federated Mutual Insurance YES IN87043 First Health YES IN48117 FMH Benefit Services, Inc. YES IN39065 Fortis Insurance Company YES IN25169 Gateway Health Plan Medicaid PA YES IN76028 Gateway Health Plan of Ohio YES IN67815 GEGLAC - G.E. Group Life Assurance Company YES IN59041 GEVB - PIC (GE Voluntary Benefits Professional Ins YES IN25141 GHP (Group Health Plan) YES IN07205 Gilsbar, Inc. YES IN44054 Government Employees Hospital Association (GEHA) YES IN80705 Great-West Healthcare YES IN25126 Health America Inc./Health Assurance/Advantra YES IN95567 Health Net of California and Oregon - Claims YES IN06108 Health Net of the Northeast, Inc. YES IN25143 Healthcare USA YES IN80141 Healthfirst, Inc of New York YES IN22099 Horizon Blue Cross Blue Shield NJ YES IN61101 Humana Inc. YES IN54704 Independence Blue Cross YES INSX073 Independent Health YES OUT36609 International Brotherhood of Boilermakers YES IN41099 John Alden Life Insurance Co. YES IN91617 Kaiser Foundation Health Plan of Colorado YES IN21313 Kaiser Foundation Health Plan of Georgia YES IN
© 2008 DataLink Solutions and it's affiliates 2 of 5
DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
ELECTRONIC REMITTANCE ADVICE (ERA) PAYER LIST
52095 Kaiser Foundation Health Plan of the Mid-Atlantic YES IN57038 Kanawha Insurance Company YES IN23284 Keystone Mercy Health Plan YES IN01260 Magellan Behavioral Health YES IN94265 Medica Choice (ALLINA) YES IN
MDCLNK Medicaid - Carelink YES INMDAL00 Medicaid of Alabama - EDS AL YES OUTMDAK00 Medicaid of Alaska - First Health Services Corp. AK YES OUTMDAR00 Medicaid of Arkansas AR YES OUTMDCA00 Medicaid of California - EDS - Medi-Cal CA YES OUTMDCT00 Medicaid of Conneticut - EDS CT YES OUTMDFL00 Medicaid of Florida - ACS Inc. FL YES OUTMDGA00 Medicaid of Georgia - ACS Inc. GA YES OUTMDID00 Medicaid of Idaho - EDS ID YES OUTMDIN00 Medicaid of Indiana - EDS IN YES OUTMDKS00 Medicaid of Kansas - EDS KS YES OUTMDKY00 Medicaid of Kentucky - EDS KY YES OUTMDLA00 Medicaid of Louisiana - UNISYS Corp. LA YES OUTMDMD00 Medicaid of Maryland - Department of Health and Me MD YES OUTMDMI00 Medicaid of Michigan - Blue Cross Blue Shield of M MI YES OUTMDMN00 Medicaid of Minnesota - Dept. of Human Services MN YES OUTMDMS00 Medicaid of Mississippi - ACS Inc. MS YES OUTMDMO00 Medicaid of Missouri MO YES INMDNE00 Medicaid of Nebraska - Health and Human Services o NE YES OUTMDNV00 Medicaid of Nevada - First Health Services Corp. NV YES OUTMDNJ00 Medicaid of New Jersey - UNISYS Corp. NJ YES OUTMDNC00 Medicaid of North Carolina - EDS NC YES OUTMDOH00 Medicaid of Ohio - Dept. of Human Services OH YES OUTMDPA00 Medicaid of Pennsylvania - EDS PA YES OUTMDSC00 Medicaid of South Carolina - South Carolina Depart SC YES OUTMDTN00 Medicaid of Tennessee TN YES INMDTN01 Medicaid of Tennessee - PHP TennCare TN YES INMDTX00 Medicaid of Texas TX YES INMDVA00 Medicaid of Virginia - First Health Services Corp. VA YES OUTMDWA00 Medicaid of Washington - ACS Inc. WA YES INMDWV00 Medicaid of West Virginia - UNISYS Corp. WV YES OUTMDWY00 Medicaid of Wyoming WY YES IN
74323 Medical Benefits Mutual Life Insurance Co. YES IN29076 Medical Mutual of Ohio OH YES IN
MCAL00 Medicare of Alabama - Cahaba GBA AL YES OUTMCAK00 Medicare of Alaska - Noridian AK YES OUTMCAZ00 Medicare of Arizona - Noridian AZ YES OUTMCAR00 Medicare of Arkansas - Blue Cross Blue Shieldof Ar AR YES OUTMCCA01 Medicare of California - Northern Region - NHIC CA YES INMCCA00 Medicare of California - Southern Region CA YES INMCCO00 Medicare of Colorado - Noridian CO YES OUTMCCT00 Medicare of Conneticut - First Coast Service Optio CT YES INMCDC00 Medicare of DC DC YES INMCDE00 Medicare of Delaware - Trailblazers DE YES INMCFL00 Medicare of Florida - First Coast Services FL YES INMCGA00 Medicare of Georgia - Cahaba GBA GA YES OUTMCHI00 Medicare of Hawaii - Noridian HI YES INMCID00 Medicare of Idaho - CIGNA ID YES OUTMCIL00 Medicare of Illinois - Wisconsin Physicians Servic IL YES INMCIN00 Medicare of Indiana - AdminaStar IN YES OUTMCIA00 Medicare of Iowa - Noridian IA YES OUTMCKS00 Medicare of Kansas KS YES OUTMCMO01 Medicare of Kansas City MO YES OUTMCKS01 Medicare of Kansas City - Coventry KS YES OUTMCKY00 Medicare of Kentucky - AdminaStar KY YES OUTMCLA00 Medicare of Louisiana YES INMCME00 Medicare of Maine - NHIC ME YES OUTMCMD00 Medicare of Maryland MD YES INMCMA00 Medicare of Massachusetts - NHIC MA YES OUT
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DataLink SolutionsInnovative Revenue Cycle Solutions
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External Payer ID
Payer Name State Enrollment Network
ELECTRONIC REMITTANCE ADVICE (ERA) PAYER LIST
MCMI00 Medicare of Michigan - Wisconsin Physicians Service MI YES INMCMN00 Medicare of Minnesota - Wisconsin Physicians Servi MN YES OUTMCMS00 Medicare of Mississippi - Cahaba GBA MS YES OUTMCMO00 Medicare of Missouri (Eastern) MO YES INMCMO01 Medicare of Missouri (Western) - Blue Cross Blue S MO YES OUTMCMT00 Medicare of Montana - Blue Cross Blue Shield of Montana MT YES OUTMCNE00 Medicare of Nebraska - Blue Cross Blue Shield of K NE YES OUTMCNV00 Medicare of Nevada - Noridian NV YES OUTMCNH00 Medicare of New Hampshire - NHIC NH YES OUTMCNJ00 Medicare of New Jersey - HGSA NJ YES INMCNM00 Medicare of New Mexico NM YES INMCNY00 Medicare of New York - Empire Medicare Services NY YES OUTMCNY01 Medicare of New York - Queens County (GHI) NY YES OUTMCNY02 Medicare of New York - Upstate/Albany (Healthnow) NY YES OUTMCNC00 Medicare of North Carolina - CIGNA NC YES INMCND00 Medicare of North Dakota - Noridian ND YES OUTMCOH00 Medicare of Ohio - Palmetto OH YES INMCOK00 Medicare of Oklahoma YES INMCOR00 Medicare of Oregon - Noridian OR YES OUTMCPA00 Medicare of Pennsylvania - HGSA PA YES INMCRI00 Medicare of Rhode Island YES INMCSC00 Medicare of South Carolina - Palmetto GBA SC YES OUTMCSD00 Medicare of South Dakota - Noridian SD YES OUTMCTN00 Medicare of Tennessee - CIGNA TN YES INMCTX01 Medicare of Texas - HealthFirst YES OUTMCTX00 Medicare of Texas - Trailblazers TX YES INMCUT00 Medicare of Utah - Noridian Medicare UT YES OUTMCVT00 Medicare of Vermont - NHIC VT YES OUTMCVA00 Medicare of Virginia - Trailblazers VA YES OUTMCWA00 Medicare of Washington - Noridian WA YES INMCWV00 Medicare of West Virginia - Palmetto GBA WV YES INMCWI00 Medicare of Wisconsin - Wisconsin Physicians Service YES INMCWY00 Medicare of Wyoming - Noridian WY YES OUT
36193 Memphis Managed Care YES IN22326 Mercy Health Plan of NJ YES IN59224 Mid-West National Life Insurance Co. of Tennessee YES IN71412 Mutual of Omaha Insurance Company YES IN31417 Nationwide Health Plans YES IN81264 Nippon Life Insurance Company of America YES IN25150 Omnicare, A Coventry Health Plan YES IN
MDOR00 Oregon Medicaid - Oregon Medical Assistance Progra OR YES OUT06111 Oxford Health Plans YES out
091712414 PacifiCare Health Systems & Subsidiaries YES OUT95959 PacifiCare of California - Claims YES IN95959 Pacificare of Oklahoma - Claims YES IN95959 PacifiCare of Oregon - Claims YES IN95959 Pacificare of Texas - Claims YES IN95959 PacifiCare of Washington - Claims YES IN61129 Passport Health Plan YES INSX106 PEHP - Utah Public Employee Health Plan YES OUT25146 PersonalCare YES INIM0001 PHP of Mid-Michigan YES INIM0001 PHP of South Michigan YES INIM0001 PHP of Southwest Michigan YES INIM0001 PHP of West Michigan YES IN12399 Physicians Health Plan of Northern Indiana YES INSX089 Preferred Care YES OUT61271 Principal Financial Group YES IN38217 Priority Health YES OUT00882 Railroad Medicare YES IN95959 Secure Horizons of California YES IN95959 Secure Horizons of Oklahoma YES IN95959 Secure Horizons of Oregon YES IN95959 Secure Horizons of Texas YES IN
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DataLink SolutionsInnovative Revenue Cycle Solutions
Payer Gatewayplus
10/30/2008
External Payer ID
Payer Name State Enrollment Network
ELECTRONIC REMITTANCE ADVICE (ERA) PAYER LIST
95959 Secure Horizons of Washington YES IN23285 Select Health of South Carolina YES IN25128 Southern Healh Services, Inc. YES IN
84146S Spina Bifida - VA HAC YES IN31053 State Farm Insurance Companies YES IN59221 The MEGA Life & Health Insurance Company - Insuran YES IN39065 Time Insurance Company YES IN59222 TransAmerica Life Insurance Company YES IN61425 Trustmark Insurance Company YES INBS910 UHIN UT YES OUT80314 UNICARE YES OUT70408 Union Security Insurance Company YES IN62183 Unison Health Plan/Better Health Plans YES OUT25175 Unison Health Plans / Three Rivers Health Plans YES OUT87726 United Healthcare YES IN12115 VA Fee Basis Programs YES IN
VALHLTH Vale-U-Health YES IN39026 Wausau Benefits, Inc. YES IN25129 WellPath YES IN87815 Wells Fargo TPA (formerly Acordia National) YES IN75276 World Insurance Company YES INSX022 WPS/Tricare YES IN
© 2008 DataLink Solutions and it's affiliates 5 of 5
